Published online Aug 14, 2013. doi: 10.3748/wjg.v19.i30.4887
Revised: June 6, 2013
Accepted: June 19, 2013
Published online: August 14, 2013
AIM: To evaluate the histopathological findings of type C liver disease to determine risk factors for development of hepatocellular carcinoma (HCC).
METHODS: We studied 232 patients, who underwent liver biopsy for type C chronic liver disease between 1992 and 2009, with sustained virological response (SVR) after interferon therapy. The patients were divided into two groups according to the F stage 0 + 1 + 2 group (n = 182) and F3 + 4 group (n = 50). We prospectively observed and compared the incidence of HCC of the patients with SVR in the F0 + 1 + 2 and F3 + 4 groups. Then, the background factors and liver histopathological findings, including the degree of fibrosis, F stage, inflammation, necrosis, bile duct obstruction, fat deposition, and degree of irregular regeneration (IR) of hepatocytes, were correlated with the risk of developing HCC.
RESULTS: HCC developed in three of 182 (1.6%) patients in the F0 + 1 + 2 group, and four of 50 (8.0%) in the F3 + 4 group. The cumulative incidence of HCC in the former group was found to be significantly lower than in the F3 + 4 group (log rank test P = 0.0224). The presence of atypical hepatocytes among IR of hepatocytes in the F3 + 4 group resulted in a higher cumulative incidence of HCC, and was significantly correlated with risk of HCC development (RR = 20.748, 95%CI: 1.335-322.5, P = 0.0303).
CONCLUSION: Atypical hepatocytes among the histopathological findings of type C liver disease may be an important risk factor for HCC development along with progression of liver fibrosis.
Core tip: To evaluate the histopathological findings of type C liver disease to determine risk factors for the development of hepatocellular carcinoma (HCC), we studied 232 patients, who underwent liver biopsy, with sustained virological response after interferon therapy. We investigated in detail the histopathological findings, and analyzed the findings to determine the risk factors. Consequently, atypical hepatocytes among irregular regeneration of hepatocytes may be an important risk factor for HCC development, along with progression of liver fibrosis. Clarification of atypical hepatocytes as a risk factor of carcinogenesis may aid in the early diagnosis of HCC.