Hepatic adenomas occur most commonly in women between the ages of 20 and 40 years, but rarely they occur in older aged persons, including those 60 years of age or older. This group of adenomas, however, has not been systemically examined. Twenty-six hepatic adenomas in persons 60 years of age or older were studied, along with a control group of 50 hepatic adenomas in persons aged 30 to 39. Hepatic adenomas in persons 60 or more years of age were found in 21 women and 5 men, while the control group had 44 women and 6 men. Subtyping the adenomas in persons 60 years or older showed the following results: 18 HNF1A-inactivated adenomas (69%), 4 inflammatory adenomas (15%), and 4 unclassified adenomas (15%). In contrast, the control group showed a significantly different pattern (P=0.003), with a greater percentage of inflammatory adenomas (28, 56%), fewer HNF1A-inactivated adenomas (8, 16%), and more unclassified adenomas (14, 28%). Atypia and malignant transformation within the hepatic adenomas was studied next. Of the hepatic adenomas in persons age 60 or greater, 3 (12%) showed atypical histologic features, and 6 (23%) had a malignant transformation. In contrast, for hepatic adenomas in the control group, only 4 (8%) adenomas showed atypical histologic features, and 3 (6%) had undergone malignant transformation. In addition, the hepatic adenomas that were atypical or showed early malignant transformation were less likely to have beta-catenin activation in patients over 60 (2/9 cases) compared with those between 30 and 39 years (5/7 cases). Myxoid change and heavy lipofuscin deposition were also more common in adenomas in older aged persons. In conclusion, hepatic adenomas in persons 60 years of age or older are enriched for HNF1A-inactivated adenomas and have a higher frequency of malignant transformation. Malignant transformation, however, is less likely to develop through activation of the beta-catenin pathway.

肝腺瘤最常见于20至40岁的女性，但很少发生于老年人，包括60岁或以上的人。然而，这组腺瘤尚未经过系统检查。研究人员对 26 例 60 岁或以上人群的肝腺瘤以及 50 例 30 至 39 岁人群的肝腺瘤进行了研究。在 60 岁或以上人群中发现了 21 名女性和 5 名男性的肝腺瘤，而对照组有 44 名女性和 6 名男性。对 60 岁或以上人群的腺瘤进行分型显示以下结果：18 个HNF1A灭活腺瘤 (69%)、4 个炎性腺瘤 (15%) 和 4 个未分类腺瘤 (15%)。相比之下，对照组表现出显着不同的模式（P = 0.003），炎症性腺瘤比例较高（28， 56%），HNF1A失活腺瘤较少（8， 16%），未分类腺瘤较多（14， 28%）。接下来研究了肝腺瘤内的异型性和恶变。在60岁或以上人群的肝腺瘤中，3例（12%）表现出非典型组织学特征，6例（23%）出现恶变。相比之下，对照组的肝腺瘤中，只有4个（8%）腺瘤表现出非典型组织学特征，3个（6%）发生恶变。此外，与30至39岁患者（5/7例）相比，60岁以上患者（2/9例）不典型或表现出早期恶变的肝腺瘤发生β-catenin激活的可能性较小。粘液样改变和重度脂褐素沉积在老年人的腺瘤中也更常见。总之，60岁或以上人群的肝腺瘤富含HNF1A灭活的腺瘤，并且恶变的频率更高。然而，通过激活β-连环蛋白途径而发生恶性转化的可能性较小。