Comparison of the pathological features among HBV, HCV, and nonviral etiology-related hepatocellular carcinoma using explanted whole liver examinations.

Abstract

245 Background: The aim of this study is to compare the pathological features among HBV, HCV and non-viral etiology related hepatocellular carcinoma (HCC) in the explanted cirrhotic liver using whole liver examinations. Methods: Ninety patients (HBV 23, HCV 53, HBV+HCV 3, nonBnonC 16) out of 246 recipients of liver transplantation were analyzed. All specimens were sectioned serially at 5-7 mm intervals and then were examined by an experienced pathologist. The pathological characteristics of HCC among each group were retrospectively analyzed using whole liver thin sliced histological examinations. Results: The median number and maximum size of HCC were one nodule (range 0-3 nodules), 22 mm (range 7-50 mm) by pre-operative imaging, and two nodules (range 0-37 nodules), 20 mm (range 4-50 mm) based on histological examinations. Twenty-six patients (27.4%) had more than 3 nodules measuring less than 1 cm diameter based on histological examinations. Fifteen patients (15.8%) had HCC with micro vascular invasion. Twenty-seven patients (28.4%) demonstrated findings beyond the Milan Criteria based on pathological examinations. NonBnonC related HCC tended to be within the Milan Criteria based on pathological examinations in contrast to viral related HCC (nonBnonC 12.5%, HBV 34.8% and HCV 39.6%). There were significantly more undetectable HCCs in HCV related HCC than in detectable HCCs by imaging. Conclusions: The undetectable HCCs in HCV tended to be found in the explanted liver. HCCs exceeding the rate of the Milan Criteria were less frequently found in non-viral related HCC than in viral related HCC.