Age-related clinicopathologic and molecular features of patients receiving curative hepatectomy for hepatocellular carcinoma

作者：Katsuta Eriko; Tanaka Shinji^*; Mogushi Kaoru; Matsumura Satoshi; Ban Daisuke; Ochiai Takanori; Irie Takumi; Kudo Atsushi; Nakamura Noriaki; Tanaka Hiroshi; Tanabe Minoru; Arii Shigeki

来源：American Journal of Surgery, 2014, 208(3): 450-456.

DOI：10.1016/j.amjsurg.2014.01.015

• Hepatocellular carcinoma
• Aged
• Gene expression
• Fibrosis
• Pre-existing comorbidity
• Non-B non-C hepatocellular carcinoma

BACKGROUND: Age-related differences of clinicopathologic features, outcomes, and molecular properties of hepatocellular carcinoma remain unclarified. %26lt;br%26gt;METHODS: We classified patients who underwent hepatectomy for hepatocellular carcinoma into 3 groups by age bracket; younger group (%26lt;50 years), middle-aged group (50 to 79 years), and elderly group (%26gt;= 80 years) and compared age-related features. %26lt;br%26gt;RESULTS: Hepatitis viral infection was dominant in the younger group (hepatitis B virus [HBV]; 67%) and middle-aged group (hepatitis C virus [HCV]; 56%), whereas the elderly group showed a significantly higher rate without hepatitis virus infection (absence of HBV and HCV infection, 66%; P = .0001). There was a significantly greater proportion of age-associated preexisting comorbidity in the elderly group (89%; P = .0004). Liver cirrhosis in the elderly group (24%) was significantly lower than other groups (younger, 67%; middle-aged, 50%; P = .0058). There was no significant difference in perioperative and postoperative outcomes among these groups. Microarray analysis revealed age-related upregulation of androgen and phosphatidylinositol 3-kinase pathways in the tumor tissue and downregulation of the fibrosis-related pathways in the noncancerous liver tissue. %26lt;br%26gt;CONCLUSIONS: Based on increased correlation with the absence of HBV and HCV infection and pre-existing comorbidity, the age-related carcinogenic pathways might play a critical role in elderly hepatocarcinogenesis.

• 出版日期2014-9