title: A clustered ground-glass hepatocyte pattern represents a new prognostic marker for the recurrence of hepatocellular carcinoma after surgery.
abstract: BACKGROUND
  The recurrence of hepatocellular carcinoma (HCC) after hepatectomy is a serious event. It has been demonstrated that different ground-glass hepatocyte (GGH) patterns harbor specific hepatitis B virus (HBV) pre-S deletion mutants and represent preneoplastic lesions in chronic HBV infection. In the current study, the authors investigated whether a specific GGH pattern in nontumorous liver tissues was associated with the recurrence of HBV-related HCC after surgery.
  
  
  METHODS
  Clinicopathologic data from 82 patients with HBV-related HCC were reviewed. GGH patterns were assessed on hematoxylin and eosin-stained sections. Tissue hepatitis B surface antigen (HBsAg) expression was evaluated by immunohistochemical staining. Serum profiles of pre-S status, viral load, and HBV genotype were determined and correlated with clinical recurrence and survival after surgery.
  
  
  RESULTS
  The results indicated that the clustered pattern of GGHs or HBsAg expression was associated significantly with decreased local recurrence-free survival (LRFS) during a mean follow-up of 46.4 months (P<.001). This biomarker was comparable to or better than the prognostic value of other parameters, such as multifocal tumors (P = .022), satellite nodules (P = .005), small cell dysplasia (P = .045), or elevated viral load (P = .027), to predict recurrent HCC. Multivariate analysis also revealed that type II GGHs, which expressed marginal HBsAg and consistently clustered in nodules, were independent variables associated with LRFS (P<.001) and overall survival (P = .003).
  
  
  CONCLUSIONS
  The current results indicated that the assessment of GGH patterns or HBsAg expression in nontumorous liver tissues provides an easily recognized, new risk marker for the recurrence of HBV-related HCC after hepatic resection.
authors.affiliation: Department of Pathology, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Tsai
authors.forename: Yih-Jyh
authors.initials: YJ
authors.lastname: Lin
authors.forename: Pin-Wen
authors.initials: PW
authors.lastname: Lin
authors.forename: Han-Chieh
authors.initials: HC
authors.lastname: Wu
authors.forename: Kai-Hsi
authors.initials: KH
authors.lastname: Hsu
authors.forename: Chia-Jui
authors.initials: CJ
authors.lastname: Yen
authors.forename: Shih-Huang
authors.initials: SH
authors.lastname: Chan
authors.forename: Wenya
authors.initials: W
authors.lastname: Huang
authors.forename: Ih-Jen
authors.initials: IJ
authors.lastname: Su
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology; D005260:Female; D005838:Genotype; D006498:Hepatectomy; D006514:Hepatitis B Surface Antigens; D006515:Hepatitis B virus / Q000235:genetics*; D022781:Hepatocytes / Q000473:pathology* / Q000821:virology*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions; D011379:Prognosis; D017384:Sequence Deletion; D019562:Viral Load
chemical_list: D014408:Biomarkers, Tumor; D006514:Hepatitis B Surface Antigens