Clinical Gastroenterology Vol.27 No.5(3-1)

Theme Non-B, Non-C Hepatocellular Carcinoma : The Latest Findings
Title Analysis of Nationwide Survey for Hepatocellular Carcinoma Arising from Non-B, Non-C Liver Diseases
Publish Date 2012/05
Author Katsutoshi Tokushige Department of Internal Medicine and Gastroenterology, Tokyo Womenʼs Medical University
Author Etsuko Hashimoto Department of Internal Medicine and Gastroenterology, Tokyo Womenʼs Medical University
[ Summary ] Purpose : To clarify the etiology of hepatocellular carcinoma (HCC) in Japanese patients with non-viral liver disease, we performed a nationwide survey. The influence of obesity, lifestyle-related diseases, and alcohol consumption was investigated.
Patients and Methods：A nationwide survey of 14,530 HCC patients was conducted in 2009. Clinical features were studied concerning HCC patients with nonalcoholic fatty liver disease (NAFLD-HCC; n=292), alcoholic liver disease (ALC-HCC; n=991), and chronic liver disease of unknown etiology (unknown HCC; n=614). The unknown HCC group was divided into two subgroups, a no alcohol intake group and a modest alcohol intake group. Results: ALC-HCC accounted for 7.2% of all HCC cases, followed by the unknown HCC group (5.1 %) and the NAFLD-HCC group (2.0 %). The characteristics of these three groups were clearly different. Obesity and lifestylerelated diseases were significantly more frequent in NAFLD-HCC cases than in ALC-HCC and unknown HCC cases. The no alcohol intake subgroup of the unknown HCC group exhibited female predominance and was older, without a high prevalence of obesity and lifestyle-related diseases. In contrast, the modest alcohol intake subgroup showed the same trends regarding gender, body mass index, prevalence of lifestyle-related diseases, and liver function as the ALC-HCC group.
Conclusions: The clinical features of ALC-HCC, NAFLD-HCC and unknown HCC were clearly different. Modest intake of alcohol may play a more significant role in hepatic carcinogenesis than is presently thought.
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