Koga H, Kai K, Aishima S, Kawaguchi A, Yamaji K, Ide T, Ueda J, Noshiro H. Occult hepatitis B virus infection and surgical outcomes in non-B, non-C patients with curative resection for hepatocellular carcinoma. World J Hepatol 2017; 9(35): 1286-1295 [PMID: 29290910 DOI: 10.4254/wjh.v9.i35.1286]
Corresponding Author of This Article
Dr. Keita Kai, MD, PhD, Associate Professor, Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga City, Saga 849-8501, Japan. kaikeit@cc.saga-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hiroki Koga, Koutaro Yamaji, Takao Ide, Junji Ueda, Hirokazu Noshiro, Department of Surgery, Saga University Faculty of Medicine, Saga 849-8501, Japan
Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan
Shinichi Aishima, Koutaro Yamaji, Department of Pathology and Microbiology, Saga University Faculty of Medicine, Saga 849-8501, Japan
Atsushi Kawaguchi, Center for Comprehensive Community Medicine, Saga University Faculty of Medicine, Saga 849-8501, Japan
Author contributions: Koga H is the main author of this article and performed the data correction and statistical analyzes; Kai K designed the study and conducted the data collection and contributed to the statistical analyses and the writing of the manuscript; Aishima S performed the pathological work and reviewed the manuscript; Kawaguchi A supervised the statistical analyses; Yamaji K, Ide T and Ueda J contributed to the data collection; Noshiro H contributed to the data collection and review the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study protocol was approved by the Ethics Committee of the Faculty of Medicine at Saga University.
Informed consent statement: Informed consent for the use of resected tissue and medical information was obtained from all patients.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Keita Kai, MD, PhD, Associate Professor, Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga City, Saga 849-8501, Japan. kaikeit@cc.saga-u.ac.jp
Telephone: +81-952-343264 Fax: +81-952-342055
Received: July 18, 2017 Peer-review started: July 20, 2017 First decision: September 7, 2017 Revised: September 19, 2017 Accepted: October 30, 2017 Article in press: October 30, 2017 Published online: December 18, 2017 Processing time: 141 Days and 18.2 Hours
Abstract
AIM
To investigate the prevalence, clinicopathological characteristics and surgical outcomes of occult hepatitis B virus (HBV) infection (OBI) in patients with non-B, non-C (NBNC) hepatocellular carcinoma (HCC).
METHODS
This study retrospectively examined the cases of 78 NBNC patients with curative resection for HCC for whom DNA could be extracted from formalin-fixed paraffin-embedded tissue. OBI was determined by the HBV-DNA amplification of at least two different sets of primers by TaqMan real-time polymerase chain reaction. Possibly carcinogenetic factors such as alcohol abuse, diabetes mellitus, obesity and non-alcoholic steatohepatitis (NASH) were examined. Surgical outcomes were evaluated according to disease-free survival (DFS), overall survival (OS) and disease-specific survival (DSS).
RESULTS
OBI was found in 27/78 patients (34.6%) with NBNC HCC. The OBI patients were significantly younger than the non-OBI cases at the time of surgery (average age 63.0 vs 68.1, P = 0.0334) and the OBI cases overlapped with other etiologies significantly more frequently compared to the non-OBI cases (P = 0.0057). OBI had no impact on the DFS, OS or DSS. Only tumor-related factors affected these surgical outcomes.
CONCLUSION
Our findings indicate that OBI had no impact on surgical outcomes. The surgical outcomes of NBNC HCC depend on early tumor detection; this reconfirms the importance of a periodic medical examination for individuals who have NBNC HCC risk factors.
Core tip: We analyzed the occult hepatitis B virus infection (OBI) status of 78 cases of non-B, non-C hepatocellular carcinoma (NBNC HCC). OBI was found in 27/78 patients (34.6%). The OBI patients were significantly younger than the non-OBI patients at the time of surgery, and the OBI cases were frequently overlapped with other etiologies. OBI had no impact on surgical outcomes. Only tumor-related factors affected the surgical outcomes. The surgical outcomes of NBNC HCC thus depend in part on the early detection of the tumor.
