Analysis of background factors and evaluation of a population at high risk of hepatocellular carcinoma.
OBJECTIVE
We investigated the background clinical factors of patients with hepatocellular carcinoma (HCC) diagnosed at our institute and, from these results, determined those factors important for evaluation of a population at high risk of HCC.


METHODS
This study comprised 250 patients diagnosed with HCC from 1990 through 1995 in the Nihon University Itabashi Hospital. Background clinical factors, such as the results of blood chemistry at the time of the first angiography, were examined.


RESULTS
Markers of viral hepatitis in the 250 cases were as follows: type B (B-HCC), 29 (11.6%), type C (C-HCC), 201 (80.4%); type B+C, 3 (1.2%), and non-B, non-C (NBNC-HCC), 17 (6.8%). Approximately 35% of B-HCC and NBNC-HCC cases, but only 6% of C-HCC cases, exhibited platelet counts (PLT) equal to or more than 200,000/ml. On the other hand, 56.5% of the C-HCC cases exhibited PLT less than 100,000/ml, in contrast to less than 30% of the B-HCC and NBNC-HCC cases. Irrespective of the etiology of HCC, male sex and a history of smoking were characteristic risk factors. The percentages of abnormal results in combinations of tests in the B-HCC, C-HCC and NBNC-HCC subsets were: 69, 97 and 70% in the aspartate aminotransferase (AST) + PLT group (group A); 83, 98 and 70% in the group A + alanine aminotransferase (ALT) group (group B), and 86, 98 and 100% in the group B + gamma-glutamyl transpeptidase (gamma-GTP) group (group C), respectively. When hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV-Ab) were also taken into account, abnormal results were found in every case in all of the HCC groups.


CONCLUSIONS
C-HCC was found predominantly in cases with liver cirrhosis, whereas B-HCC and NBNC-HCC were observed more frequently in cases without liver cirrhosis. Testing for HBsAg and HCV-Ab, in addition to AST, ALT, PLT and gamma-GTP, is considered necessary when screening for HCC.
Miyazawa
Kouji
K
Third Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Moriyama
Mitsuhiko
M
Mikuni
Morio
M
Matsumura
Hiroshi
H
Aoki
Hiroshi
H
Shimizu
Toshihiro
T
Yamagami
Hiroaki
H
Kaneko
Miki
M
Shioda
Atsuo
A
Tanaka
Naohide
N
Arakawa
Yasuyuki
Y
D001774:Blood Chemical Analysis; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012307:Risk Factors