Occult hepatitis B virus infection and surgical outcomes in non-B, non-C patients with curative resection for hepatocellular carcinoma

doi:10.4254/wjh.v9.i35.1286

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World Journal of Hepatology

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World J Hepatol. Dec 18, 2017; 9(35): 1286-1295
Published online Dec 18, 2017. doi: 10.4254/wjh.v9.i35.1286

Occult hepatitis B virus infection and surgical outcomes in non-B, non-C patients with curative resection for hepatocellular carcinoma

Hirokazu Noshiro, Junji Ueda, Takao Ide, Koutaro Yamaji, Atsushi Kawaguchi, Shinichi Aishima, Keita Kai, Hiroki Koga

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.

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.

Keywords: Hepatocellular carcinoma; Non-B non-C; Occult hepatitis B virus infection; Surgery; Surgical outcome

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.