Histopathology of type C liver disease for determining hepatocellular carcinoma risk factors.
OBJECTIVE
To evaluate the histopathological findings of type C liver disease to determine risk factors for development of hepatocellular carcinoma (HCC).


METHODS
We studied 232 patients, who underwent liver biopsy for type C chronic liver disease between 1992 and 2009, with sustained virological response (SVR) after interferon therapy. The patients were divided into two groups according to the F stage 0 + 1 + 2 group (n = 182) and F3 + 4 group (n = 50). We prospectively observed and compared the incidence of HCC of the patients with SVR in the F0 + 1 + 2 and F3 + 4 groups. Then, the background factors and liver histopathological findings, including the degree of fibrosis, F stage, inflammation, necrosis, bile duct obstruction, fat deposition, and degree of irregular regeneration (IR) of hepatocytes, were correlated with the risk of developing HCC.


RESULTS
HCC developed in three of 182 (1.6%) patients in the F0 + 1 + 2 group, and four of 50 (8.0%) in the F3 + 4 group. The cumulative incidence of HCC in the former group was found to be significantly lower than in the F3 + 4 group (log rank test P = 0.0224). The presence of atypical hepatocytes among IR of hepatocytes in the F3 + 4 group resulted in a higher cumulative incidence of HCC, and was significantly correlated with risk of HCC development (RR = 20.748, 95%CI: 1.335-322.5, P = 0.0303).


CONCLUSIONS
Atypical hepatocytes among the histopathological findings of type C liver disease may be an important risk factor for HCC development along with progression of liver fibrosis.
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo173-8610, Japan. hsh.matsumura@nifty.com
Hiroshi
H
Matsumura
Kazushige
K
Nirei
Hitomi
H
Nakamura
Teruhisa
T
Higuchi
Yasuo
Y
Arakawa
Masahiro
M
Ogawa
Naohide
N
Tanaka
Mitsuhiko
M
Moriyama
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D016009:Chi-Square Distribution; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000627:therapeutic use; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000187:drug effects / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin
Hepatocellular carcinoma; Histopathology of liver biopsy; Irregular regeneration of hepatocytes; Liver fibrosis; Type C chronic liver disease