title: Clinical features of hepatitis C virus-related hepatocellular carcinoma and their association with alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II.
abstract: OBJECTIVE
  We investigated the differences in clinical features between alpha-fetoprotein (AFP)-predominant hepatocellular carcinoma (HCC) and protein induced by vitamin K absence or antagonist-II (PIVKA-II)-predominant HCC, especially regarding host factors thought to contribute to hepatocarcinogenesis in chronic hepatitis C virus (HCV) infection.
  
  
  METHODS
  HCV-related HCC patients (n=306) were divided into four groups according to median AFP (48.1 ng/ml) and PIVKA-II (60 mAU/ml). Host factors, tumor factors, survival, and risk factors affecting survival were compared.
  
  
  RESULTS
  Aspartate aminotransferase (AST; IU/L), alanine aminotransferase (ALT; IU/L), and platelet count (x 10(4)/ml) were, respectively, 81, 67, and 8.2 in AFP-predominant HCC (group A; n=66) vs. 50, 42, and 11.4 in PIVKA-II-predominant HCC (group P; n=52). Tumor sizes (mm) in groups A and P were 20 and 37, respectively. Significant differences were evident. Survival was identical between the two groups. Factors affecting survival were total bilirubin, portal tumor thrombus and number of nodule in group A, and albumin and tumor distribution in group P.
  
  
  CONCLUSIONS
  PIVKA-II-predominant HCC had a milder hepatitis and a better-preserved platelet count compared with AFP-predominant HCC. Considering the strong relation between hepatocarcinogenesis and hepatic inflammation with chronic HCV infection, these differences indicate that hepatocarcinogenic mechanisms in PIVKA-II-predominant HCC may differ from those in AFP-predominant HCC.
authors.affiliation: Department of Gastroenterology and Hepatology, Saga Social Insurance Hospital, Saga City, Japan. syano@kumin.ne.jp
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Yano
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Yamashita
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kuwaki
authors.forename: Kazuta
authors.initials: K
authors.lastname: Fukumori
authors.forename: Osamu
authors.initials: O
authors.lastname: Kato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Ando
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Tanaka
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000503:physiopathology* / Q000821:virology; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism / Q000503:physiopathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011498:Protein Precursors / Q000096:biosynthesis*; D011516:Prothrombin / Q000096:biosynthesis*; D012307:Risk Factors; D016019:Survival Analysis; D000509:alpha-Fetoproteins / Q000096:biosynthesis*
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin