Hepatitis C virus-associated primary hepatocellular carcinoma in non-cirrhotic patients.
Abstract
BACKGROUND
There is limited literature on hepatocellular carcinoma (HCC) in patients with chronic hepatitis C virus (HCV) infection in
the absence of cirrhosis.
AIMS
To investigate the relationship between HCV and HCC in the absence of cirrhosis and to characterize patients with HCV infection
presenting with HCC in the absence of cirrhosis.
METHODS
We identified all adult patients with histological confirmation of HCC between 1994 and 2007 (404 patients). A case-control
design (four controls for each case with non-cirrhotic HCC) was chosen to compare characteristics and survival of HCV in HCC
patients without (cases) and with (controls) cirrhosis. Conditional logistic regression analysis was used to identify factors
independently associated with HCV in non-cirrhotic HCC.
RESULTS
Eighty-seven patients with non-cirrhotic HCC were identified, six (7 %) had HCV infection in comparison with 107 of 317 (55.7
%) with cirrhotic HCC (P < 0.001). Compared with the HCV-associated HCC cirrhotic group, patients with HCV-associated HCC
in the absence of cirrhosis were more likely to present with a single nodule (100 vs. 66.7 %), larger nodule size (>5 cm)
(100 vs. 16.7 %), and macrovascular invasion (66.7 vs. 17.4 %) at time of diagnosis. Four of six patients with HCV-associated
HCC in the absence of cirrhosis where alive at three years (all had resection), which was better survival than for HCC arising
in cirrhotic livers of HCV-infected individuals (66.7 vs. 39.1 %).
CONCLUSION
We found that HCV is responsible for a small minority of non-cirrhotic HCC cases representing an uncommon and poorly defined
subgroup of HCC.
Links
Authors
Albeldawi M, Soliman M, Lopez R, Zein NN
Institution
Department of Gastroenterology and Hepatology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA.
Source
Digestive diseases and sciences 57:12 2012 Dec pg 3265-70MeSH
AgedCarcinoma, Hepatocellular
Female
Hepacivirus
Hepatitis C, Chronic
Humans
Liver Cirrhosis
Liver Neoplasms
Male
Middle Aged
alpha-Fetoproteins
Pub Type(s)
Journal ArticleLanguage
eng
PubMed ID
22695885
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