Severe Inflammation in the Background Liver Cirrhosis Correlates with the Development of Poorly Differentiated HCC in HCV-Associated Liver Cirrhosis
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概要
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Objective Whether severe inflammation in the background liver cirrhosis might correlate with the development of poorly differentiated human hepatocellular carcinoma (HCC) was studied in hepatitis C virus (HCV)-associated liver cirrhosis. Methods Out of 214 HCC patients who underwent curative hepatic resection, 148 patients were HCV-associated liver cirrhosis (LC) patients. Out of these 148, 31 patients with small solitary HCC nodule (diameter ≤3 cm) were included in this study. Inflammation in the background LC was evaluated by modified histology activity index (HAI). To evaluate the inflammation, piece meal necrosis, intra lobular cellular degeneration and focal necrosis, portal cellular inflammation (each 0-4) were estimated. In each case, the average HAI was calculated. The grade of malignancy of HCC was determined by World Health Organization (WHO) classification. Results The average HAI score in the cirrhotic portion in 17 patients with poorly differentiated HCC (5.21±1.15, mean ± standard deviation (SD)) was significantly larger than that in 14 patients without poorly differentiated HCC (4.05±0.83, p<0.005). The occurrence rate of HCC containing poorly differentiated HCC component in the patients whose HAI was more than 5.0 was 80.0% (12 out of 15), and was significantly higher compared with those in patients whose HAI was less than 5.0 (5 out of 16, 31.3%, p<0.025). In univariate and multivariate analyses for contribution to poorly differentiated HCC development, HAI was the only significant contributor (p=0.011, p=0.012 respectively). Conclusion It is suggested that severe inflammation in the background cirrhosis accelerates the promotion in the HCC development from HCV-associated LC.
著者
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Kobayashi Satoshi
Department of Aging Medicine and Geriatrics, Shinshu University, Graduate School of Medicine
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Yamamoto Naoto
Department Of Chemistry Faculty Of Engineering Science Osaka University
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Tamai Setsuo
Department Of Gastroenterology Kanagawa Cancer Center
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Kameda Yoichi
Department Of Pathology Kanagawa Cancer Center
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Miyakawa Kaoru
Department Of Gastroenterology Kanagawa Cancer Center
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Okudaira Masahiko
Department Of Pathology Faculty Of Medicine Kitazato University
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Ohkawa Shinichi
Department Of Gastroenterology Kanagawa Cancer Center
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Nakamura Yoshiyasu
Research Institute Kanagawa Cancer Center
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Morinaga Soichiro
Department Of Gastrointestinal Surgery Kanagawa Cancer Center
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Ueno Makoto
Department Of Applied Physics
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Kameda Yoichi
Department of Pathology, Kanagawa Cancer Center Hospital, Japan
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Kameda Ryou
Department of Gastroenterology, Kanagawa Cancer Center Hospital, Japan
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Ohkawa Shinichi
Department of Gastroenterology, Kanagawa Cancer Center Hospital, Japan
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Endo Yuichi
Tarao's Gastroenterological Clinic, Japan
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Tarao Kazuo
Tarao's Gastroenterological Clinic, Japan
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Miyagi Yohei
Research Institute, Kanagawa Cancer Center, Japan
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Oshige Kenji
Yokohama National University, Center for Health Service Sciences, Japan
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Tarao Kazuo
Tarao's Gastroenterological Clinic, Japan
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Tamai Setsuo
Department of Gastroenterology, Kanagawa Cancer Center Hospital, Japan
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Ueno Makoto
Department of Gastroenterology, Kanagawa Cancer Center Hospital, Japan
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