Long-term prognosis after resection of hepatocellular carcinoma associated with hepatitis B-related cirrhosis.

PURPOSE: The optimum management of hepatocellular carcinoma (HCC) associated with cirrhosis has not yet been clarified. Very few data are available in the literature regarding the prognosis after resection of HCC associated with hepatitis B virus (HBV)-related cirrhosis. This study evaluated the long-term results and prognostic factors after resection of HCC complicating HBV-related cirrhosis. PATIENTS AND METHODS: One hundred forty-six patients with HBV-related Child's A or B cirrhosis who had undergone resection of HCC over a 10-year period were prospectively studied for long-term results. They were compared with 155 noncirrhotic patients with HBV-related HCC resected in the same period. RESULTS: The overall survival results of cirrhotic patients after resection of HCC were comparable to those of noncirrhotic patients (5-year survival, 44.3% v 45.6%, respectively; P =.216), but the former group had significantly smaller tumors. Stratified according to tumor size, the survival results were similar between cirrhotic and noncirrhotic patients with tumors 相似文献   

根治切除术联合抗病毒治疗肝癌合并乙肝病毒感染的临床研究

目的:探讨根治切除术联合抗病毒治疗肝癌合并乙肝病毒（HBV）感染的临床效果。方法:选取2010年4月-2013年4月100例肝癌合并乙肝病毒感染患者为研究对象,按照HBV-DNA水平不同分成高病毒复制组和低病毒复制组（以HBV-DNA载量为105拷贝/ml为标准）,比较四组在肝功能、HBV-DNA水平、生存时间、肿瘤复发率和住院时间、住院费用方面的差异性。结果:抗病毒治疗后无论在高病毒复制组和低病毒复制组中,肝功能明显好转,HBV-DNA水平明显低于未抗病毒治疗,且在住院时间、费用、生存时间和肿瘤复发率上抗病毒治疗均好于未抗病毒者,但低病毒复制者在住院时间、住院费用上优于高病毒复制者。在生存时间上高病毒复制者1~2年生存率更好,在肿瘤复发率上低病毒复制者更低。结论:抗病毒结合根治切除术能改善肝癌合并HBV感染者的肝功能和病毒指标,缩短住院时间,延长生存时间。     

Recurrent hepatocellular carcinoma after hepatic resection: prognostic factors and long-term outcome.

AIM: The prognosis of patients with recurrent hepatocellular carcinoma (HCC) after hepatic resection varies widely. This study analyzed long-term survival and prognostic factors of patients with recurrent HCC after hepatectomy. METHODS: From July 1991 to December 2000, 623 patients underwent hepatic resection for HCC. Of those, 347 (56.5%) patients had tumour recurrence, and 286 patients with follow-up time more than 24 months after recurrence were enrolled. Twenty-seven clinicopathologic factors underwent both univariate and multivariate analysis. RESULTS: Of these 286 patients, survival times after tumour recurrence were mean 672+/-619 days; median 468 days; and, range 10-3753 days. The overall 1-, 3-, 5-, and 10-year post-recurrence survival rates were 61.5, 33.4, 18.2, and 9.0%, respectively. Seventy (24.5%) patients were alive at the time of study, and 10 of the 34 patients who underwent re-resection were disease-free. By Cox regression analysis, multiple initial tumours (relative risk (RR) 1.428), recurrent multiple (RR 1.372), extrahepatic recurrence (RR 2.434), recurrent tumour size >2 cm (RR 1.926), post-hepatectomy period until recurrence <1 year (RR 1.769), and non-resectional treatment of recurrent tumours (RR 3.527) were independent prognostic factors for post-recurrent survival rates. CONCLUSIONS: In patients with recurrent HCC after hepatectomy, both initial and recurrent tumour factors influenced their prognosis. Early detection of recurrent tumours is important. Re-resection correlated with better post-recurrent survival rates.     

Influence of previous interferon therapy on recurrence after resection of hepatitis c virus-related hepatocellular carcinoma.

Interferon (IFN) therapy decreases the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV). One hundred and fifty-nine consecutive patients who underwent liver resection for HCV-related HCC were studied. In 17 (group 1) of the 159 patients, HCC was detected during or after IFN therapy. The incidences of recurrence after surgery in the group 1 patients and the other 142 patients (group 2) were compared. Eight patients had a complete response to IFN, 4 had a partial response, and 5 had no response. The proportion of patients without HCV viremia was significantly higher in the group 1 patients (P < 0.0001). The tumor-free survival rate was significantly higher in the group 1 patients (P = 0.0010). By multivariate analysis of various risk factors for recurrence, no previous IFN was a significant independent risk factor for recurrence (risk ratio = 6.336; 95%CI, 1.512 - 26.50). The patients with HCC who underwent IFN therapy previously are good candidates for liver resection because recurrence after the operation was rarely observed.     

Bone metastases of hepatocellular carcinoma after liver resection.

Between January 1985 and July 1990, 323 cases of hepatocellular carcinoma underwent liver resection in our department. Bone metastases were found in 12 of these cases (3.7%). Bone metastases were mainly found in vertebral bone (58.3%) and pelvic bone (41.7%). The time interval to the development of bone metastasis after liver resection was closely related to the presence of intrahepatic metastasis and the stage at operation. In all cases, the initial clinical symptom was pain and/or motor disturbance. Radiotherapy was performed in 10 cases and transcatheter arterial embolization or surgery was performed in 4 cases. The pain or neurological symptoms improved with these therapies in all cases. Cumulative survival was 1 year in 74%, 2 years in 34%, and 3 years in 17%, respectively.     

Effect of viral status on recurrence after liver resection for patients with hepatitis B virus-related hepatocellular carcinoma

BACKGROUND: Risk factors for recurrence after resection of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) require more precise definition. METHODS: Forty patients who underwent liver resection for HBV-related HCC were studied. Their clinical findings, laboratory data (including viral status), pathologic findings, and operative methods were evaluated for recurrence risk in univariate and multivariate analyses. RESULTS: The HB envelope (HBe) antigen, wild-type HBV, intrahepatic metastases, elevated serum activities of aspartate aminotransferase and alanine aminotransferase, and moderately or severely active hepatitis were more likely to be found in patients with a high viral load than in patients with a low viral load. Precore mutant-type HBV was more likely to be found in patients with a low viral load than in patients with a high viral load. The platelet count was significantly lower in the patients with a high viral load. A high viral load, the presence of wild-type HBV, the absence of anti-HBe, the absence of precore mutant-type HBV, Child score B, a low platelet count, and a positive surgical margin were risk factors for recurrence in univariate analysis. A nonanatomic resection tended to be a risk factor. A high viral load and positive surgical margin were independent risk factors for recurrence. CONCLUSIONS: The measurement of viral load and detection of anti-HBe, wild-type HBV, and precore mutant-type HBV are useful for estimating a patient's prognosis after resection of HBV-related HCC.     

Adjuvant treatment of hepatocellular carcinoma after resection

Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer, and surgical resection offers an opportunity for cure in patients fortunate enough to ...     

Type C hepatitis and hepatocellular carcinoma]

Recently the number of hepatitis C virus antibody (HCV-Ab) positive male cases with hepatocellular carcinoma (HCC) is increasing only in Japan mainly for two reasons. One is that cases with liver cirrhosis are surviving longer than before. The other is the increasing number of HCC cases receiving blood transfusions at operations approximately 30 years ago. The prognosis of NS' 4 positive cases was worse than NS' 4 negative cases with HCV-Ab positive chronic hepatitis. The rate of HCV-Ab and HBsAg positive cases among 113 ones with HCC was about 70 percent and 25 percent, respectively. Some 239 cases with cirrhosis were followed for 6 years. Consequently HCV-Ab positive HCC cases were found to have a yearly incidence rate of 7 percent. The rate of development to HCC with HCV-Ab and HBsAg positive cases was significantly higher than that of both HCV-Ab and HBsAg negative ones. The integration of HCV-RNA was not found both in cancerous and non-cancerous region, different from the very high integration rate of HBsAg positive cases. Pathoepidemiologically, HCV is closely related to HCC. However, the role of HCV in the development of HCC remains unknown.     

Serum ferritin level after resection of hepatocellular carcinoma. Correlation with alpha-fetoprotein level

Total serum ferritin concentrations were serially estimated in 24 patients with primary hepatocellular carcinoma (HCC) for 4 to 8 weeks after resection of the tumor. The patients were divided into four groups according to the tumor size and the result of ferritin was compared with that of serum alpha-fetoprotein (AFP) levels. All patients had underlying parenchymal diseases of the liver (liver cirrhosis in 19 and chronic hepatitis in 5 cases). The serum ferritin levels did not reflect the therapeutic result of hepatic resection in most of the patients of all groups. Serum AFP levels, which were measured simultaneously with ferritin levels, were much superior to the ferritin estimation. The current study may indicate that ferritin cannot be used as a tumor marker in the follow-up of Japanese patients with HCC and associated liver disease. Acidic isoferritin, which is known to be produced in and secreted from HCC, should be measured for this purpose.     

Regression of hepatocellular carcinoma after treatment of hepatitis C: a case report

Chronic hepatitis C induced cirrhosis predisposes to hepatocellular carcinoma (HCC). There is no data regarding the impact of hepatitis C treatment on HCC. We report a case of a 53-year-old man with chronic hepatitis C and HCC with lung metastasis who failed treatment with sorafenib but the tumor regressed after treatment of hepatitis C with ribavirin and sofosbuvir for 24 weeks.     

Molecular markers of hepatitis C virus-related hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is triggered by many factors including infection with hepatitis C virus (HCV). However, the molecular basis of the development of HCV-related HCC remains unknown. The present study was designed to reveal the interference of the HCV infection in HCC patients with a set of anti-apoptotic factors, and expression levels of some molecular markers between HCV-related HCC and non-HCV-related HCC. We have determined the plasma circulating levels of Bcl-2, TGF-betaI, VEGF, beta2-MG and immunohistochemistry staining of p53 in HCV-related HCC patients (n = 40) and compared them in relation to both HCV-free HCC patients (n = 37) and normal control group (n = 20). The present data do not distinctly predict a significant role of HCV infection on the circulating Bcl-2 protein since in both HCC and HCC/HCV groups a limited number of patients have high levels of Bcl-2. However, TGF-betaI expression is markedly decreased in all patients, particularly in HCC associated with HCV. Moreover, serum VEGF is significantly higher in HCC patients with or without HCV infection than in normal control. No significant difference, however, was found between HCV-infected and HCV-free groups. Presence of HCV is associated with a high incidence of Loss of Heterozygosity (LOH) at M6P/IGFIIr site compared to HCV-free patients. Although beta2-MG is markedly elevated in all patients, a significant increase was observed in the presence of HCV. Immunohistochemical positive total staining for p53 protein was detected in 32/77 (41.5%); HCC-positive HCV was 21/40 (52.2%), and HCC-negative HCV was 11/37 (29.73%). Collectively, in HCC patients, HCV infection does not affect the levels of Bcl-2 and VEGF. beta2-MG and LOH levels at the M6P/IGFIIr site were higher in the presence of HCV concomitant with a decrease in TGF-beta1. There was no significant correlation between p53 and stage of the disease or between p53 protein expression and clinicopathological manifestations.     

Correlation of clinicopathologic features of resected hepatocellular carcinoma with hepatitis C virus genotype.

Clinicopathologic findings in patients with hepatocellular carcinoma complicating hepatitis C virus and outcomes after liver resection were compared between different viral genotypes. One hundred and forty-seven patients with both anti-hepatitis C virus antibody and hepatitis C virus RNA in their sera underwent curative resection for hepatocellular carcinoma in our department between 1991 and 1997. Of these patients, 115 were infected with hepatitis C virus genotype 1b (group 1), and 32 were infected with 2a or 2b (group 2). Clinicopathologic findings and outcomes after operation were compared between the two groups. Alanine aminotransferase activity was significantly higher in group 2 than in group 1. Genotypes did not differ concomitantly with histopathologic features of the carcinoma or adjacent hepatic tissue. Although the tumor-free survival rate did not differ significantly between the two groups, recurrence was not detected during the period beyond 3 years following operation in group 2, while recurrences arose during that period in 16 group 1 patients, most of whom continued to manifest active hepatitis. In 7 of these 16 patients, the recurrent tumors were histologically multicentric in origin. The cumulative survival rate was significantly lower in group 1 than 2. Multivariate analysis indicated that genotype 1b was an independent risk factor for short survival. Patients infected with genotype 1b may have a relatively high risk of ongoing hepatocarcinogenesis and more aggressive progression of associated liver dysfunction, resulting in a poorer outcome than with other genotypes.     

Comparison of proteome between hepatitis B virus- and hepatitis C virus-associated hepatocellular carcinoma.

PURPOSE: Hepatocellular carcinoma (HCC) is one of the most common malignant cancers closely associated with chronic infection by the hepatitis B virus (HBV) or the hepatitis C virus (HCV) throughout the world. Differential expression of the proteome in HBV- and HCV-associated HCC was investigated to identify any useful biomarkers indicating virus-specific hepatocarcinogenesis. EXPERIMENTAL DESIGN: Twenty-one pairs of specimens (tumorous and surrounding nontumorous liver tissues) were obtained from 21 HCC patients. They were divided into three HCC types by viral markers: 7 hepatitis B surface antigen-positive (B-type HCC), 7 anti-HCV-positive (C-type HCC), and 7 hepatitis B surface antigen-negative and anti-HCV-negative. Total proteins were analyzed by two-dimensional gel electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and alterations in the proteome were examined. RESULTS: Sixty proteins were identified that show significant changes in the expression level between nontumorous and tumorous tissues. Among these, 14 proteins were commonly changed in all three of the HCC types, but 46 proteins showed a tendency of viral marker specificity. CONCLUSIONS: The identified proteins were classified according to the viral factor as being involved in B-type and C-type HCC. These results suggest strongly that the expression pattern of proteome in HCC tissues is closely associated with etiologic factors. The different protein profiles between B-type and C-type HCC indicate that the pathogenetic mechanisms of hepatocarcinogenesis may be different according to the viral factor, HBV and HCV.     

Clinical significance of prior hepatitis B virus infection in patients with hepatitis C virus-related hepatocellular carcinoma.

BACKGROUND: The effect of prior hepatitis B virus (HBV) infection on the clinicopathologic findings for patients with hepatitis C virus (HCV) RNA and hepatocellular carcinoma (HCC) is still unclear. METHODS: Of 59 patients who underwent liver resection for HCV-related HCC (相似文献   

Lactoferrin inhibits hepatitis C virus viremia in patients with chronic hepatitis C: a pilot study.

Hepatitis C virus (HCV) is associated with the development of cirrhosis and hepatocellular carcinoma. We recently found that bovine lactoferrin, a milk protein belonging to the iron transporter family, effectively prevented HCV infection in cultured human hepatocytes (PH5CH8). We tested the hypothesis that lactoferrin inhibits HCV viremia in patients with chronic hepatitis C. Eleven patients with chronic hepatitis C received an 8-week course of bovine lactoferrin (1.8 or 3.6 g/day). At the end of lactoferrin treatment, a decrease in serum alanine transaminase and HCV RNA concentrations was apparent in 3 (75%) of 4 patients with low pretreatment serum concentrations of HCV RNA. However, 7 patients with high pretreatment concentrations showed no significant changes in these indices. This pilot study suggests that lactoferrin is one potential candidate as an anti-HCV reagent that may be effective for the treatment of patients with chronic hepatitis.