title: Viral hepatitis markers in liver tissue in relation to serostatus in hepatocellular carcinoma.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) incidence is increasing in the United States. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of HCC. Hepatitis infection in patients with HCC is generally diagnosed by serology, which is not always consistent with the presence of HBV and HCV in the liver. The relationship of liver viral status to serostatus in hepatocarcinogenesis is not fully understood.
  
  
  METHODS
  HBV and HCV were evaluated in formalin-fixed, paraffin-embedded liver tissue specimens in a retrospective study of 61 U.S. HCC cases of known serologic status. HBV DNA and HCV RNA were detected by PCR, reverse transcription PCR (RT-PCR), and pyrosequencing, and HBsAg and HBcAg were evaluated by immunohistochemistry.
  
  
  RESULTS
  Viral markers were detected in the liver tissue of 25 of 61 (41%) HCC cases. Tissue viral and serologic status were discordant in 27 (44%) cases, including those with apparent "occult" infection. Specifically, HBV DNA was detected in tissue of 4 of 39 (10%) serum HBsAg (-) cases, including 1 anti-HCV(+) case; and HCV RNA was detected in tissue of 3 of 42 (7%) anti-HCV seronegative cases, including two with serologic evidence of HBV.
  
  
  CONCLUSIONS
  Viral hepatitis, including HBV-HCV coinfection, may be unrecognized in up to 17% of patients with HCC when based on serology alone. Further research is needed to understand the clinical significance of viral makers in liver tissue of patients with HCC in the absence of serologic indices.
  
  
  CONCLUSIONS
  The contribution of HBV and HCV to the increasing incidence of HCC in the United States may be underestimated.
authors: Authors' Affiliations: University of Hawaii Cancer Center; The Queen's Medical Center; University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii; Division of Cancer Epidemiology and Genetics, and Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
authors: Brenda Y
authors: BY
authors: Hernandez
authors: Xuemei
authors: X
authors: Zhu
authors: Sandi
authors: S
authors: Kwee
authors: Owen T M
authors: OT
authors: Chan
authors: Naoky
authors: N
authors: Tsai
authors: Gordon
authors: G
authors: Okimoto
authors: David
authors: D
authors: Horio
authors: Katherine A
authors: KA
authors: McGlynn
authors: Sean
authors: S
authors: Altekruse
authors: Linda L
authors: LL
authors: Wong
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000453:epidemiology / Q000821:virology*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006512:Hepatitis B Core Antigens / Q000032:analysis / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000032:analysis / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000097:blood / Q000453:epidemiology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens
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