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Viral hepatitis markers in liver tissue in relation to serostatus in hepatocellular carcinoma.
Cancer Epidemiol Biomarkers Prev. 2013 Nov; 22(11):2016-23.CE

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) incidence is increasing in the United States. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of HCC. Hepatitis infection in patients with HCC is generally diagnosed by serology, which is not always consistent with the presence of HBV and HCV in the liver. The relationship of liver viral status to serostatus in hepatocarcinogenesis is not fully understood.

METHODS

HBV and HCV were evaluated in formalin-fixed, paraffin-embedded liver tissue specimens in a retrospective study of 61 U.S. HCC cases of known serologic status. HBV DNA and HCV RNA were detected by PCR, reverse transcription PCR (RT-PCR), and pyrosequencing, and HBsAg and HBcAg were evaluated by immunohistochemistry.

RESULTS

Viral markers were detected in the liver tissue of 25 of 61 (41%) HCC cases. Tissue viral and serologic status were discordant in 27 (44%) cases, including those with apparent "occult" infection. Specifically, HBV DNA was detected in tissue of 4 of 39 (10%) serum HBsAg (-) cases, including 1 anti-HCV(+) case; and HCV RNA was detected in tissue of 3 of 42 (7%) anti-HCV seronegative cases, including two with serologic evidence of HBV.

CONCLUSIONS

Viral hepatitis, including HBV-HCV coinfection, may be unrecognized in up to 17% of patients with HCC when based on serology alone. Further research is needed to understand the clinical significance of viral makers in liver tissue of patients with HCC in the absence of serologic indices.

IMPACT

The contribution of HBV and HCV to the increasing incidence of HCC in the United States may be underestimated.

Authors+Show Affiliations

Authors' Affiliations: University of Hawaii Cancer Center; The Queen's Medical Center; University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii; Division of Cancer Epidemiology and Genetics, and Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23983238

Citation

Hernandez, Brenda Y., et al. "Viral Hepatitis Markers in Liver Tissue in Relation to Serostatus in Hepatocellular Carcinoma." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 22, no. 11, 2013, pp. 2016-23.
Hernandez BY, Zhu X, Kwee S, et al. Viral hepatitis markers in liver tissue in relation to serostatus in hepatocellular carcinoma. Cancer Epidemiol Biomarkers Prev. 2013;22(11):2016-23.
Hernandez, B. Y., Zhu, X., Kwee, S., Chan, O. T., Tsai, N., Okimoto, G., Horio, D., McGlynn, K. A., Altekruse, S., & Wong, L. L. (2013). Viral hepatitis markers in liver tissue in relation to serostatus in hepatocellular carcinoma. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 22(11), 2016-23. https://doi.org/10.1158/1055-9965.EPI-13-0397
Hernandez BY, et al. Viral Hepatitis Markers in Liver Tissue in Relation to Serostatus in Hepatocellular Carcinoma. Cancer Epidemiol Biomarkers Prev. 2013;22(11):2016-23. PubMed PMID: 23983238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Viral hepatitis markers in liver tissue in relation to serostatus in hepatocellular carcinoma. AU - Hernandez,Brenda Y, AU - Zhu,Xuemei, AU - Kwee,Sandi, AU - Chan,Owen T M, AU - Tsai,Naoky, AU - Okimoto,Gordon, AU - Horio,David, AU - McGlynn,Katherine A, AU - Altekruse,Sean, AU - Wong,Linda L, Y1 - 2013/08/27/ PY - 2013/8/29/entrez PY - 2013/8/29/pubmed PY - 2014/8/26/medline SP - 2016 EP - 23 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 22 IS - 11 N2 - BACKGROUND: Hepatocellular carcinoma (HCC) incidence is increasing in the United States. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of HCC. Hepatitis infection in patients with HCC is generally diagnosed by serology, which is not always consistent with the presence of HBV and HCV in the liver. The relationship of liver viral status to serostatus in hepatocarcinogenesis is not fully understood. METHODS: HBV and HCV were evaluated in formalin-fixed, paraffin-embedded liver tissue specimens in a retrospective study of 61 U.S. HCC cases of known serologic status. HBV DNA and HCV RNA were detected by PCR, reverse transcription PCR (RT-PCR), and pyrosequencing, and HBsAg and HBcAg were evaluated by immunohistochemistry. RESULTS: Viral markers were detected in the liver tissue of 25 of 61 (41%) HCC cases. Tissue viral and serologic status were discordant in 27 (44%) cases, including those with apparent "occult" infection. Specifically, HBV DNA was detected in tissue of 4 of 39 (10%) serum HBsAg (-) cases, including 1 anti-HCV(+) case; and HCV RNA was detected in tissue of 3 of 42 (7%) anti-HCV seronegative cases, including two with serologic evidence of HBV. CONCLUSIONS: Viral hepatitis, including HBV-HCV coinfection, may be unrecognized in up to 17% of patients with HCC when based on serology alone. Further research is needed to understand the clinical significance of viral makers in liver tissue of patients with HCC in the absence of serologic indices. IMPACT: The contribution of HBV and HCV to the increasing incidence of HCC in the United States may be underestimated. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/23983238/Viral_hepatitis_markers_in_liver_tissue_in_relation_to_serostatus_in_hepatocellular_carcinoma_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=23983238 DB - PRIME DP - Unbound Medicine ER -