インターフェロン療法著効後6年目に肝細胞癌が認められたC型慢性肝炎の1切除例 : 本邦報告例も含めて

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A 60-year-old man diagnosed with chronic active hepatitis with hepatitis C virus infection was treated with interferon (IFN)-alpha. A successful response was obtained with normalization of serum alanine aminotransferase (ALT) and the disappearance of serum hepatitis C virus-ribonucleic acid (HCV-RNA). Serum ALT remained within normal levels and serum HCV-RNA was not detected during observation. Six years later, the level of serum PIVKA-II increased and hepatocellular carcinoma (HCC) was detected by CT examination. Partial hepatectomy of segment 4 was performed following transcatheter arterial embolization. Histological examination of the surgical specimen showed moderately differentiated HCC, and chronic hepatitis, bridging fibrosis with mild activity of necro-inflammatory reaction. These results suggest that even patients with chronic hepatitis C infection who show complete response to interferon therapy should be followed up at 3 to 6 month intervals associated with examinations for serum tumor markers and ultrasonographic screening for the potential development of HCC.