Liver Cirrhosis Hepatocellular Carcinoma Research Articles

The impact of high body mass index on hepatocellular carcinoma in viral hepatitis and cirrhosis.

10537 Background: The impact of a high body mass index (BMI) on hepatocellular carcinoma (HCC) has been unclear in patients with viral hepatitis and liver cirrhosis (LC). Our aim is to investigate the association between BMI and HCC in patients with viral hepatitis and LC. Methods: We conducted a population-based cohort study. In total, 156,143 Korean adults who underwent routine health examinations during 2003-2006 were followed up until December 2019 via linkage to the national hospital discharge records. Multivariable-adjusted hazard ratios (HRs) per each 5 kg/m2 increase in BMI for HCC risk were calculated using Cox proportional hazard models. Results: BMI was positively associated with HCC in hepatitis B virus (HBV) patients with BMI range of 27.5~29.9 kg/m² and BMI ≥30 kg/m² and LC patients with a BMI range of 27.5~29.9 kg/m². Assuming linear associations, HRs were 1.17 for HBV, 1.08 for hepatitis C virus (HCV), and 1.11 for LC. In the subgroup analysis for the LC, the HR were 1.19 in the HBV-LC, 1.38 in the HCV-LC, 1.36 in the alcoholic LC, and 1.59 in the fatty liver LC. Women showed stronger positive associations between BMI and HCC than men in the HBV (HR, 1.45 vs 1.06) and LC (1.27 vs. 1.02). The positive association seemed to be stronger in younger age ( < 65 years) in HBV (1.17 vs 1.05) and HCV (1.33 vs 0.77) patients compared to older age ( > 65 years). Conclusions: In the BMI range of ≥25 kg/m2, a higher BMI was associated with an increased risk of HCC in LC and HBV. The associations between BMI and HCC risk are different according to liver disease, sex and age.

THU579 - LiMAx faciliates patient selection prior radioembolization for patients with hepatocellular carcinoma in liver cirrhosis

THU579 - LiMAx faciliates patient selection prior radioembolization for patients with hepatocellular carcinoma in liver cirrhosis

Focal liver lesions in cirrhosis: Role of contrast-enhanced ultrasonography.

Contrast-enhanced ultrasound (CEUS) represents a great innovation for the evaluation of focal liver lesions (FLLs). The main advantage of CEUS is the real-time imaging examination and the very low toxicity in patients with renal failure. Liver cirrhosis has been recognized as a major risk factor for the onset of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). HCC in liver cirrhosis develops as the last step of a complex that leads to the gradual transformation from regenerative nodule through dysplastic nodule to HCC. In patients with liver cirrhosis, a surveillance program is recommended consisting of ultrasound (US) for detecting small focal lesions. A wide spectrum of benign and malignant lesions other than HCC may be found in the cirrhotic liver and their differentiation is important to avoid errors in staging diseases that may preclude potentially curative therapies. Several published studies have explored the value of CEUS in liver cirrhosis and they have been shown to have excellent diagnostic and prognostic performances for the evaluation of non-invasive and efficient diagnosis of FLLs in patients at high risk for liver malignancies. The purpose of this article is to describe and discuss CEUS imaging findings of FLLs including HCC and ICC, all of which occur in cirrhotic livers with varying prevalence.

Experimental Validation of Novel Glypican 3 Exosomes for the Detection of Hepatocellular Carcinoma in Liver Cirrhosis.

Background and AimsHepatocellular carcinoma (HCC) developing in the context of preexisting cirrhosis is characterized by impaired autophagy that results in increased exosome release. This study was conducted to determine whether circulating exosomes expressing glypican 3 (GPC3) could be utilized as a biomarker for HCC detection and treatment response in patients with cirrhosis.MethodsImmunohistochemistry was performed to assess p62 and GPC3 expression in the lesion and adjacent tissue from cirrhosis with HCC. GPC3-enriched exosomes were captured by an enzyme-linked immunosorbent assay (ELISA). The diagnostic specificity of serum exosome-derived GPC3 (eGPC3) was determined using samples obtained from malignancy-free controls, malignancy-free cirrhotics, cirrhotics with confirmed HCC, and patients with a non-HCC malignancy. The performance of eGPC3 was validated using serum samples of HCC patients received chemotherapy.ResultsWe found that the expression of p62 and GPC3 was significantly increased in HCC tissues compared to adjacent cirrhotic liver. Impaired autophagy and exosome shedding were confirmed in HCC cell lines. Mass spectroscopic analysis revealed that GPC3 was enriched in exosomes isolated from HCC cell lines. An affinity ELISA assay was developed that specifically captures GPC3 positive exosomes in the serum. Total exosome concentration and eGPC3 were significantly elevated in cirrhotic patients with HCC as compared to the reference control groups. Furthermore, decreases in post-treatment exosome concentration and eGPC3 levels were more closely correlated with response to locoregional chemotherapy compared to change in serum AFP in HCC patients awaiting liver transplantation.ConclusionWe developed an affinity exosome capture assay to detect GPC3 enriched exosomes. Our preliminary assessment shows that GPC3 positive exosomes can be used for HCC detection and prediction of treatment outcomes.

Risk and outcome of hepatocellular carcinoma in liver cirrhosis in Southern Sweden: a population-based study

Background and aims: Liver cirrhosis is a risk factor for hepatocellular carcinoma (HCC). While the HCC risk is thought to be highest in hepatitis B and hepatitis C, the risk in other cirrhosis etiologies is not fully established. Therefore, we aimed to study the risk and outcome of HCC in alcoholic cirrhosis compared to cirrhosis of other etiologies, in Sweden.Material and methods: We used population-based medical registries to identify patients diagnosed with cirrhosis in the Scania region in southern Sweden between 2001 and 2010. Medical records were reviewed to identify all HCC cases and to register clinical parameters. All patients were followed until death, emigration or December 2017.Results: The cohort comprised 1317 patients with cirrhosis. A total of 200 patient developed HCC, including 75 with prevalent HCC. The annual incidence of HCC after six months was 1.5% in alcoholic cirrhosis and 4.7% in hepatitis C cirrhosis. In alcoholic cirrhosis, 40 patients were diagnosed with HCC during follow-up, of which 15 patients fulfilled the Milan criteria and 10 received treatment, curative or palliative. The overall median survival after HCC diagnosis was 7.7 months, with 4.5, 11 and 9.3 months, in cirrhosis due to alcohol, hepatitis C or remaining causes, respectively.Conclusion: We find an annual incidence of HCC in alcoholic cirrhosis of 1.5% indicating need for surveillance in these patients. Survival after HCC diagnosis was worst in alcoholic cirrhosis due to more advanced stage at diagnosis with few patients eligible for treatment.

Comparison of pre-S1/S2 variations of hepatitis B virus between asymptomatic carriers and cirrhotic/hepatocellular carcinoma-affected individuals.

Aim of the studyHost and viral factors can influence the clinical course of chronic hepatitis B virus (HBV) infection. Mutations in pre-S1/S2 gene regions are among the most important viral factors determining the HBV infection outcome. The aim of this study was to investigate the role of pre-S1/S2 mutations in HBV infection outcome.Material and methodsA total of 52 samples from 26 asymptomatic carriers (ASCs) and 26 liver cirrhosis/hepatocellular carcinoma (LC/HCC) patients were enrolled. The HBV DNA genome was extracted from the sera, and pre-S1/S2 regions of the samples were amplified by nested-polymerase chain reaction, prior to being subjected to sequencing, sequence investigation and phylogenetic analysis.ResultsCertain deletions were detected mostly located at the boundary of the pre-S1 and pre-S2 regions. These deletions were detected more frequently in ASC cases than in LC/HCC patients (p < 0.007). The rate of critical point mutations, including L11Q, N37S and K38R, was significantly higher in the ASC group, whereas the A49V substitution rate was significantly higher in the LC/HCC group (p < 0.05). The phylogenetic analysis indicated that all the sequences belonged to genotype D.ConclusionsAccording to the results, point mutations such as L11Q, N37S, K38R and A49V, as well as certain deletions, may be associated with HBV infection outcome, among an HBV genotype D pure population.

Gut Dysbiosis Associated With Hepatitis C Virus Infection.

Little is known about the effect of hepatitis C virus (HCV) infection on gut microbiota and the relationship between alteration of gut microbiota and chronic hepatitis C (CHC) progression. We performed a comparative study of gut microbiota composition between CHC patients and healthy individuals. Fecal samples from 166 CHC patients were compared with those from 23 healthy individuals; the gut microbiota community was analyzed using 16S ribosomal RNA gene sequencing. CHC patients were diagnosed with persistently normal serum alanine aminotransferase without evidence of liver cirrhosis (LC) (PNALT, n = 18), chronic hepatitis (CH, n = 84), LC (n = 40), and hepatocellular carcinoma in LC (n = 24). Compared with healthy individuals, bacterial diversity was lower in persons with HCV infection, with a decrease in the order Clostridiales and an increase in Streptococcus and Lactobacillus. Microbiota dysbiosis already appeared in the PNALT stage with the transient increase in Bacteroides and Enterobacteriaceae. Predicted metagenomics of microbial communities showed an increase in the urease gene mainly encoded by viridans streptococci during CHC progression, consistent with a significantly higher fecal pH in CH and LC patients than in healthy individuals or those in the PNALT stage. HCV infection is associated with gut dysbiosis, even in patients with mild liver disease. Additionally, overgrowth of viridans streptococci can account for hyperammonemia in CH and LC. Further studies would help to propose a novel treatment strategy because the gut microbiome can be therapeutically altered, potentially reducing the complications of chronic liver disease.

A case of the cirrhotic patient performed living donor liver transplantation after carbon-ion radiotherapy for hepatocellular carcinoma

The patient was a 50-year-old female with an initial diagnosis of a single hepatocellular carcinoma in liver cirrhosis. The tumor was located in the posterior liver segment (S7) and measured 5cm with a rapid growth rate and portal invasion. The pre-treatment Child-Pugh (C-P) was grade A (six points). The total prescribed dose of carbon-ion radiotherapy (C-ion RT) was 60Gy (relative biological effectiveness) given in 4 fractions. Thereafter, tumor shrinkage and rapid decrease of the serum alpha-fetoprotein level were observed. At 1-year follow-up a new lesion was diagnosed in the left lobe and the underlying liver failure had worsened to C-P grade B (eight points). Thus, she was recommended to undergo living-donor liver transplantation (LDLT). The postoperative course was uneventful. At pathological examination, no viable tumor cells in the region treated with C-ion RT were detected. At the time of the last follow-up, the patient was in overall good general condition with no signs of tumor recurrence.

Contrast-enhanced ultrasound features of hepatocellular carcinoma not detected during the screening procedure

Aim The aim of this retrospective study is to report on the characteristics of contrast-enhanced ultrasound (CEUS) of primarily not detected hepatocellular carcinoma (HCC) during the screening procedure of patients at risk. Methods Sixty-four patients with a finally solitary and histologically proven HCC not detected HCC during the screening procedure were retrospectively analyzed. Most of HCC lesions (90.6 %, 58/64) measured < 20 mm in diameter. All HCC lesions were not detected during the initial screening procedure but suspected using contrast-enhanced magnetic resonance imaging. The final gold standard was biopsy or surgery with histological examination. Results On CEUS, 62/64 (96.8 %) of HCC were characterized as an obviously hyperenhanced lesion in arterial phase, and 41/64 (64.1 %) of HCC were characterized as hypoenhancing lesions in the portal venous and late phases. During the arterial phase of CEUS, 96.8 % of HCC displayed homogeneous hyperenhancement. Knowing the CEUS and magnetic resonance imaging findings, 45/64 (70.3 %) could have been detected using B-mode ultrasound (BMUS). Conclusion BMUS as a screening procedure is generally accepted. Contrast-enhanced imaging modalities have improved detection and characterization of HCC. Homogeneous hyperenhancement during the arterial phase and mild washout are indicative for HCC in liver cirrhosis.

Significance of serum angiogenin assay as a novel marker for diagnosis of hepatocellular carcinoma in liver cirrhosis

Significance of serum angiogenin assay as a novel marker for diagnosis of hepatocellular carcinoma in liver cirrhosis

Long-term lamivudine for chronic hepatitis B and cirrhosis: A real-life cohort study.

To investigate clinical outcomes of chronic hepatitis B (CHB) and liver cirrhosis (LC) patients under whole-course management with lamivudine (LAM). This was a retrospective-prospective cohort study based on two nonrandom cohorts of Chinese patients (LAM group and history control group). Two hundred thirty-eight patients with LAM treatment for at least 12 mo under whole-course management were included in the LAM group. The management measures included regular follow-up and timely adjustment of the therapeutic regimen according to drug-resistance and relapse. Two hundred thirty-eight patients with CHB or LC without any antiviral treatment and with follow-up over 12 mo were included in the history control group. The LAM and control group patients were 1:1 matched by propensity score method to ensure both patients were similar in general datum, sex, age, E antigen, and diagnosis. The incidence rates of endpoint events [LC, hepatocellular carcinoma (HCC), and death] were compared between the LAM and control groups. Hepatitis B virus-DNA < 1000 copies per mL rate and rate of alanine transaminase < 1.3 of the upper normal limit in LAM and control groups were 89.1% vs 18.5% (P < 0.05) and 89.8% vs 31.1% (P < 0.05), respectively. Viral breakthrough occurred in 77 patients (32.4%); the one-, three-, and five-year cumulative rates were 6.8%, 33.1%, and 41.3%, respectively. In total, 44.5% (106/238) of patients had once stopped LAM, and 63 (59.4%) of them developed virologic relapse; the relapse rate of patients with and without reaching Asian Pacific Association for the Study of the Liver endpoint criteria were 52.4% and 69.8%, respectively. Six CHB patients in the LAM group developed LC compared to 47 patients in the control group; the three-, and five-year cumulative rates of CHB at baseline of LAM were lower than those of the control group: 0.7% vs 12.0% and 1.8% vs 23.8% (P < 0.01), respectively. The incidence of HCC in CHB at baseline of LAM was lower than that of the control group; the three-, and five-year cumulative rates were 0% vs 3.2% and 1.1% vs 3.2% (P = 0.05), respectively. The incidence of HCC in LC at baseline of LAM was lower than that of the control group: 9.8% (5/51) vs 25.0% (12/48), and the three-, and five-year cumulative rates were 4.5% vs 20.7% and 8.1% vs 37.5% (P < 0.01), respectively. The mortality rate in the LAM group was lower than the control group. Standardized long-term LAM treatment in combination with comprehensive management can reduce the incidence rates of LC and HCC as well as hepatitis B virus-related deaths.

Comparison of the Accuracy of DWI and Ultrasonography in Screening Hepatocellular Carcinoma in Patients With Chronic Liver Disease.

Background:Hepatocellular carcinoma (HCC) is a neoplasm usually arising in a cirrhotic liver by a multistep carcinogenesis process. Early detection of HCC and accurate assessment of tumor burden are crucial to successful treatment planning and long-term survival.Objectives:In this study, we compared the accuracy of diffusion weighted imaging (DWI) combined with limited sequence magnetic resonance imaging (MRI) set as a potentially quick and practical MR candidate with ultrasonography (US) for screening of HCC in patients with cirrhosis.Patients and Methods:Of 96 patients with cirrhosis, 30 who had concomitant HCC proved by pathology were selected. MRI, DWI, and US of the liver were performed for the patients. Sensitivity, specificity, and accuracy of DWI alone, limited sequences MRI alone, a combination of them, and US were calculated for the detection of HCC in these patients and then comparison between these modalities was performed.Results:Combination of limited sequences MRI and DWI had the highest accuracy (94.79%) followed by DWI alone followed by limited sequence MRI alone. The least accuracy was for US (78.12%) with a statistically significant difference.Conclusion:Due to the significant improvement in the treatment of early stage of HCC compared to the previous decade, we suggest a fast, non-invasive, more accurate, but more expensive method (HASTE, OP/IP T1W sequences MRI combined with DWI) rather than US for the screening of HCC in liver cirrhosis.

Characterization and prognosis of patients with hepatocellular carcinoma (HCC) in the non-cirrhotic liver

BackgroundHCC predominantly develops in the condition of chronic inflammation that has led to liver cirrhosis. A small proportion of patients with HCC is diagnosed in the non-cirrhotic liver (NCL). Data on patients with HCC in NCL in advanced stages are scarce.MethodsA retrospective analysis was performed comparing 93 patients with HCC in NCL to 571 patients with HCC in liver cirrhosis (LC) with respect to clinical and demographic characteristics. Also factors influencing survival in patients with HCC in NCL were analyzed.ResultsPatients with HCC in NCL were diagnosed at older age and in more advanced tumor stages than patients with LC. More than 25% of patients with HCC in NCL presented with extrahepatic metastases. Only a minority of patients with HCC in NCL lacked any sign of hepatic damage. Risk factors for LC and risk factors for NAFLD are present in the majority of patients with HCC in NCL. The BCLC classification corresponded with the survival of patients with HCC in NCL although the therapeutic options differ from those for patients with liver cirrhosis.ConclusionsIt will be one of the major challenges in the future to awake awareness of carrying a risk of hepatic malignancies in patients with chronic liver diseases apart from liver cirrhosis, especially in NAFLD. Surveillance programs need to be implemented if these are cost-effective.

Real-time ultrasound contrast quantitative comparison study of regenerative nodules and small hepatocellular carcinoma in liver cirrhosis

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound(CEUS) in regenerative nodules(RNs)and small hepatocellular carcinoma(sHCC).Methods Thirty-four cases of liver cirrhosis with small nodule were examined by CEUS.Among these cases,18 cases with 20 lesions were diagnosed s HCC,16 cases with 18 lesions were diagnosed RN eventually,all the diagnoses were confirmed by pathology.Perfusion characteristic and quantitative difference of RNs and sHCC were summarized.Results ①The majority of sHCC showed hyper-enhancement during the arterial phase,iso-enhancement or hypo-enhancement during the portal phase,hypo-enhancement during the late phase.The enhanced phase and degree of RNs were diverse,most of RNs showed iso enhancement during the three phases.The enhanced phase of two groups had significant difference(P ＜0.05).②The enhancement type of RNs and sHCC had no significant difference (P ＞ 0.05).③ 11 of 20 sHCC lesions showed contrast-enhancement pattern of fast-in and slow-out,9 lesions were fast-in and fast-out;among 18 RNs,1 lesion enhanced during the portal phase and the late phase,it didn't enhanced during the arterial phase,3 lesions started to enhanced at the late arterial phase,14 lesions were iso-enhancement during the three phases.④Comparison of parameters of RNs and the adjacent liver parenchyma had no significant difference(P ＞0.05).Compared with the adjacent liver parenchyma or RNs,the arrival time and peak time were shorter,the peak intensity and the curve sharpness were higher in sHCC (P ＜ 0.05).Conclusions CEUS is a useful method to distinguish RNs and sHCC in liver cirrhosis. Key words: Ultrasonography ; Microbubbles ; Carcinoma, hepatocellular; Regenerative nodule

Role of Laparoscopy in Changing the Management of Hepatocellular Carcinoma

Background: Laparoscopic approach offers the advantages of intra-operative laparoscopic ultrasonography (IOLUS), which provides better resolution of the number and location of liver tumors, and liver condition. In recent years the progress of laparoscopic procedures and the development of new and dedicated technologies have made laparoscopic hepatic surgery feasible and safe. The aim of this study is to present the results of our experience in laparoscopic management of Hepatocellular carcinoma (HCC) in cirrhotic patients. Patients and methods: Between September 2010 and January 2013, Four hundred patients with HCC in liver cirrhosis were referred from HCC clinic at National Hepatology and Tropical Medicine Research Institute (NHTMRI). 65 patients were submitted to diagnostic laparoscopy. 33 patients had Laparoscopic Radiofrequency Ablation with IOLUS guidance and 14 patients had laparoscopic non-anatomical resection while 18 patients had been converted to open laparotomy. Operation time, hospital stay, post-procedure complications were recorded. Spiral CT scan one month postoperative was mandatory during follow up. Results: Laparoscopic management was completed in 47 patients. The IOLUS examination identified new HCC in three patients. A total of 50 lesions were treated laparoscopically. The mean operative time was 120 ± 50 minutes; eight procedures were associated in six patients: cholecystectomy (6) and adhesiolysis (2). A complete tumor ablation was observed in treated patients by LRFA which were documented via spiral computed tomography (CT scan) one month after treatment. In resection group, histopathology was confirmed that, all tumor resection were with safety margin. Conclusion: Laparoscopic procedure proved to have a role in changing the management of HCC either by resection or by LRFA. Laparoscopy proved to be a safe and effective technique.

Laparoscopic Radiofrequency Thermal Ablation of Hepatocellular Carcinoma in Liver Cirrhosis Patients.

BackgroundLaparoscopic radiofrequency ablation (LRFA) for hepatocellular carcinoma (HCC) under guidance of intra-operative laparoscopic ultrasound (IOLUS) aiming of obtaining additional information for liver situation, better tumor staging and effective treatment of hepatic focal lesion (HFL) in patients with a difficult percutaneous approach.MethodsBetween September 2010 and July 2012, 301 patients with HCC in liver cirrhosis were referred from HCC clinic at National Hepatology and Tropical Medicine Research Institute (NHTMRI). Twenty nine patients were submitted to LRFA with IOLUS guidance. Operation time, hospital stay, post procedure complication were recorded. Spiral CT scan one month postoperative was mandatory during follow up.ResultsLRFA was completed in all patients. The IOLUS examination identified new HFL in three patients. A total of 32 lesions were treated. The mean operative time was 120 minutes; eight procedures were associated in six patients: cholecystectomy (6) and adhesiolysis (2). A complete tumor ablation was observed in all patients which were documented via spiral computed tomography (CT scan) one month after treatment.ConclusionLRFA of HCC proved to be a safe and effective technique. IOLUS is superior on spiral CT scan in detection a small HCC.

Grading of hypervascular hepatocellular carcinoma using late phase of contrast enhanced sonography—A prospective study

Background Outcome of patients with hepatocellular carcinoma is influenced by their histological grade. Invasive biopsy of the lesions is the gold standard in this regard. Aims We therefore analysed the diagnostic accuracy of contrast enhanced ultrasound for non-invasive grading of hypervascular hepatocellular carcinoma in liver cirrhosis. Methods According to the tumour perfusion kinetics on contrast enhanced ultrasound two grading groups were prospectively defined: well-differentiated hepatocellular carcinoma (US-G1) and higher grade hepatocellular carcinoma (US-G2/G3). Immediately after contrast enhanced ultrasound-grading, biopsies of hepatocellular carcinoma-lesions ( n = 95, 1.2–12.5 cm) were obtained and analysed for tumour grading (G). Descriptive statistics, sensitivity, specificity positive and negative predictive values, diagnostic likelihood ratios and interoperator reproducibility were calculated ( κ). Results Histologically 77 (81.1%) patients had G2–G3 and 18 (18.9%) had G1 tumours. Higher grade hepatocellular carcinoma showed more often a washout in the portal or late phase ( p < 0.0001). The sensitivity, specificity, positive predictive values and negative predictive values of contrast enhanced ultrasound for grading of hepatocellular carcinoma for all patients were 94% (CI: 72–99%), 95% (CI: 88–99%), 81% and 99% and for patients with tumours < 5 cm 100%(95% CI: 79–100), 96% (95% CI: 80–99), 92% and 100%. Positive and negative diagnostic likelihood ratios’ were 18 and 26 and 0.06 and 0, respectively. κ = 0.941 ( p < 0.001). Conclusions Contrast enhanced ultrasound has a high diagnostic value and reproducibility for non-invasive grading of hypervascular hepatocellular carcinoma >1 cm in patients with liver cirrhosis.

Exploration of the effect and regulatory mechanism of hepatitis B virus on the expression of apolipoprotein B

Objective To explore the effect of hepatitis B virus（HBV） on the expression of apolipoprotein B（ApoB） and its regulatory mechanism. Methods mRNA and protein expression of ApoB in HepG2 and HepG2.2.15 cells was measured by RT-PCR and Western blot, serum ApoB levels in patients with HBV infection and in healthy individuals were measured by biochemical analyzer Olympus 5400, the expression of ApoB difference among healthy individuals, patients with chronic hepatitis B, liver cirrhosis, and hepatocellular carcinoma were analyzed, HBV infectious clone pHBV1.3 was tranfected into HepG2 cells,and expression of ApoB and microsomal triglyceride transfer protein（MTP） was measured by RT-PCR and Western blot. Results Expression of ApoB mRNA and protein was lower in HepG2.2.15 cells than in HepG2 cells, serum apoB levels was much lower in patients with chronic hepatitis B and liver cirrhosis as compared to healthy individuals（ P 〈0.05 ）, HBV could inhibit the expression of ApoB and MTP at mRNA and protein levels. Conclusion HBV may downregulate the synthesis and secretion of ApoB via inhibits the expression of MTP. Key words: Hepatitis B virus Apolipoprotein B Microsomal triglyceride transfer protein Liver cirrhosis Hepatocellular carcinoma

Sorafenib therapy in patients with advanced hepatocellular carcinoma in liver cirrhosis: a single center experience

Sorafenib therapy in patients with advanced hepatocellular carcinoma in liver cirrhosis: a single center experience

No association of EGF 5'UTR variant A61G and hepatocellular carcinoma in Chinese patients with chronic hepatitis B virus infection

Epidermal growth factor (EGF) has many biological functions, including mitogenesis, tumorigenesis, and proliferation of epidermal tissues. Previous studies have reported that the EGF +61 (A/G) single nucleotide polymorphism in the 5'-untranslated region of the EGF gene is functional, and is associated with development of hepatocellular carcinoma (HCC) in liver cirrhosis and various malignancy. Our aim was to investigate whether EGF gene A61G polymorphism could be implicated in susceptibility to and/or clinicopathological characteristics of HCC in Chinese patients with chronic hepatitis B virus (HBV) infection. This polymorphism was studied in 387 patients with chronic HBV infection and in 208 healthy volunteers using restriction fragment-length polymorphism. The patients were divided into two groups: those without (n = 172) and those with HCC (n = 215). These 215 HCC patients with chronic HBV infection were designated as cases, and the remaining 172 patients without HCC served as controls. There were no significant differences in EGF genotype or allelic frequencies between cases and controls nor was EGF genotype or allelic frequencies associated with tumour number, size, growth phase, stage, and invasiveness. We also found ethnic heterogeneity in the functional EGF polymorphism. The present results show that although EGF gene A61G polymorphism is associated with development of HCC in liver cirrhosis, it is not sufficient for HCC in Chinese patients with chronic HBV infection.