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Titolo:
Viral serostatus and coexisting inflammatory activity affect metachronous carcinogenesis after hepatectomy for hepatocellular carcinoma. A further report
Autore:
Yamanaka, N; Takada, M; Tanaka, T; Yamanaka, J; Yasui, C; Ando, T; Maeda, S; Matsushita, K; Okamoto, E;
Indirizzi:
Hyogo Coll Med, Dept Surg 1, Nishinomiya, Hyogo 6638501, Japan Hyogo Coll Med Nishinomiya Hyogo Japan 6638501 miya, Hyogo 6638501, Japan
Titolo Testata:
JOURNAL OF GASTROENTEROLOGY
fascicolo: 3, volume: 35, anno: 2000,
pagine: 206 - 213
SICI:
0944-1174(200003)35:3<206:VSACIA>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEPATITIS-C VIRUS; MULTIVARIATE-ANALYSIS; RISK-FACTORS; SCORING SYSTEM; DNA-SYNTHESIS; LIVER-CANCER; B VIRUS; CIRRHOSIS; MULTICENTRICITY; RECURRENCE;
Keywords:
hepatocellular carcinoma; hepatectomy; intrahepatic recurrence; metachronous carcinogenesis; viral serostatus; viral hepatitis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Yamanaka, N Hyogo Coll Med, Dept Surg 1, 1-1 Mukogawa Cho, Nishinomiya, Hyogo 6638501,Japan Hyogo Coll Med 1-1 Mukogawa Cho Nishinomiya Hyogo Japan 6638501
Citazione:
N. Yamanaka et al., "Viral serostatus and coexisting inflammatory activity affect metachronous carcinogenesis after hepatectomy for hepatocellular carcinoma. A further report", J GASTRO, 35(3), 2000, pp. 206-213

Abstract

Little data are available regarding the effects of hepatitis virus serostatus and the severity of coexisting chronic inflammation on intrahepatic recurrence after hepatectomy for hepatocellular carcinoma (HCC). We investigated the extent to which these factors modified the prognosis of hepatectomized patients. A total of 274 patients treated in the period January 1981 to December 1996 were divided into three groups: antihepatitis C-positive (HCV; n = 144), hepatitis B surface antigen-positive and HCV antibody (Ab)-negative (HBsAg; n = 106), and HBsAg-negative and HCV Ab-negative (NBNC; n = 20). Positivity for HBV-related antibody in the HCV group was 76%. Histologicgrading of inflammatory activity from coexisting hepatitis was determined according to Knodel's histological activity index (HAI) scoring system. Post-hepatectomy crude survival rates and disease-free survival (DFS) rates were compared, according to tumor characteristics, between the three groups. In the patients overall and also in the patients with a single nodular HCC,the HCV group had significantly higher HAI scores and preoperative serum aspartate aminotransaminase (AST) levels than the other two groups. When thepatients were limited to those with a single nodular HCC, the crude survival was similar in the three groups with comparable tumor characteristics; however, the DFS was different (NBNC > HBsAg > HCV). When the patients were further limited to those with a single nodular HCC without microscopic extracapsular spread, in whom removal of the tumor was expected to be microscopically complete, the difference in the DFS became more marked. Irrespectiveof the viral serostatus, better crude and disease-free survivals were observed in the patients with lower AST levels (less than or equal to 50 IU/1) than in those with higher AST levels (>50 IU/1). In contrast, there were nodifferences in survivals and HAI scores according to the presence or absence of HBV-related antibody in the HCV group. From our univariate analysis, we can conclude that the severity of virally induced inflammation, which was well correlated with viral serostatus, may be a factor that affects intrahepatic recurrence, which is more likely to originate from metachronous carcinogenesis. Prior co-infection of HBV in HCV patients may not be an adverse risk factor for intrahepatic recurrence.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 18:25:03