| 特集名 | 非B非C型肝癌―最新の知見 | |
|---|---|---|
| 題名 | わが国における非B非C型肝癌の実態 (1) 非B非C型肝癌全国調査からわかること | |
| 発刊年月 | 2012年 05月 | |
| 著者 | 徳重 克年 | 東京女子医科大学消化器内科 |
| 著者 | 橋本 悦子 | 東京女子医科大学消化器内科 |
| 【 要旨 】 | 非B非C型肝細胞癌の全国集計（2006〜2009年）では，非B非C型肝細胞癌の割合は肝細胞癌全体の約16％で，その内訳をみるとアルコール性肝障害を基盤にしたものが一番多く，次に原因不明，NAFLD関連の順であった．アルコール性肝障害に基づく肝細胞癌，NAFLD関連肝細胞癌，原因不明の肝細胞癌を比較すると，アルコール性肝細胞癌が，一番若年で，男性が多かった．生活習慣病の合併頻度に関しては，肥満・糖尿病・脂質異常症・高血圧の頻度が，有意にNAFLD関連肝細胞癌で高率であった．原因不明肝疾患を基盤にした肝細胞癌のうち飲酒と肥満・糖尿病の影響を検討すると，アルコール性肝障害の基準を満たさない飲酒者（エタノール換算20〜70 g／日）では，アルコール性肝障害を基盤にした肝細胞癌に近い傾向を認め，飲酒の影響が示唆された． | |
| Theme | Non-B, Non-C Hepatocellular Carcinoma : The Latest Findings | |
|---|---|---|
| Title | Analysis of Nationwide Survey for Hepatocellular Carcinoma Arising from Non-B, Non-C Liver Diseases | |
| Author | Katsutoshi Tokushige | Department of Internal Medicine and Gastroenterology, Tokyo Womenʼs Medical University |
| Author | Etsuko Hashimoto | Department of Internal Medicine and Gastroenterology, Tokyo Womenʼs Medical University |
| [ Summary ] | Purpose : To clarify the etiology of hepatocellular carcinoma (HCC) in Japanese patients with non-viral liver disease, we performed a nationwide survey. The influence of obesity, lifestyle-related diseases, and alcohol consumption was investigated. Patients and Methods：A nationwide survey of 14,530 HCC patients was conducted in 2009. Clinical features were studied concerning HCC patients with nonalcoholic fatty liver disease (NAFLD-HCC; n=292), alcoholic liver disease (ALC-HCC; n=991), and chronic liver disease of unknown etiology (unknown HCC; n=614). The unknown HCC group was divided into two subgroups, a no alcohol intake group and a modest alcohol intake group. Results: ALC-HCC accounted for 7.2% of all HCC cases, followed by the unknown HCC group (5.1 %) and the NAFLD-HCC group (2.0 %). The characteristics of these three groups were clearly different. Obesity and lifestylerelated diseases were significantly more frequent in NAFLD-HCC cases than in ALC-HCC and unknown HCC cases. The no alcohol intake subgroup of the unknown HCC group exhibited female predominance and was older, without a high prevalence of obesity and lifestyle-related diseases. In contrast, the modest alcohol intake subgroup showed the same trends regarding gender, body mass index, prevalence of lifestyle-related diseases, and liver function as the ALC-HCC group. Conclusions: The clinical features of ALC-HCC, NAFLD-HCC and unknown HCC were clearly different. Modest intake of alcohol may play a more significant role in hepatic carcinogenesis than is presently thought. |
|