Abstract 394: Close association between subsided inflammation and the development of histologically less malignant HCC in HCV-associated LC

Abstract

Abstract Aim: We recently demonstrated that severe inflammation in the background cirrhotic tissue correlate with the development of histologically more malignant hepatocellular carcinoma (Edmondson III HCC) in HCV-associated liver cirrhosis (LC), and that histology activity index (HAI) was the only one significant contributor to the development of Edmondson III (Ed III) HCC in small nodular HCC. There is a possibility, in the contrary of this phenomenon, that subsided inflammation correlates with the development of histologically less malignant HCC (Ed I type HCC) and that long-term subsided inflammation correlates with the development of large Ed I HCC. We examined the possibility. Methods: Curative hepatic resection for HCC with LC was performed in 264 patients during the past 10 years in Kanagawa Cancer Center hospital. Of 264 patients 197 patients were anti-HCV-positive or HCV-RNA positive. Out of the 197 patients, 32 patients whose HCC revealed only one small HCC nodule (≤ 3 cm) were selected for this study. Furthermore, the cases whose HCC nodules were large (> 3 cm), but consisted of predominantly Ed I component, were also examined. For the evaluation of inflammation in the background LC, modified Knodell's histology activity index (HAI) was used. (for the evaluation of pure inflammation, items of fibrosis was omitted); piece meal necrosis (1-4), intra lobular cellular degeneration and focal necrosis (1-4), portal cellular inflammation (1-4), were estimated by two well experienced pathologist. In each case, the HAI score was estimated in five field and average HAI score was calculated. All the sections of resected HCC tissue was examined pathologically in all patients for determining the grade of malignancy according to Edmondson Steiner's classification; Ed I (well differentiated), Ed II (moderately diff.), Ed III (poorly diff.). Results: The average HAI score in 7 Ed I HCC patients was as low as 3.61 ± 0.70 (mean ± SD), and was significantly lower than that in 17 Ed III HCC patients (5.21 ± 1.15, P <0.001). Furthermore, the average HAI in the 5 cases whose HCC nodules were more than 3 cm and whose major component of HCC nodules were Ed I, was also as low as 3.55 ± 0.74. Conclusions: It is suggested that subsiding inflammation in the background non-cancerous cirrhotic portion might correlate with the development of histologically less malignant HCC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 394. doi:1538-7445.AM2012-394