Comparison of the Clinicopathologic Features and Surgical Outcomes of Hepatocellular Carcinoma Related with Hepatitis B and C.
- Author:
Sang Beom KIM
1
;
Kyung Suk SUH
;
Min Ku LEE
;
Kwang Woong LEE
;
Kuhn Uk LEE
Author Information
1. Department of Surgery Seoul National University College of Medicine.
- Publication Type:Original Article
- Keywords:
hepatocellular carcinoma;
hepatitis C;
hepatitis B
- MeSH:
Alanine Transaminase;
Carcinoma, Hepatocellular*;
Disease-Free Survival;
Follow-Up Studies;
Hepacivirus;
Hepatitis B virus;
Hepatitis B*;
Hepatitis C;
Hepatitis Viruses;
Hepatitis*;
Humans;
Medical Records;
Prothrombin Time;
Recurrence;
Retrospective Studies;
Risk Factors;
Seoul;
Serum Albumin;
Survival Rate
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2000;4(2):61-66
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND AIM: Hepatitis B virus and hepatitis C virus were known as risk factors of hepatocellular carcinoma( HCC). Through past epidemiological and molecular biologic studies, the pathogenesis of HCC related with hepatitis viruses has been investigated. However the clinical features of the patients with HCC according to viral infections have not been established well. The aim of this study was to evaluate the clinical features and surgical outcomes in hepatocellular carcinoma related with hepatitis B and/or C. METHODS: We retrospectively reviewed the medical records of 411 patients who underwent the hepatic resections for hepatocellular carcinoma at Seoul National University Hospital between 1990 and 1997. We checked preoperative clinical features, preoperative laboratory tests, operative findings, postoperative pathologic reports, recurrences and survivals. According to the presence of hepatitis B surface antigen(HbsAg) and antibody of heptitis C virus(anti-HCV Ab), we divided into 4 groups: Non B C group(HbsAg(-) and anti-HCV Ab (-) n=61), B group (HBsAg (+) and anti-HCV Ab (-) n=275), C group(HBsAg (-) and anti-HCV Ab (+) n=62), B C group(HBsAg (+) and anti-HCV Ab (+) n=13). RESULTS: C group were older than B group (62.6+/-6.0 years vs. 50.5+/-9.3 years, p=0.005) and had poorer hepatic functions than B group; serum albumin level(3.52+/-0.32 g/dl vs. 3.69+/-0.40 g/dl, p=0.006), aspatate aminotransferase (108.50+/-114.36 IU/L vs. 59.63+/-60.80 IU/L, p=0.015), alanine aminotransferase (99.477+/- 7.82 IU/L vs. 65.59+/-86.39 IU/L, p=0.032), prothrombin time (83.2+/-16.4% vs. 91.3+/-14.4%, p=0.006), ICG R15 ( 18.83+/-9.02% vs. 9.19+/-7.98%, p=0.001). Pathologic results showed that C group has smaller sizes(3.5+/-2.6 cm vs. 4.6+/-3.0 cm, p<0.05), less encapsulated (68.2% vs. 80.9%, p=0.001), more multiple lesions(27.4% vs. 9.1%, p=0.001) than B group. The survival rate of B,C group was significantly lower than that of B group(5- year cumulative survival rate: 32.0% vs. 58.0%, p=0.029). Otherwise, there were no differences in recurrence rates, disease free survival rates and overall survival rates among four groups. CONCLUSION: The patients with anti-HCV Ab positive had poorer hepatic functions and older age than other patients. And the patients who had combined infections with hepatitis B and C had poorer outcome. More careful pre- and post- operative follow-up is needed in these patients.
