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Diabetes: one of few remarkable differences in clinicopathologic features between cirrhotic and noncirrhotic Swedes with hepatocellular carcinoma

Artikel i vetenskaplig tidskrift
Författare Jerzy Kaczynski
G. Hansson
Sven Wallerstedt
Publicerad i Dig Dis Sci
Volym 51
Nummer/häfte 4
Sidor 796-802
ISSN 0163-2116 (Print)
Publiceringsår 2006
Publicerad vid Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin
Sidor 796-802
Språk en
Länkar www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Biopsy, Needle, Carcinoma, Hepatocellular/*epidemiology/*pathology/therapy, Case-Control Studies, Cause of Death, Child, Diabetes Mellitus, Type 2/diagnosis/drug therapy/*epidemiology, Disease Progression, Female, Humans, Immunohistochemistry, Incidence, Liver Cirrhosis/*epidemiology/pathology/therapy, Liver Neoplasms/*epidemiology/*pathology/therapy, Male, Middle Aged, Probability, Reference Values, Registries, Retrospective Studies, Risk Assessment, Sex Distribution, Survival Analysis, Sweden/epidemiology
Ämneskategorier Medicin och Hälsovetenskap

Sammanfattning

The prognosis of hepatocellular carcinoma (HCC) is usually very poor, so increased knowledge of clinicopathologic characteristics and etiologic factors may improve the clinical handling. Because HCC in many patients is unrecognized before death, it is of particular interest to study cases from a period with a high autopsy frequency. The records and liver biopsies from all patients with a diagnosis of primary liver cancer in Goteborg, Sweden, during a 22-year period were scrutinized. Only patients with evaluable non-neoplastic liver tissue were included in the final analysis. The majority (95%) of 478 HCC cases were autopsied and cirrhosis of the liver could be established in 71%. At presentation, general paramalignant symptoms such as malaise, weight loss, anorexia, and hepatomegaly (84%) were common irrespective of cirrhosis. Alcoholism and diabetes mellitus were each significantly more common among cirrhotics (29% and 20%, respectively; P < .001), than among noncirrhotics, in which cholelithiasis was more common (54%; P < .001). The correlation between diabetes and cirrhosis was independent of reported alcoholism. In an unselected population in a low HCC incidence area, there are few differences in clinicopathologic features between cirrhotic and noncirrhotic patients. Diabetes mellitus seems to play an etiologic role in HCC in cirrhotics, and cholelithiasis in noncirrhotics.

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