title: The male preponderance in incidence of hepatocellular carcinoma in cirrhotic patients may depend on the higher DNA synthetic activity of cirrhotic tissue in men.
abstract: BACKGROUND
  The relationship between the DNA synthetic activity of hepatocytes from cirrhotic liver tissue and the incidence of hepatocellular carcinoma (HCC) during a 3-year follow-up period was studied in male and female patients with posthepatitic cirrhosis.
  
  
  METHODS
  The bromodeoxyuridine labeling index (BrdU LI) of hepatocytes was estimated in 38 cirrhotic patients (Child A stage, 23 men and 15 women) using a BrdU/anti-BrdU in vitro method. The incidence of HCC was compared between male and female cirrhotic patients during a 3-year follow-up period.
  
  
  RESULTS
  Sixteen of 23 (69.6%) male patients belonged to the high-DNA synthesis group (BrdU LI > or = 1.5%), and only 7 (30.4%) were in the low-DNA synthesis group (BrdU LI < 1.5%). Among female patients, only 5 of 15 (33.3%) were in the high-DNA synthesis group, and 10 of 15 (66.7%) were in the low-DNA synthesis group (P < 0.05). Eleven of 23 (47.8%) male patients and 3 of 15 (20.0%) female patients had HCC develop. In the high-DNA synthesis group, 10 of 16 (62.5%) of the men and 3 of 5 (60.0%) of the women had HCC develop during the follow-up period. In contrast, only one of seven (14.3%) male patients and none of ten (0%) female patients in the low-DNA synthesis group had HCC develop.
  
  
  CONCLUSIONS
  It was concluded that HCC developed frequently (about 60% of the time within 3 years) in patients of both sexes who were in a high-DNA synthesis group. Thus, the larger proportion of men in the high-DNA synthesis group compared with the number of women in the group (69.6% versus 33.3%) might be one possible reason for the male predominance in the development of HCC in cirrhotic patients.
authors.affiliation: Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tarao
authors.forename: S
authors.initials: S
authors.lastname: Ohkawa
authors.forename: A
authors.initials: A
authors.lastname: Shimizu
authors.forename: M
authors.initials: M
authors.lastname: Harada
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Y
authors.initials: Y
authors.lastname: Ito
authors.forename: S
authors.initials: S
authors.lastname: Tamai
authors.forename: H
authors.initials: H
authors.lastname: Hoshino
authors.forename: N
authors.initials: N
authors.lastname: Okamoto
authors.forename: K
authors.initials: K
authors.lastname: Iimori
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D001706:Biopsy; D001973:Bromodeoxyuridine / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D004247:DNA / Q000096:biosynthesis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000150:complications* / Q000235:genetics; D008113:Liver Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins; D004247:DNA; D001973:Bromodeoxyuridine