| Theme | Algorithm for Diagnosis and Treatment of Liver Cancer | |
|---|---|---|
| Title | Carcinogenesis Rates and Risk Factors for Hepatocellular Carcinogenesis in Patients with Hepatitis B Virus-related Chronic Hepatitis and Cirrhosis | |
| Publish Date | 2010/04 | |
| Author | Kenji Ikeda | Department of Hepatology, Toranomon Hospital |
| [ Summary ] | Cumulative carcinogenesis rates for hepatitis B virus (HBV)-related chronic hepatitis and cirrhosis were 2.9% and 19.7% at the end of the fifth year, 7.2% and 29.8% at the tenth year, and 9.9% and 36.3% at the fifteenth year, respectively. Independent risk factors for hepatocellular carcinogenesis in patients with chronic hepatitis included fibrotic stage of hepatitis (F1 vs. F2/3, H. R. 4.14, P=0.0042), heavy alcohol intake (former alcohol intake>=500 kg, H. R. 2.97, P=0.027), and positive HBe antigen levels (P=0.078). In patients with cirrhosis, carcinogenesis was significantly affected by advanced age (P＝0.0001), male gender (P=0.029), low platelet counts (P=0.0079), and positive HBe antigen levels (P=0.019). In a nested case-controlled study of 98 patients with untreated HBV-related cirrhosis, hepatocellular carcinogenesis was exclusive found in patients with a high HBV DNA level of 3.7 log copy/ml or higher. In the advanced stages of chronic hepatitis or cirrhosis, HBV DNA concentrations were more associated with future carcinogenesis rates compared to values of aminotranseferase. Since carcinogenesis rates are low in patients with HBs antigen-positive chronicinactivehepatitis, the significance of general surveillance of liver cancer for all "HBV positive" patients still remains unknown. |
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