AGE-RELATED, DIFFERENT CLINICOPATHOLOGICAL FEATURES OF HEPATOCELLULAR-CARCINOMA PATIENTS

Objective The authors attempted to clarify the clinicopathologic diffe rences of hepatocellular carcinoma (HCC) patients, according to age di stribution, and to investigate whether these differences contribute a certain hepatocarcinogenesis. Background Data Hepatitis-associated vir uses causing HCC have been investigated, and the infection of the viru ses and etiologically, the peak age of the disease vary according to g eographic barriers. However, a correlation between clinicopathologic d ifferences and the age distribution of the patients is not well unders tood. Methods The authors reviewed their institutional experience from 1978 to 1990 in treating 428 patients with HCC. The carrier rate for hepatitis B surface antigen (HBsAg), the frequency of occurrence of hi gh serum alpha-fetoprotein (AFP) of 2000 ng/mL, the degree of liver da mage represented by the retention rate of indocyanine green dye at 15 minutes (ICGR(15)), and the incidence of accompanying liver cirrhosis were investigated and compared in each decade of age. Results The HBsA g carrier rate and the frequency of high serum AFP values were signifi cantly prominent in the younger patients (20-49 yrs). The degree of li ver damage and the incidence of liver cirrhosis were prominent in the elderly patients (older than 70 yrs) or the middle-aged patients (50-6 9 yrs); however, these four values in the middle-aged patients were in termediate with respect to those observed in the other two age groups. In addition, there was a positive correlation between the HBsAg carri er rate and the frequency of high serum AFP values or between the degr ee of liver damage represented by ICGR(15) and the incidence of liver cirrhosis, showing that the former correlation was inversely related t o the latter. Conclusions The authors' study indicates that there are age-related differences of clinicopathologic features in HCC patients, suggesting that there are different steps or mechanisms of hepatocarc inogenesis according to the patient's age-distribution.