Laparoscopic findings of reddish markings predict

liver411

<http://www.springerlink.com/content/0474237118555j43/>

Laparoscopic findings of reddish markings predict hepatocellular carcinoma in
patients with hepatitis B virus-related liver disease

Journal Journal of Gastroenterology
Publisher Springer Japan
ISSN 0944-1174 (Print) 1435-5922 (Online)
Category Original Article―Liver, Pancreas, and Biliary Tract
DOI 10.1007/s00535-010-0266-9
Subject Collection Medicine
SpringerLink Date Monday, June 14, 2010


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Original Article―Liver, Pancreas, and Biliary Tract
Laparoscopic findings of reddish markings predict hepatocellular carcinoma in
patients with hepatitis B virus-related liver disease

Bon Shoji1, Fusao Ikeda1, 2 , Shin-ichi Fujioka3, Haruhiko Kobashi1, Tetsuya
Yasunaka1, Yasuhiro Miyake1, 2, Hidenori Shiraha1, Akinobu Takaki1, Kazuhiro
Nouso1, 2, Yoshiaki Iwasaki1 and Kazuhide Yamamoto1, 2

(1)  Department of Gastroenterology and Hepatology, Okayama University
Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1,
Shikata-cho, Okayama 700-8558, Japan
(2)  Department of Molecular Hepatology, Okayama University Graduate School of
Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
(3)  Department of Internal Medicine, Okayama Saiseikai General Hospital,
Okayama, Japan

Received: 25 January 2010  Accepted: 18 May 2010  Published online: 12 June
2010


Abstract

Background
For patients with chronic hepatitis due to hepatitis B virus (HBV), factors
predicting hepatocellular carcinoma (HCC) other than high levels of HBV-DNA
and alanine aminotransferase (ALT) are needed to prevent HCC development, as
many patients with chronic HBV infection fulfill these conditions. The purpose
of this study was to clarify factors predictive of HCC development for those
patients.

Methods
The study was a systematic cohort analysis of 303 consecutive patients with
hepatitis B e-antigen, receiving laparoscopic examination for assessment of
liver disease. Laparoscopic, histological, and clinical characteristics were
investigated as related to HCC development.

Results
HCC occurred in 27 patients during a mean follow-up of 8.0 ± 5.0 years, at
the age of 37¨C72 years. Significant associations with HCC development were
shown for liver cirrhosis, histological activity grade, reddish markings, and
older age. Multivariate analysis revealed that HCC development was strongly
associated with older age and male gender (P = 0.002 and P = 0.043,
respectively). HCC occurred more frequently in patients of age ≥30 years
even with early stage than in patients of age <30 years (P = 0.031). Severe
reddish markings, a laparoscopic finding of widespread parenchymal
destruction, were highly associated with HCC development in patients of age
≥30 years at diagnosis (odds ratio = 1.67, P = 0.034), while histological
activity grade and ALT level were not (P = 0.075 and P = 0.69, respectively).

Conclusions
HCC development is associated with older age, male gender, and liver
cirrhosis. Reddish markings, rather than histological activity or ALT level,
can be useful to predict HCC for HBV patients of age ≥30 years.
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Fusao Ikeda
Email: [email protected]