Meshwork pattern is an important risk factor for development of hepatocellular carcinoma in patients with HBV-related chronic hepatitis and cirrhosis

Abstract

We analyzed the importance of ‘meshwork pattern’, a sign representing severe irregularity on the intra-hepatic echogram, in hepatitis B virus (HBV)-related chronic hepatitis and cirrhosis, as a risk factor for development of hepatocellular carcinoma (HCC). Two hundred and thirty-one patients (143 men and 88 women) with HBV-related chronic hepatitis and cirrhosis who visited our hospital from January 1993 to December 1994 were enrolled in this study. Since enrollment, abdominal ultrasonography had in principle been performed every 3 months for cirrhotic patients and every 4–6 months for patients with chronic hepatitis for HCC screening. Cumulative HCC incidences in patient groups positive or negative for meshwork pattern were calculated by the Kaplan–Meier method. The incidence of HCC was significantly higher in the group positive for meshwork pattern (average incidence per year: 4.4%) than in the group negative for it (average incidence per year: 0.5%) ( P<0.0001, Mantel–Cox test). On regression analysis with Cox's proportional hazards model, sex, α-fetoprotein and meshwork pattern were selected as independent risk factors for HCC. In conclusion, meshwork pattern appears to be an ultrasonographic sign useful for detecting a latent risk factor for HCC in patients with HBV-related chronic hepatitis and cirrhosis.