title: Risk of hepatocellular carcinoma in patients with cirrhosis in Japan. Analysis of infectious hepatitis viruses.
abstract: BACKGROUND
  The development of hepatocellular carcinoma (HCC) is associated closely with cirrhosis. In the present study, the cumulative risk of HCC in patients with cirrhosis was investigated.
  
  
  METHODS
  A total of 401 patients were registered from April 1977 and followed for a mean of 4.4 years. Of 401 patients, 255 (64%) were tested for hepatitis B surface antigen (HBsAg) and antibody (anti-) to the hepatitis C virus (HCV); 87 (34%) patients were positive for HBsAg but were negative for anti-HCV (hepatitis B virus [HBV] group), 126 (49%) were negative for HBsAg but were positive for anti-HCV (HCV group), 10 (4%) were positive for both and 32 (13%) were negative for both (non-B non-C group).
  
  
  RESULTS
  By the end of March 1993, HCC was diagnosed in 127 (31.6%) patients. The cumulative risk of HCC in the HCV group was slightly higher than that in HBV group (P = 0.3, 5-year risk: 36.9 versus 21.2%). In contrast, the rate was significantly lower in the non-B non-C group than in the HBV or HCV groups (P < 0.05 and P < 0.01, respectively, 5 year risk: 12.4%).
  
  
  CONCLUSIONS
  These results suggest that not only HBV infection but also HCV infection increase the risk for HCC in patients with cirrhosis.
authors.affiliation: First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kato
authors.forename: K
authors.initials: K
authors.lastname: Nakata
authors.forename: K
authors.initials: K
authors.lastname: Omagari
authors.forename: R
authors.initials: R
authors.lastname: Furukawa
authors.forename: Y
authors.initials: Y
authors.lastname: Kusumoto
authors.forename: I
authors.initials: I
authors.lastname: Mori
authors.forename: H
authors.initials: H
authors.lastname: Tajima
authors.forename: H
authors.initials: H
authors.lastname: Tanioka
authors.forename: M
authors.initials: M
authors.lastname: Yano
authors.forename: S
authors.initials: S
authors.lastname: Nagataki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000276:immunology; D006509:Hepatitis B / Q000150:complications* / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012698:Serologic Tests