Liver
Cell Dysplasia Predicts Development of Hepatocellular Carcinoma in Patients with
Chronic Hepatitis B In
the present study, described in the July 2008 Journal of Clinical Gastroenterology,
researchers from Taiwan aimed to determine whether the presence of large liver
cell dysplasia (LLCD) and/or small liver cell dysplasia (SLCD) in chronic hepatitis
B patients is a risk factor for HCC. As
background, they noted that a close relationship has been observed between HBV
infection and both type of liver cell dysplasia, or abnormal cell growth. SLCD
has been proposed as a putative precursor of HCC, but the significance of LLCD
is still controversial. In
this study, 181 chronic hepatitis B patients who underwent needle liver biopsy
were evaluated for the presence of LLCD and SLCD. The predictive value of LLCD
and SLCD for HCC development was assessed. Results
•
LLCD was present at initial biopsy in 82 patients (45%), while SLCD was present
in 17 (9%).
•
During a mean follow-up period of 115 months, a total of 19 cases of HCC were
diagnosed (incidence rate of 10%).
•
13 of these cases (76%) occurred in patients who had demonstrated LLCD, while
3 (17%) were in patients with SLCD at initial evaluation.
•
Patients with LLCD had a significantly higher cumulative probability of developing
HCC than those without LLCD (P = 0.016).
•
The risk of HCC development increased approximately 3-fold in the presence of
LLCD.
•
Positive and negative predictive values for LLCD were 15.9% and 94.9%, respectively.
•
By contrast, patients with SLCD showed no significant difference in cumulative
probability of developing HCC compared to those without SLCD (P > 0.05).
Based
on these findings, the study authors concluded, "LLCD in chronic hepatitis
B is considered to be one of the risk factors for HCC development and its presence
may help to identify a high-risk subgroup of patients requiring more intensive
screening for HCC."
Department
of Pathology, Brain Korea 21 Project for Medical Science; Institute of Gastroenterology,
Yonsei University College of Medicine, Seoul; Department of Pathology, Seoul National
University Bundang Hospital, Seongnam; Department of Internal Medicine, Yonsei
University College of Medicine, Seoul, Korea.
8/01/08 Reference
JS
Koo, H Kim, BK Park, and others. Predictive value of liver cell dysplasia for
development of hepatocellular carcinoma in patients with chronic hepatitis B.
Journal of Clinical Gastroenterology 42(6): 738-743. July 2008.
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Over
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