【病理資訊】脂肪性肝炎型肝細胞癌與酒精性和非酒精性脂肪性肝炎均相關(guān): 兩個具有分子洞察力的隊列研究
Steatohepatitic Variant of Hepatocellular Carcinoma Is Associated With Both Alcoholic Steatohepatitis and Nonalcoholic Steatohepatitis: A Study of 2 Cohorts With Molecular Insights
Qin, Jia; Higashi, Takaaki; Nakagawa, Shigeki; Yamashita, Yo-ichi; Beppu, Toru; Baba, Hideo; Kobayashi, Masahiro; Kumada, Hiromitsu; Gunasekaran, Ganesh; Schiano, Thomas D.; Thung, Swan N.; Fiel, Maria Isabel; Hoshida, Yujin; Ward, Stephen C.
Am J Surg Pathol. 2020 Jun 30.
doi: 10.1097/PAS.0000000000001533.
ABSTRACT
Steatohepatitic hepatocellular carcinoma (SH-HCC) is a variant of hepatocellular carcinoma (HCC) with established association with nonalcoholic steatohepatitis (NASH), while its association with alcoholic steatohepatitis (ASH) is unclear. We studied 2 cohorts of patients who underwent resection for HCC in the setting of steatohepatitis. In our Mount Sinai (New York) cohort, we found SH-HCC in 17/24 (71%) patients with NASH and in 14/19 (74%) patients with ASH, while SH-HCC was the predominant tumor morphology in 12/24 (50%) in the NASH group and 9/19 (47%) in the ASH group. Upon review, 12/19 patients diagnosed with ASH also had diabetes and/or a body mass index >30. When these patients were removed, we still found similar rates of SH-HCC (6/7 [86%] showed SH-HCC, while SH-HCC was predominant in 3/7 [43%]. Interestingly, glycogenated hepatocyte nuclei were seen in the nontumor liver in 4/7 (57%) of these cases. In our Japan cohort, we also found similar rates of SH-HCC in NASH and ASH patients with HCC, 15/58 (26%), and 16/45 (36%), respectively. We determined molecular subclassification of tumors from the Japan cohort and found no difference in the distribution of S1, S2 and S3 subclasses among the ASH and NASH groups, though, among cases of SH-HCC, there was a trend toward an association of ASH with S1 (P=0.054) and NASH with S3 (P=0.052). Our study shows that SH-HCC is common in both ASH and NASH and that both underlying liver diseases produce tumors with similar molecular profiles, though different pathways may underlie the development of SH-HCC in ASH versus NASH.
原文獻地址:
https://pubmed.ncbi.nlm.nih.gov/32618599/
脂肪性肝炎型肝細胞癌與酒精性和非酒精性脂肪性肝炎均相關(guān): 兩個具有分子洞察力的隊列研究
摘要
I 譯者點評(Comments)
1. 肝細胞癌（HCC）是世界范圍內(nèi)導(dǎo)致癌癥死亡的第四大病因, 大多數(shù)病例發(fā)生在慢性肝病的基礎(chǔ)中, 例如HBV, HCV, ASH以及NASH。近年來隨著肥胖病的流行以及抗HCV病毒的有效藥物治療, 脂肪性肝炎正日益成為HCC的主要病因。
2. SH-HCC是近年來認識到的一種HCC亞型。HCC還有很多其他分子學分類, 比如這篇文章中提到的S1， S2 和S3分類。S1 常為SH-HCC和有大量免疫細胞浸潤的HCC。S2 常為粗梁型/緊湊型 (macrotrabecular/compact) HCC并伴血清α-甲胎蛋白高（> 400 ng / ml）增高。S3 常為微骨小梁型 (microtrabecular), 透明細胞型 (clear cell ) 或低級別組織學的HCC。S1, S2 和S3 HCC有不同的分子學改變 (1)。
3. SH-HCC可發(fā)生在有或無脂肪性肝炎, 有或無肝硬化, 以及任何原因?qū)е碌母闻K疾病的基礎(chǔ)上 (2, 3)。
4. 病理診斷SH-HCC應(yīng)注意與脂肪性肝炎和脂肪性肝炎型局灶性結(jié)節(jié)增生區(qū)別 (4) 。
II 相關(guān)文獻(Related references)
1. Tan PS, et al. Clinicopathological indices to predict hepatocellular carcinoma molecular classification. Liver Int. 2016 Jan;36(1):108-18. doi: 10.1111/liv.12889
2. Yeh MM, et al. Steatohepatitic variant of hepatocellular carcinoma in the absence of metabolic syndrome or background steatosis: a clinical, pathological, and genetic study. Hum Pathol . 2015 Nov;46(11):1769-75. doi: 10.1016/j.humpath.2015.07.018
3. Salomao M, et al. The steatohepatitic variant of hepatocellular carcinoma and its association with underlying steatohepatitis. Hum Pathol. 2012 May;43(5):737-46. doi: 10.1016/j.humpath.2011.07.005
4. Deniz K, et al. Steatohepatitis-like Changes in Focal Nodular Hyperplasia, A Finding to Distinguish From Steatohepatitic Variant of Hepatocellular Carcinoma. Am J Surg Pathol. 2017 Feb;41(2):277-281. doi: 10.1097/PAS.0000000000000781
III 文獻譯者
