Relationship between the recurrence of hepatocellular carcinoma (HCC) and serum alanine aminotransferase levels in hepatectomized patients with hepatitis C virus-associated cirrhosis and HCC

Abstract

BACKGROUND The relationship between the recurrence of hepatocellular carcinoma (HCC) and the serum alanine aminotransferase (ALT) level was studied in hepatectomized patients with hepatitis C virus (HCV)‐associated cirrhosis and HCC. METHODS Twenty‐six hepatectomized patients with HCV‐associated cirrhosis and HCC whose resected specimens showed neither portal vein nor hepatic vein invasion by HCC histologically were divided into 2 groups: 15 patients who had no recurrence 3 years after surgery (Group A) and 11 patients whose disease recurred 1‐3 years after surgery (Group B). The patients' serum ALT levels during this period were examined. RESULTS In Group A, serum ALT generally showed sustained low levels < 80 international units (INU) in 12 patients (80%). In contrast, ALT levels in Group B showed several peaks or plateaus > 80 INU in all patients except 2. The recurrence rate of HCC in the hepatectomized patients with sustained low levels of ALT was 14.3% (2 of 14 patients) at 3 years, and was significantly lower (P < 0.01) than that in those patients whose ALT levels showed several peaks or plateaus > 80 INU (9 of 12 patients; 75.0%). The average level of mode of ALT in Group A (48.8 ± 26.0 INU) was significantly smaller than that in Group B (101.1 ± 47.3 INU) (P < 0.005). CONCLUSIONS The importance of hepatocytic necrosis in the recurrence of HCC in hepatectomized patients with cirrhosis and HCC of HCV origin was demonstrated and the significance of subsiding hepatic necroinflammatory process in the prevention of HCC recurrence suggested. Cancer 1997; 79:688‐94. © 1997 American Cancer Society.

Interferon Therapy for Hapatitis C Virus (HCV)-related Advanced Chronic Hepatitis after Treatment of Recurrent Hepatocellular Carcinoma: A Successful Case.

“…Tarao and colleagues reported earlier that the cumulative rate of HCCcomplications was higher as the serum transaminase persists at high levels (6). The data in this case indicate that serum transaminase levels also persisted at a high level with multimodalvariations even after the curative treatment of HCC, suggesting the possibility of a recurrence of HCC.…”

Prediction of Hepatocellular Carcinoma Development by Plasma ADAMTS13 in Chronic Hepatitis B and C

“…The current finding that plasma ADAMTS13 activity or antigen level significantly correlated with serum AST and ALT levels may explain this. Of note, it was previously shown that the higher serum ALT is associated with the higher rate of incidence of HCC development (31) and HCC recurrence after the surgical treatment (32) in HCV-related cirrhosis, suggesting that more hepatocellular damage increases a risk for HCC development in the liver of the same stage of fibrosis. Because plasma ADAMTS13 activity or antigen level reflect hepatocellular damage and subsequent wound healing as well as liver fibrosis stage, plasma ADAMTS13 activity, or antigen level may act distinctly from liver stiffness value in the risk analysis of HCC development.…”

Effect of interferon therapy on hepatocellular carcinogenesis in patients with chronic hepatitis type C: A long-term observation study of 1,643 patients using statistical bias correction with proportional hazard analysis

“…Moreno et al 23 reported that IFN exhibited remission of liver fibrosis, and control of necroinflammatory process can therefore induce a suppression of the growth process of HCC. Tarao et al 24 reported that high aminotransferase activity resulted in an increase of an HCC recurrence rate in patients with cirrhosis. Our results also suggested that the carcinogenic process in the patients with chronic hepatitis C was greatly enhanced by the aminotransferase fluctuation and its persistence.…”