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

• 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.

Nyckelord

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

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)