Significance of sublobular hepatic necrosis in the progression of chronic hepatitis C.
The clinical characteristics of hepatitis C virus associated chronic liver diseases (C-LD) in 17 patients were compared with hepatitis B virus associated diseases (B-LD) in 47 patients, by analysing the histological findings of the liver and the change in serum alanine aminotransferase (ALT) level. The persistence of the moderate abnormality in ALT (> 100 IU/L) for longer than 1 year was more frequently seen in the C-LD group (P < 0.01), although the severe exacerbation of the disease with ALT higher than 500 IU/L was more frequent in the B-LD group (P < 0.01). The patients with the histological finding of sublobular hepatic necrosis (SN) in the C-LD group progressed to advanced stages more frequently than those with SN in the B-LD group (P < 0.05). Furthermore, nine of 10 patients with SN in C-LD finally progressed to hepatocellular carcinoma (HCC) in 52 +/- 23 months, whereas three of 16 with SN in B-LD developed HCC in 81 +/- 34 months. Although the morphological features of SN in C-LD and B-LD were almost the same, SN in C-LD seemed to be a more significant diagnostic condition for the progression to liver cirrhosis or HCC. The patients with SN in the C-LD group should be closely followed for the early detection of HCC, although further study with a greater number of patients is necessary.
Third Department of Internal Medicine, Ehime University School of Medicine, Japan.
K
K
Kajino
N
N
Horiike
K
K
Tanimoto
K
K
Michitaka
T
T
Nonaka
K
K
Kanda
K
K
Nakanishi
K
K
Doi
T
T
Masumoto
B
B
Matsuura
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology; D002908:Chronic Disease; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000473:pathology; D006526:Hepatitis C / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012189:Retrospective Studies