Risk of hepatocellular carcinoma in patients with cirrhosis in Japan. Analysis of infectious hepatitis viruses.
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.
Kato
Y
Y
First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Nakata
K
K
Omagari
K
K
Furukawa
R
R
Kusumoto
Y
Y
Mori
I
I
Tajima
H
H
Tanioka
H
H
Yano
M
M
Nagataki
S
S
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