Analysis of Background Factors and Evaluation of a Population at High Risk of Hepatocellular Carcinoma

Abstract

Objective: We investigated the background clinical factors of patients with hepatocellular carcinoma (HCC) diagnosed at our institute and, from these results, determined those factors important for evaluation of a population at high risk of HCC. Methods: This study comprised 250 patients diagnosed with HCC from 1990 through 1995 in the Nihon University Itabashi Hospital. Background clinical factors, such as the results of blood chemistry at the time of the first angiography, were examined. Results: Markers of viral hepatitis in the 250 cases were as follows: type B (B-HCC), 29 (11.6%), type C (C-HCC), 201 (80.4%); type B+C, 3 (1.2%), and non-B, non-C (NBNC-HCC), 17 (6.8%). Approximately 35% of B-HCC and NBNC-HCC cases, but only 6% of C-HCC cases, exhibited platelet counts (PLT) equal to or more than 200,000/ml. On the other hand, 56.5% of the C-HCC cases exhibited PLT less than 100,000/ml, in contrast to less than 30% of the B-HCC and NBNC-HCC cases. Irrespective of the etiology of HCC, male sex and a history of smoking were characteristic risk factors. The percentages of abnormal results in combinations of tests in the B-HCC, C-HCC and NBNC-HCC subsets were: 69, 97 and 70% in the aspartate aminotransferase (AST) + PLT group (group A); 83, 98 and 70% in the group A + alanine aminotransferase (ALT) group (group B), and 86, 98 and 100% in the group B + γ-glutamyl transpeptidase (γ-GTP) group (group C), respectively. When hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV-Ab) were also taken into account, abnormal results were found in every case in all of the HCC groups. Conclusion: C-HCC was found predominantly in cases with liver cirrhosis, whereas B-HCC and NBNC-HCC were observed more frequently in cases without liver cirrhosis. Testing for HBsAg and HCV-Ab, in addition to AST, ALT, PLT and γ-GTP, is considered necessary when screening for HCC.

Thrombocytopenia as a surrogate for cirrhosis and a marker for the identification of patients at high‐risk for hepatocellular carcinoma

“…In a Japanese study, approximately 35% of patients with HBV-related HCC and patients with non-HBV/non-HCV (NBNC) HCC, but only 6% of patients with HCVrelated HCC, exhibited platelet counts !200 Â 10 3 / mm 3 ; whereas 56.5% of patients with HCV-related HCC exhibited platelet counts <100 Â 10 3 /mm 3 , in contrast to <30% of patients with HBV-related HCC and patients with NBNC-HCC. 33 Those findings are compatible with the results from our Pilot Study 2. Patients with HCVrelated HCC had a higher prevalence of thrombocytopenia than patients with HBV-related HCC (63% vs. 42%).…”

Hepatocellular carcinoma in Native South Asian Pakistani population; trends, clinico-pathological characteristics & differences in viral marker negative & viral-hepatocellular carcinoma

“…The studies describing the characteristics and prognosis of viral marker negative HCC are limited and most involved the patients who underwent hepatic resection, selected as the study population; hence, might not truly reflect the entire population of viral marker negative HCC [5,36,37]. Differences exist in exposure to the various etiological factors for HCC and host factors in Asian population as compared to West.…”

Prediction model of hepatocarcinogenesis for patients with hepatitis C virus-related cirrhosis. Validation with internal and external cohorts

“…However, the reasons for the significant differences found in the rates among various hospitals have not been fully elucidated until recently. Many risk factors have been identified as important for the development of HCC in patients with hepatitis or cirrhosis [10,13,29,30], but of even greater interest is the precise prediction of HCC. In order to establish a reliable method for predicting carcinogenesis risk in a variety of patients with HCV-positive cirrhosis (compensated and decompensated), we investigated a large cohort of patients with few dropout cases, using a multivariate proportional model.…”