Characterization of hepatocellular carcinoma developed after achieving sustained virological response to interferon therapy for hepatitis C.
BACKGROUND
Interferon (IFN) reduces the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C (CHC). However, HCC develops in the some patients who have achieved a sustained virological response (SVR). The aim of this study was to clarify the features and prognosis of SVR patients who developed HCC.


METHODS
Twenty-six patients who underwent curative hepatectomy for initial HCC after IFN therapy were closely investigated. Twenty patients who were seropositive for HCV-RNA (non-SVR), and a further 6 patients who achieved SVRs (SVR) were included. We analyzed the clinicopathological features, immunological expression levels of p53 and whether HCV-RNA is present in the excised liver.


RESULTS
The liver functions of the SVR group were almost better than those of the non-SVR group. However, there was no significant difference in pathological features, surgical factors and prognosis between the groups. In one case with SVR out of eight specimens tested was HCV-RNA detected in the non-cancerous tissue. Immunohistochemistry revealed overexpression of p53 in eight HCCs (100%) from SVR patients.


CONCLUSIONS
Recurrent HCC still developed after the curative hepatectomy, even if viral elimination had been successful. And molecular alterations in hepatocarcinogenesis of SVR patients might be different from those of CHC patients.
Sanefuji
Kensaku
K
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. sanefuji@surg2.med.kyushu-u.ac.jp
Kayashima
Hiroto
H
Iguchi
Tomohiro
T
Sugimachi
Keishi
K
Yamashita
Yo-Ichi
Y
Yoshizumi
Tomoharu
T
Soejima
Yuji
Y
Nishizaki
Takashi
T
Taketomi
Akinobu
A
Maehara
Yoshihiko
Y
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000601:surgery / Q000821:virology*; D005260:Female; D016174:Hepacivirus; D006498:Hepatectomy; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000821:virology*; D011379:Prognosis; D012367:RNA, Viral; D016159:Tumor Suppressor Protein p53 / Q000097:blood; D019562:Viral Load
D000998:Antiviral Agents; D014408:Biomarkers, Tumor; D012367:RNA, Viral; D016159:Tumor Suppressor Protein p53; D007372:Interferons