1.Occult Hepatitis B Virus Infection and Hepatocellular Carcinoma.
The Korean Journal of Gastroenterology 2013;62(3):160-164
Many studies have suggested that occult HBV infection has a substantial clinical relevance to hepatocellular carcinoma (HCC). Occult HBV infection is an important risk factor for the development of cirrhosis and HCC in patients without HBsAg. As a matter of fact, occult HBV infection is one of the most common causes of crytogenic HCC in endemic areas of HBV. However, there still are controversial issues about the association between occult HBV infection and HCC according to the underlying liver disease. In alcoholic cirrhosis, occult HBV infection may exert synergistic effect on the development of HCC. However, there is insufficient evidence to relate occult HBV infection to hepatocarcinogenesis in non-alcoholic fatty liver disease. In cryptogenic HCC, occult HBV infection may play a direct role in the development of HCC. In order to elucidate the assocciation between occult HBV infection and HCC, underlying liver disease must be specified and larger number of cases must be included in future studies.
Carcinoma, Hepatocellular/*complications/*diagnosis/epidemiology
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DNA, Viral/analysis
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Hepatitis/complications
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Hepatitis B/*complications/*diagnosis/epidemiology
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Hepatitis B virus/genetics
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Humans
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Liver Cirrhosis, Alcoholic/complications
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Liver Neoplasms/*complications/*diagnosis/epidemiology
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Risk Factors
2.Is the Prevalence of Cryptogenic Hepatocellular Carcinoma Increasing in Korea?.
Kil Chan OH ; Sang Hoon PARK ; Jin Cheol PARK ; Do Kyun JIN ; Chul Sung PARK ; Kyong Oh KIM ; Hyun Joo JANG ; Ja Young LEE ; Cheol Hee PARK ; Tai Hoo HAN ; Kyo Sang YOO ; Jong Hyeok KIM ; Dong Jun KIM ; Myung Seok LEE ; Choong Kee PARK
The Korean Journal of Gastroenterology 2005;45(1):45-51
BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) has been characterized by a wide spectrum of liver damages that span from steatosis to cryptogenic liver cirrhosis and even to hepatocellular carcinoma (HCC). The aims of this study were to determine whether the prevalence of HCC arising from cryptogenic cirrhosis has increased during the last ten years and to characterize the clinical features of cryptogenic HCC in Korea. METHODS: A retrospective and hospital-based analysis of the clinical data was done in 1,145 HCC patients; group A (Jan. 1993-Dec. 1995), group B (Jan. 2000-Dec. 2002). The etiologies of HCC with liver cirrhosis in group A and group B were analyzed. The risk factors of NAFLD such as obesity, type 2 diabetes mellitus, hypertriglyceridemia and hypertension between cryptogenic HCC and HCC with well-defined etiologies were compared. RESULTS: The major leading causes of HCC in each group were hepatitis B virus infection, followed by alcohol, hepatitis C virus and cryptogenic. There was a significant increase in the proportion of cryptogenic HCC in group B (A: 2.3%, B: 5.4%, p<0.05). In the case of HCV, it was 5.3% in group A and 9.9% in group B (p<0.05). Although the prevalence of cyptogenic HCC was significantly increased at an interval of seven years apart, there was no significant difference in the proportions of risk factors of NAFLD between cryptogenic HCC group and well-defined etiology group. CONCLUSIONS: The prevalence of cryptogenic HCC was significantly increased in Korea during the last decade. Although statistically insignifcant, there was a trend toward the higher proportion of risk factors with NAFLD in patients with cryptogenic HCC. This suggests that increased proportion of risk factors associated for NAFLD may have contributed to the development of cryptogenic HCC.
Aged
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Carcinoma, Hepatocellular/*epidemiology/etiology
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English Abstract
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Fatty Liver/complications
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Female
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Hepatitis B/complications
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Hepatitis C/complications
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Humans
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Incidence
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Korea/epidemiology
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Liver Diseases, Alcoholic/complications
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Liver Neoplasms/*epidemiology/etiology
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Male
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Middle Aged
3.A Comparative Cross-sectional Study of the Development of Hepatocellular Carcinoma in Patients with Liver Cirrhosis Caused by Hepatitis B Virus, Alcohol, or Combination of Hepatitis B Virus and Alcohol.
Nak So CHUNG ; Oh Sang KWON ; Cheul Hee PARK ; Young Nam KIM ; Gwon Hyun CHO ; Jong Jun LEE ; Gil Hyun KIM ; Hyun Ok KIM ; Kwang Il KO ; Sang Kyun YU ; Kwang An KWON ; Yun Soo KIM ; Duck Ju CHOI ; Ju Hyun KIM
The Korean Journal of Gastroenterology 2007;49(6):369-375
BACKGROUND/AIMS: Alcohol may be a cocarcinogen in patients with chronic viral hepatitis. We investigated the effect of alcohol on the development of hepatocellular carcinoma (HCC) in liver cirrhosis (LC) caused by hepatitis B virus (HBV). METHODS: All patients with LC or HCC associated with HBV or alcohol, admitted between March 2001 and June 2005, were included. Patients were divided into three groups according to the etiology of LC: Alcohol (AL), HBV, or HBV+alcohol (HBV+AL). Age and laboratory data at the enrollment of study were analyzed. The logistic regression coefficiency for the prevalence of HCC was calculated by using variables such as age, gender, serologic markers, and etiology of LC. RESULTS: In LC patients (n=342), the proportions of AL, HBV, and HBV+AL groups were 44%, 39%, and 17%, respectively. The proportions of HCC in AL, HBV and HBV+AL groups were 17%, 55%, and 76%, respectively. Age at the diagnosis of HCC was younger in HBV+AL than in AL group (p=0.036). In logistic regression analysis for the risk factor of HCC, odds ratio of age was 1.056 (p<0.001). Odds ratios of HBV and HBV+AL group comparing AL were 8.449 (p<0.001) and 17.609 (p<0.001), respectively. Therefore, old age and chronic alcohol intake in patients with HBsAg were the risk factors of HCC. CONCLUSIONS: Chronic alcohol intake may be an additive factor for the development of HCC in patient with LC caused by HBV. However, a prospective cohort study is needed to confirm these findings.
Adult
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Aged
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Carcinoma, Hepatocellular/*epidemiology/etiology
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Cross-Sectional Studies
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Female
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Hepatitis B, Chronic/*complications/epidemiology
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Hepatitis, Alcoholic/complications/epidemiology
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Humans
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Liver Cirrhosis/*complications/virology
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Liver Cirrhosis, Alcoholic/*complications/epidemiology/virology
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Liver Neoplasms/*epidemiology/etiology
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Male
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Middle Aged
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Odds Ratio
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Regression Analysis
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Retrospective Studies
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Risk Factors
4.The significance of anti-HBc and occult hepatitis B virus infection in the occurrence of hepatocellular carcinoma in patients with HBsAg and anti-HCV negative alcoholic cirrhosis.
Min Ju KIM ; Oh Sang KWON ; Nak So CHUNG ; Seo Young LEE ; Hyuk Sang JUNG ; Dong Kyun PARK ; Yang Suh KU ; Yu Kyung KIM ; Yun Soo KIM ; Ju Hyun KIM
The Korean Journal of Hepatology 2008;14(1):67-76
BACKGROUND/AIMS: Alcohol and the hepatitis B virus (HBV) exert synergistic effects in hepatocelluar carcinogenesis. We aimed to elucidate the clinical significance of the antibody to hepatitis B core antigen (anti-HBc) and occult HBV infection on the development of hepatocellular carcinoma (HCC) in patients with alcoholic liver cirrhosis (LC). METHODS: Patients with alcoholic LC alone (n=193) or combined with HCC (n=36), who did not have HBsAg or antibody to hepatitis C virus were enrolled. Clinical data and laboratory data including anti-HBc were investigated at enrollment. The polymerase chain reaction was applied to HBV DNA using sera of patients with HCC or LC after age and sex matching. RESULTS: Patients with HCC were older (60+/-11 years vs. 53+/-10 years, mean+/-SD, P<0.001), more likely to be male (100% vs. 89%, P=0.03), and had a higher positive rate of anti-HBc (91.2% vs. 77.3%, P=0.067), and a higher alcohol intake (739+/-448 kg vs. 603+/-409 kg, P=0.076) than those with LC. Age was the only significant risk factor for HCC revealed by multiple logistic regression analysis (odds ratio, 1.056; P=0.003). The positive rate of anti-HBc and alcohol intake did not differ in age- and sex-matched subjects between the LC (n=32) and HCC (n=31) groups. However, the detection rate of serum HBV DNA was higher in the HCC group (48.4%) than in the LC group (0%, P<0.001). CONCLUSIONS: Anti-HBc positivity is not a risk factor for HCC. However, occult HBV infection may be a risk factor for HCC in patients with alcoholic LC.
Adult
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Aged
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Antibodies, Viral/blood
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Carcinoma, Hepatocellular/diagnosis/epidemiology/*etiology
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DNA, Viral/analysis
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Female
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Hepatitis B/*complications/diagnosis
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Hepatitis B Core Antigens/*immunology
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Hepatitis B Surface Antigens/immunology
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Hepatitis B virus/genetics/immunology/isolation & purification
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Hepatitis C/complications/diagnosis
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Humans
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Liver Cirrhosis, Alcoholic/*complications/diagnosis/epidemiology
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Liver Neoplasms/diagnosis/epidemiology/*etiology
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Male
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Middle Aged
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Risk Factors
5.Type and cause of liver disease in Korea: single-center experience, 2005-2010.
Sang Soo LEE ; Young Sang BYOUN ; Sook Hyang JEONG ; Yeo Myung KIM ; Ho GIL ; Bo Young MIN ; Mun Hyuk SEONG ; Eun Sun JANG ; Jin Wook KIM
Clinical and Molecular Hepatology 2012;18(3):309-315
BACKGROUND/AIMS: The aim of this study was to describe the types and causes of liver disease in patients from a single community hospital in Korea between April 2005 and May 2010. METHODS: A cohort of patients who visited the liver clinic of the hospital during the aforementioned time period were consecutively enrolled (n=6,307). Consistent diagnostic criteria for each liver disease were set by a single, experienced hepatologist, and the diagnosis of all of the enrolled patients was confirmed by retrospective review of their medical records. RESULTS: Among the 6,307 patients, 528 (8.4%) were classified as acute hepatitis, 3,957 (62.7%) as chronic hepatitis, 767 (12.2%) as liver cirrhosis, 509 (8.1%) as primary liver cancer, and 546 (8.7%) as a benign liver mass or other diseases. The etiologies in the acute hepatitis group in decreasing order of prevalence were hepatitis A (44.3%), toxic hepatitis (32.4%), other hepatitis viruses (13.8%), and cryptogenic hepatitis (9.1%). In the chronic hepatitis group, 51.2% of cases were attributed to viral hepatitis, 33.3% to nonalcoholic fatty liver disease, and 13.0% to alcoholic liver disease (ALD). Of the cirrhoses, 73.4% were attributable to viral causes and 18.1% to alcohol. Of the hepatocellular carcinoma cases, 86.6% were attributed to viral hepatitis and 11.6% to ALD. Among the benign tumors, hemangioma comprised 52.2% and cystic liver disease comprised 33.7%. CONCLUSIONS: Knowledge of the current status of the type and cause of liver disease in Korea may be valuable as a basis for evaluating changing trends in liver disease in that country.
Acute Disease
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Adolescent
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Adult
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Aged
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Aged, 80 and over
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Alcohol Drinking/adverse effects
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Carcinoma, Hepatocellular/epidemiology/etiology/pathology
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Chronic Disease
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Cohort Studies
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Fatty Liver/epidemiology
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Female
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Hepatitis/epidemiology
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Hepatitis, Viral, Human/complications/epidemiology
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Humans
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Liver Cirrhosis/epidemiology/etiology
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Liver Diseases/*diagnosis/epidemiology
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Liver Diseases, Alcoholic/complications/epidemiology
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Liver Neoplasms/epidemiology/etiology/pathology
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Male
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Middle Aged
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Prevalence
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Republic of Korea/epidemiology
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Retrospective Studies
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Young Adult
6.Etiologies of liver cirrhosis and their relationships with glucose metabolism disorders in Shanghai.
Zheng-jie XU ; Yan ZHONG ; Jian-gao FAN
Chinese Journal of Hepatology 2009;17(6):470-471
Adult
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Aged
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Aged, 80 and over
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China
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epidemiology
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Diabetes Mellitus
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epidemiology
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etiology
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Fatty Liver
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complications
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Female
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Glucose Metabolism Disorders
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epidemiology
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etiology
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Hepatitis B, Chronic
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complications
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virology
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Hepatitis C
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complications
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virology
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Humans
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Liver
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metabolism
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pathology
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Liver Cirrhosis
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epidemiology
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etiology
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Liver Cirrhosis, Alcoholic
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epidemiology
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etiology
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Male
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Middle Aged
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Odds Ratio
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Retrospective Studies
7.Fasting Serum Glucose and Subsequent Liver Cancer Risk in a Korean Prospective Cohort.
Jin GWACK ; Seung Sik HWANG ; Kwang Pil KO ; Jae Kwan JUN ; Sue Kyung PARK ; Soung Hoon CHANG ; Hai Rim SHIN ; Keun Young YOO
Journal of Preventive Medicine and Public Health 2007;40(1):23-28
OBJECTIVES: Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort. METHODS: Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity. RESULTS: The RRs of serum glucose for liver caner were 1.20 (95% CI=0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI=1.24-6.18) for the >126 mg/dL serum glucose category (both compared to the <100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CI=1.09-18.28) for those with glucose levels >100 mg/dL. CONCLUSIONS: The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.
Risk Factors
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Proportional Hazards Models
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Middle Aged
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Male
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Liver Neoplasms/blood/*epidemiology/etiology
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Liver Cirrhosis, Alcoholic/*complications
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Korea/epidemiology
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Humans
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Hepatitis B virus/immunology
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Hepatitis B Surface Antigens/blood
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Hepatitis B/*complications
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Female
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Fasting
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Cohort Studies
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Blood Glucose/*analysis
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Alcohol Drinking/*adverse effects/epidemiology
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Aged
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Adult
9.Research on prognosis of liver cirrhosis patients with hepatitis B virus infection superimposed on alcoholic liver disease.
Guo-Qing XIANG ; Xiao-Dan MENG ; Xiao-Hu HE
Chinese Journal of Hepatology 2009;17(1):72-73
Adult
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Aged
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Aged, 80 and over
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Alcoholism
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Diabetes Mellitus
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epidemiology
;
etiology
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Female
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Hepatic Encephalopathy
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epidemiology
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etiology
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Hepatitis B
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complications
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pathology
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Hepatitis B virus
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Humans
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Liver Cirrhosis
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etiology
;
pathology
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Liver Cirrhosis, Alcoholic
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etiology
;
pathology
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Liver Function Tests
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Liver Neoplasms
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epidemiology
;
etiology
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Male
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Middle Aged
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Prognosis
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Retrospective Studies
10.The clinical characteristics of alcoholic patients with hepatitis virus infection.
Chinese Journal of Hepatology 2009;17(11):809-811
Alcohol Drinking
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adverse effects
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Hepatitis, Viral, Human
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complications
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diagnostic imaging
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pathology
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Hepatocytes
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pathology
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Humans
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Liver
;
diagnostic imaging
;
pathology
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Liver Cirrhosis, Alcoholic
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diagnostic imaging
;
etiology
;
pathology
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Liver Diseases, Alcoholic
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diagnostic imaging
;
etiology
;
pathology
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Liver Neoplasms
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epidemiology
;
etiology
;
pathology
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Prognosis
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Radiography
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Risk Factors