Serum antibody titers against hepatitis C virus and postoperative intrahepatic recurrence of hepatocellular carcinoma.
BACKGROUND
Hepatocellular carcinoma (HCC) is the seventh most common cancer and the third leading cause of cancer deaths worldwide. Hepatitis C virus (HCV) infection is a major risk factor for HCC recurrence after curative resection. This study evaluated anti-HCV antibody (Ab) titer as a prognostic indicator of HCC recurrence after curative hepatic resection.


METHODS
A total of 82 patients with HCC (anti-HCV Ab positive and hepatitis B surface antigen negative) who underwent curative hepatic resection were evaluated. Anti-HCV Ab titers were measured using a third-generation enzyme immunoassay, and patients were divided into high (n = 41) and low (n = 41) titer groups to compare their clinicopathological characteristics and disease-free survival. Univariate and multivariate analyses were conducted to identify risk factors for early or late recurrence.


RESULTS
Multivariate analysis showed that anti-HCV Ab titer and vascular invasion were independent prognostic factors of disease-free survival [odds ratio (OR) 1.9, p = 0.03, and OR 1.8, p = 0.04, respectively]. Subgroup analysis identified only vascular invasion as an independent prognostic factor for early recurrences that were considered residual intrahepatic metastases. Subgroup analysis identified anti-HCV Ab titer and fibrosis grade as independent prognostic factors of late recurrences that were considered to be metachronous multicentric liver carcinogenesis (OR 4.8, p = 0.04, and OR 5.2, p = 0.03, respectively).


CONCLUSIONS
Anti-HCV Ab titer is a predictive factor for HCC recurrence, especially the risk of late recurrence due to multicentric carcinogenesis. Prevention of liver carcinogenesis after hepatic resection for HCC might be appropriate for patients with high anti-HCV Ab titers.
Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Mamoru
M
Uemura
Yo
Y
Sasaki
Terumasa
T
Yamada
Kunihito
K
Gotoh
Hidetoshi
H
Eguchi
Masahiko
M
Yano
Hiroaki
H
Ohigashi
Osamu
O
Ishikawa
Shingi
S
Imaoka
D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000276:immunology / Q000401:mortality / Q000601:surgery / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000302:isolation & purification; D006498:Hepatectomy / Q000401:mortality*; D006526:Hepatitis C / Q000276:immunology / Q000401:mortality / Q000601:surgery / Q000821:virology*; D006801:Humans; D008113:Liver Neoplasms / Q000276:immunology / Q000401:mortality / Q000601:surgery / Q000821:virology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate
D000914:Antibodies, Viral