Pathological characteristics of patients who develop hepatocellular carcinoma with negative results of both serous hepatitis B surface antigen and hepatitis C virus antibody.
OBJECTIVE
We tried to characterize the pathological features of patients who developed hepatocellular carcinoma (HCC) with the negative results of both serous hepatitis B surface antigen and hepatitis C virus antibody (non-B, non-C).


METHODS
In a multicenter study in Kyushu, Japan, we studied the histopathological characteristics of non-cancerous liver tissues in 129 patients (103 men and 26 women) with non-B, non-C HCC. The histological liver damage was evaluated for fibrosis (stage) and inflammation (grade) according to the Ludwig classification of chronic hepatitis. In addition, we examined the hepatitis B virus (HBV) genome in serum samples and liver tissues of 20 patients with non-B, non-C HCC.


RESULTS
Positivity of serum hepatitis B core (HBc) antibody, alcohol abuse, diabetes and non-alcoholic steatohepatitis were present in 61 (47%), 76 (59%), 57 (44%) and eight (6%) patients, respectively. The degree of fibrosis was mild (stage 1.6 ± 1.2). The stage of patients with neither serum HBc antibody nor alcohol abuse was significantly lower than the stage of patients with HBc antibody and no alcohol abuse (P < 0.05). HBV genome was detected in 15 cancerous tissues (75%) and 16 non-cancerous liver tissues (80%) in 20 patients with non-B, non-C HCC. Only three of the 20 patients were positive for serum HBc antibody.


CONCLUSIONS
Non-B, non-C patients appear to develop HCC at a low stage of fibrosis. Occult hepatitis B virus infection is the major risk factor for HCC of non-B, non-C patients in Kyushu, Japan.
Department of Pathology, Kurume University School of Medicine, Kurume, Japan; Cancer Center, Kurume University Hospital, Kurume, Japan; Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.
Reiichiro
R
Kondo
Osamu
O
Nakashima
Michio
M
Sata
Fumio
F
Imazeki
Osamu
O
Yokosuka
Ken
K
Tanikawa
Masayoshi
M
Kage
Hirohisa
H
Yano
diabetes mellitus; hepatocellular carcinoma; large liver cell change; non-B non-C; non-alcoholic steatohepatitis; occult hepatitis B infection