Prospective study of laparoscopic findings with regard to the development of hepatocellular carcinoma in patients with hepatitis C virus-associated cirrhosis.
BACKGROUND
The laparoscopic findings of hepatocarcinogenesis are not well defined. The purpose of this prospective study was to evaluate the predictive value of laparoscopic findings with regard to the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-associated cirrhosis.


METHODS
One hundred nineteen patients with HCV-associated cirrhosis who underwent laparoscopy were enrolled in this study. Ten laparoscopic variables, including degree of development and size of regenerating nodules, irregularity of regenerating nodules, and size of both hepatic lobes, were measured. The predictive value of each finding for the development of HCC was investigated by using univariate and multivariate analyses.


RESULTS
HCC developed in a total of 42 of the 119 patients (35.3%) during a mean follow-up period of 62.9 months. The degree of regenerating nodules, the presence of irregular regenerative nodules, and atrophic right lobe were significant predictive factors for HCC with univariate analysis. In particular, 67.1% of patients with irregular regenerative nodules had HCC develop within 5 years. Multivariate analysis revealed that irregular regenerative nodules (relative risk 6.32, p = 0.012), the degree of regenerative nodules (relative risk 4.78, p = 0.029), and atrophic right lobe (relative risk 3.87, p = 0.048) were independent predictive factors.


CONCLUSIONS
Morphologic observation of the liver surface by laparoscopy is important and provides information on factors that are statistically significant early predictors of the development of HCC.
First Department of Internal Medicine, Mie University School of Medicine, Tsu, Mie, Japan.
K
K
Shiraki
A
A
Shimizu
K
K
Takase
A
A
Suzuki
Y
Y
Tameda
T
T
Nakano
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005544:Forecasting; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged