TY - JOUR
T1 - Potential etiology, prevalence of cirrhosis, and mode of detection among patients with non-b non-c hepatocellular carcinoma in korea
AU - Kim, Jihye
AU - Kang, Wonseok
AU - Sinn, Dong Hyun
AU - Gwak, Geum Youn
AU - Paik, Yong Han
AU - Choi, Moon Seok
AU - Lee, Joon Hyeok
AU - Koh, Kwang Cheol
AU - Paik, Seung Woon
N1 - Publisher Copyright:
© 2020 The Korean Association of Internal Medicine.
PY - 2020
Y1 - 2020
N2 - Background/Aims: We systematically evaluated the clinical characteristics, prevalence of cirrhosis, and mode of detection in virus-unrelated (non-B non-C, NBNC) hepatocellular carcinoma (HCC) patients in Korea. Methods: A total of 447 consecutive treatment-naïve NBNC-HCC adult patients who were registered at the Samsung Medical Center HCC registry in Korea from 2010 to 2013 were analyzed. NBNC was def ined as negative hepatitis B surface antigen and negative anti-hepatitis C virus antibody. Presence of cirrhosis was determined based on histological, radiological, endoscopic, and serologic results. Mode of detection was classified as either under surveillance, incidental, or symptomatic. Results: Heavy alcohol use was the most common potential etiology in NBNC-HCC (NBNC-A, alcohol) ( 59.7%). Ten patients had other identif iable causes (NBNC-O, other identifiable cause) such as autoimmune hepatitis. The rest (38.0%) had no-identif iable cause (NBNC-NA-NO, non-alcohol, no-other identif iable cause). In NBNC-NA-NO group, 83.5% (96/115) of patients with available hepatitis B core immunoglobulin G antibody (HBcIgG) showed HBcIgG positivity, and 80.6% (137/170) had metabolic risk factors (diabetes, obesity, hypertension, and/ or dyslipidemia). Cirrhosis was present in 90.0%, 70.4%, and 60.0% of NBNC-O, NBNC-A, and NBNC-NA-NO patients, respectively. The proportion of patients diagnosed under surveillance was 25.5% across all patients, with specific proportions being 80.0%, 27.7%, and 18.8% for NBNC-O, NBNC-A, and NBNC-NA-NO, respectively. Conclusions: Among NBNC-HCC patients, heavy alcohol use or any other identifiable cause was not found in 38.0%. These NBNC-NA-NO HCC patients showed a high prevalence of HBcIgG positivity and metabolic risk factors, suggesting that prior hepatitis B virus infection and metabolic risk factors may be major contributing factors in the hepatocarcinogenesis in NBNC-NA-NO patients.
AB - Background/Aims: We systematically evaluated the clinical characteristics, prevalence of cirrhosis, and mode of detection in virus-unrelated (non-B non-C, NBNC) hepatocellular carcinoma (HCC) patients in Korea. Methods: A total of 447 consecutive treatment-naïve NBNC-HCC adult patients who were registered at the Samsung Medical Center HCC registry in Korea from 2010 to 2013 were analyzed. NBNC was def ined as negative hepatitis B surface antigen and negative anti-hepatitis C virus antibody. Presence of cirrhosis was determined based on histological, radiological, endoscopic, and serologic results. Mode of detection was classified as either under surveillance, incidental, or symptomatic. Results: Heavy alcohol use was the most common potential etiology in NBNC-HCC (NBNC-A, alcohol) ( 59.7%). Ten patients had other identif iable causes (NBNC-O, other identifiable cause) such as autoimmune hepatitis. The rest (38.0%) had no-identif iable cause (NBNC-NA-NO, non-alcohol, no-other identif iable cause). In NBNC-NA-NO group, 83.5% (96/115) of patients with available hepatitis B core immunoglobulin G antibody (HBcIgG) showed HBcIgG positivity, and 80.6% (137/170) had metabolic risk factors (diabetes, obesity, hypertension, and/ or dyslipidemia). Cirrhosis was present in 90.0%, 70.4%, and 60.0% of NBNC-O, NBNC-A, and NBNC-NA-NO patients, respectively. The proportion of patients diagnosed under surveillance was 25.5% across all patients, with specific proportions being 80.0%, 27.7%, and 18.8% for NBNC-O, NBNC-A, and NBNC-NA-NO, respectively. Conclusions: Among NBNC-HCC patients, heavy alcohol use or any other identifiable cause was not found in 38.0%. These NBNC-NA-NO HCC patients showed a high prevalence of HBcIgG positivity and metabolic risk factors, suggesting that prior hepatitis B virus infection and metabolic risk factors may be major contributing factors in the hepatocarcinogenesis in NBNC-NA-NO patients.
KW - Carcinoma
KW - Etiology
KW - Hepatocellular
KW - Liver cirrhosis
KW - Non-B non-C
UR - https://www.scopus.com/pages/publications/85077857955
U2 - 10.3904/kjim.2018.040
DO - 10.3904/kjim.2018.040
M3 - Article
C2 - 31189301
AN - SCOPUS:85077857955
SN - 1226-3303
VL - 35
SP - 65
EP - 78
JO - Korean Journal of Internal Medicine
JF - Korean Journal of Internal Medicine
IS - 1
ER -
