A prospective study on the development of hepatocellular carcinoma from liver cirrhosis with persistent hepatitis B virus infection.
We made a prospective study on the development of hepatocellular carcinoma (HCC) in patients with liver cirrhosis with hepatitis B virus infection from April, 1973 to December, 1977. Seven out of 30 patients (23%) with hepatitis B surface antigen (HBsAg)-positive cirrhosis developed HCC. On the other hand, only 5.9% of the patients with HBsAg-negative liver cirrhosis developed HCC. These patients were classified into three groups according to their anti-HB core (anti-HBc) titers. When the anti-HBc titer, expressed as a dilution of serum, was 2(10) or more (Group I), 20-24% of the liver cirrhosis patients developed HCC either with or without a detectable amount of HBs Ag present in the sera. When the anti-HBc titer was 2(9) or less (Group II), only 0-5.7% developed HCC. There was no significant difference between this and the anti-HBc and HBsAg-negative group (Group III), which was 4.4%. In five individual cases from group I, HBsAg was detected in serum, and in biopsies of liver cells, before HCC could be detected by angiography and/or rising levels of alphafetoprotein (AFP). In all of these cases, the anti-HBc titer was higher than 2(10) throughout the observation period, even before the development of HCC. These findings indicate that active virus proliferation in chronic hepatitis B virus infection precedes the development of HCC as indicated by a higher anti-HBc titer. Therefore we have prepared these studies to show the pathogenic role of hepatitis B virus in the development of hepatocellular carcinoma.
Obata
H
H
Institute of Gastroenterology, Tokyo Women's Medical College, 10 Kawada Cho, Ichigaya, Shinjuku Ward, Tokyo, Japan.
Hayashi
N
N
Motoike
Y
Y
Hisamitsu
T
T
Okuda
H
H
Kobayashi
S
S
Nishioka
K
K
D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D018450:Disease Progression; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000145:classification / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D013997:Time Factors; D000509:alpha-Fetoproteins / Q000032:analysis
D014408:Biomarkers, Tumor; D006514:Hepatitis B Surface Antigens; D000509:alpha-Fetoproteins