Is Hepatocellular Carcinoma in Fatty Liver Different to Non-Fatty Liver?
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Statistical Analysis
3. Results
3.1. Study Population
3.2. Treatment of HCC
3.3. Overall Survival Analysis
3.4. Predictors of Overall Survival in Patients with NAFLD and Non-NAFLD-HCC
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
NAFLD | Non-alcoholic fatty liver disease |
HCC | Hepatocellular carcinoma |
HBV | Hepatitis B |
HBC | Hepatitis C |
AASLD | American Association of the Study of the Liver |
BMI | Body mass index |
BCLC | Barcelona Clinic Liver Cancer |
mRECIST | Modified Response Evaluation Criteria in Solid Tumours |
INR | International Normalised Ratio/Prothrombin time |
AFP | Alpha-fetoprotein |
ALT | Alanine aminotransferase |
AST | Aspartate aminotransferase |
GGT | Gamma-glutamyltransferase |
ALP | Alkaline phosphatase |
CI | Confidence interval |
DEB-TACE | Drug-eluting bead transarterial chemoembolization |
IL-6 | Interleukin-6 |
TNF-α | Tumour necrosis factor alpha |
IGF | Insulin-like growth factor |
CP | Child–Pugh |
SIRTEX | SIR-Spheres Yttrium-90 resin microspheres |
RFA | Radiofrequency ablation |
MWA | Microwave ablation |
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NAFLD (n = 36) | Non-NAFLD (n = 116) | p-Value | |
---|---|---|---|
Patient characteristics | |||
Age at diagnosis, years (mean, 95% CI) | 71.9 (69.4–74.3) | 62.6 (60.7–64.4) | <0.001 |
Male, % | 24 (66.7) | 106 (91.4) | <0.001 |
Body mass index (mean, 95% CI) (kg/m2) | 29.1 (26.8–31.4) | 26.2 (25.1–27.4) | 0.02 |
Hypertension, % | 23 (63.9) | 32 (29.1) | <0.001 |
Type 2 Diabetes | 28 (78%) | 15 (13%) | <0.01 |
Hyperlipidaemia | 11 (31%) | 5 (4%) | <0.01 |
Ethnicity, % | 0.199 | ||
Asian | 3 (8.3) | 28 (24.1) | 0.199 |
Caucasian | 32 (88.9) | 84 (72.4) | 0.199 |
Hispanic | Nil | 1 (0.9) | 0.199 |
Middle Eastern | 1 (2.8) | 3 (2.6) | 0.199 |
Diagnosis method, % | 0.11 | ||
Incidental | 3 (8.6) | 10 (8.9) | 0.99 |
Screening | 15(42.8) | 69 (61.6) | 0.08 |
Symptomatic | 17 (48.6) | 33 (29.5) | 0.046 |
BCLC stage at diagnosis, % | 0.49 | ||
0 | Nil | 6 (5.2) | 0.34 |
A | 8 (22.2) | 19 (16.4) | 0.46 |
B | 4 (11.1) | 17 (14.6) | 0.78 |
C | 19 (52.8) | 64 (55.2) | 0.85 |
D | 5 (13.9) | 10 (8.6) | 0.05 |
Cirrhosis, % | 29 (80.6) | 103 (90.4) | 0.12 |
Stage of cirrhosis, % | 0.16 | ||
Non-cirrhotic | 7 (19.5) | 11 (9.6) | 0.16 |
CPA | 17 (47.2) | 62 (54.4) | 0.16 |
CPB | 12 (33.3) | 33 (29.0) | 0.16 |
CPC | Nil | 8 (7.0) | 0.16 |
HCC characteristics at diagnosis | |||
Lesion size (mean, 95% CI) | 5.4 (3.9 to 6.8) | 4.4 (3.7 to 5.1) | 0.20 |
Number of lesions (mean, 95% CI) | 1.5 (1.2 to 1.9) | 1.7 (1.4 to 1.9) | 0.53 |
AFP (mean, 95% CI) | 2882.5 (−1859.0 to 7623.9) | 5078.6 (−1204.1 to 11361.3) | 0.72 |
Liver Disease | Patient Number (%) |
---|---|
Alcoholic liver disease | 35 (30%) |
Hepatitis B | 27 (23%) |
Hepatitis C | 18 (16%) |
Hepatitis B + Hepatitis C | 1 (1%) |
Hepatitis B + alcoholic liver disease | 2 (2%) |
Hepatitis C + alcoholic liver disease | 29 (25%) |
Hepatitis B + Hepatitis C + alcoholic liver disease | 1 (1%) |
Autoimmune hepatitis | 1 (1%) |
Haemochromatosis + alcoholic liver disease | 1 (1%) |
Primary biliary cholangitis | 1 (1%) |
NAFLD | Non-NAFLD | p-Value | |
---|---|---|---|
Initial Treatment, % | <0.001 | ||
Resection | 12 (33.3) | 11 (9.5) | |
DEB-TACE | 6 (16.7) | 55 (47.4) | |
SIRTEX | Nil | 6 (5.2) | |
RFA | 2 (5.6) | 12 (10.3) | |
MWA | 1 (2.8) | 2 (1.7) | |
Sorafenib | 1 (2.8) | 9 (7.8) | |
Best supportive care | 11 (30.6) | 20 (17.2) | |
Transplant | 1 (2.8) | Nil | |
DEB-TACE + Resection | Nil | 1 (0.9) | |
DEB-TACE + RFA | 1 (2.8) | Nil | |
DEB-TACE + SIRTEX | 1 (2.8) | Nil | |
Total number of treatments (mean, 95% CI) | 1.57 (1.02–2.13) | 1.84 (1.55–2.14) | 0.192 |
NAFLD | Non-NAFLD | p-Value | |
---|---|---|---|
Deceased, % | 20 (55.6) | 64 (58.2) | 0.78 |
Cause of death, % | |||
Liver | 15 (88.2) | 44 (88.0) | 0.98 |
Non-liver | 2 (11.8) | 6 (12.0) | 0.98 |
Liver transplant, % | 1 (2.8) | 5 (4.4) | 0.67 |
Survival from diagnosis, months | |||
Mean | 25.3 | 30.1 | 0.23 |
Median | 17.2 | 23.5 | 0.47 |
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Nguyen, X.-v.K.; Zhang, J.; Chin, K.L.; Bloom, S.; Nicoll, A.J. Is Hepatocellular Carcinoma in Fatty Liver Different to Non-Fatty Liver? Nutrients 2022, 14, 3875. https://doi.org/10.3390/nu14183875
Nguyen X-vK, Zhang J, Chin KL, Bloom S, Nicoll AJ. Is Hepatocellular Carcinoma in Fatty Liver Different to Non-Fatty Liver? Nutrients. 2022; 14(18):3875. https://doi.org/10.3390/nu14183875
Chicago/Turabian StyleNguyen, Xuan-vinh Kevin, Jason Zhang, Ken Lee Chin, Stephen Bloom, and Amanda J. Nicoll. 2022. "Is Hepatocellular Carcinoma in Fatty Liver Different to Non-Fatty Liver?" Nutrients 14, no. 18: 3875. https://doi.org/10.3390/nu14183875
APA StyleNguyen, X. -v. K., Zhang, J., Chin, K. L., Bloom, S., & Nicoll, A. J. (2022). Is Hepatocellular Carcinoma in Fatty Liver Different to Non-Fatty Liver? Nutrients, 14(18), 3875. https://doi.org/10.3390/nu14183875