title: Inflammation in background cirrhosis evokes malignant progression in HCC development from HCV-associated liver cirrhosis.
abstract: OBJECTIVE
  It is accepted that inflammation promotes malignant progression in the development of cancers. Whether, this is true for hepatocellular carcinoma (HCC) remains as an open question. We examined the relationship between the inflammatory histology activity index (HAI) in the background liver cirrhosis (LC) and the histological grading of the HCC in the hepatectomized HCC patients with HCV-associated LC.
  
  
  METHODS
  Out of 264 HCC patients who underwent curative hepatic resection, 197 had HCV-associated LC. Among them, 52 patients with a small solitary HCC nodule (< 5 cm in diameter) were studied. Inflammation in the background LC was evaluated by modified Knodell's HAI. To evaluate the inflammation, piece meal necrosis, intra lobular cellular degeneration and focal necrosis, portal cellular inflammation (0-4, each) were estimated. The average HAI was calculated. The grade of malignancy of HCC was determined by WHO classification.
  
  
  RESULTS
  The average HAI in the 15 patients with moderately differentiated HCC (4.3 ± 0.8, mean ± SD) was significantly larger than that in 11 patients with well differentiated HCC (3.5 ± 0.6, p = 0.036). The HAI in the 24 patients whose HCC nodules contained poorly differentiated HCC (5.2 ± 1.1) was significantly larger than that in patients with moderately differentiated HCC (p = 0.025). Thus, the HAI order was well differentiated group < moderately differentiated group < poorly differentiated group.
  
  
  CONCLUSIONS
  Inflammation in the background non-cancerous cirrhotic portion would evoke malignant progression in HCC development from HCV-associated LC.
authors.affiliation: Tarao's Gastroenterological Clinic, Yokohama, Japan. nrg18449@nifty.com
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tarao
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ohkawa
authors.forename: Yohei
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Soichiro
authors.initials: S
authors.lastname: Morinaga
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohshige
authors.forename: Naoto
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Ueno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Ryo
authors.initials: R
authors.lastname: Kameda
authors.forename: Setsuo
authors.initials: S
authors.lastname: Tamai
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Miyakawa
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kameda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Okudaira
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery / Q000821:virology; D002471:Cell Transformation, Neoplastic; D005260:Female; D016174:Hepacivirus; D006505:Hepatitis / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology* / Q000821:virology; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading