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Patients with ultrasonic coarse‐nodular cirrhosis who are anti‐hepatitis C virus‐positive are at high risk for hepatocellular carcinoma
Author(s) -
Tarao Kazuo,
Hoshino Hiroshi,
Shimizu Akio,
Ohkawa Shinichi,
Harada Masaoki,
Nakamura Yoshiyasu,
Ito Yoshihiko,
Tamai Setsuo,
Okamoto Naoyuki
Publication year - 1995
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19950315)75:6<1255::aid-cncr2820750607>3.0.co;2-q
Subject(s) - cirrhosis , hepatocellular carcinoma , bromodeoxyuridine , medicine , dna synthesis , hepatitis c virus , dna , thymidine , ultrasonography , ultrasound , gastroenterology , pathology , virus , immunohistochemistry , radiology , virology , biology , biochemistry
Background . The relationships between echosonographic patterns of patients with cirrhosis who are antihepatitis C virus (HCV)‐positive, the DNA synthesis of hepatocytes, and the risk for HCC were studied. Methods . Thirty‐eight patients with anti‐C‐100 antibody‐positive and Child's grade A posthepatitic cirrhosis were studied. DNA synthesis activity was measured by a bromodeoxyuridine (BrdU, a thymidine analogue)‐labeling index (LI), using the BrdU‐anti‐BrdU in vitro method, and the patients were followed prospectively by frequent liver ultrasonography for 3 years. The ultrasound patterns were classified into fine, coarse, and coarse‐nodular (CN) patterns, and the reproducibility of the classification in practical use also was confirmed. Results . Of the 21 patients with high DNA synthesizing cirrhosis (BrdU LI ⩾ 1.5%), 10 (48%) showed coarse‐nodular, 5 (24%) coarse, and 6 (29%) fine pattern in ultrasonography. Conversely, of the 17 patients with low DNA synthesizing LC (BrdU LI < 1.5%), only 1 (6%) showed coarse‐nodular, 2 (12%) coarse, and 14 (82%) fine pattern.A significant relationship was found between the two groups of BrdU LI and ultrasound imaging patterns [ P < 0.05). The incidence of CN pattern was significantly higher ( P < 0.01) in the high DNA synthesizing group than in low DNA synthesizing group. Of the 11 patients with CN pattern by ultrasound imaging, 10 (91%) were in the high DNA synthesizing group, and 9 (82%) developed HCC during the follow‐up period, compared with 3 of 7 (43%) with coarse, and only one of 20 (5%) with fine pattern developed HCC. The incidence of HCC was significantly higher ( P < 0.01) in patients with a CN cirrhosis pattern than in those with a fine pattern. Conclusions . In patients with cirrhosis who are anti‐HCV‐positive, the CN pattern by ultrasound imaging indicates increased DNA synthesis of hepatocytes and a high risk for developing HCC. Cancer 1995;75:1255‐62.