Hepatocellular carcinoma without cirrhosis in the West: epidemiological factors and histopathology of the non-tumorous liver
Identifieur interne : 002228 ( Istex/Checkpoint ); précédent : 002227; suivant : 002229Hepatocellular carcinoma without cirrhosis in the West: epidemiological factors and histopathology of the non-tumorous liver
Auteurs : Véronique Grando-Lemaire [France] ; Catherine Guettier [France] ; Sylvie Chevret [France] ; Michel Beaugrand [France] ; Jean-Claude Trinchet [France]Source :
- Journal of Hepatology [ 0168-8278 ] ; 1999.
English descriptors
- Teeft :
- Abou rached, Activity score, Alcohol consumption, Alcohol intake, Alcoholic hepatitis, Alcoholic liver disease, Carcinoma, Carcinome hcpatocellulaire, Cedex, Cell dysplasia, Centre hospitalier, Chemical carcinogens, Chronic hepatitis, Chronic liver disease, Cigarette smoking, Cirrhosis, Cirrhotic, Cirrhotic liver, Clin gastroenterol, Dysplasia, Epidemiological factors, Genetic hemochromatosis, Hepatic fibrosis, Hepatitis, Hepatocellular, Hepatocellular carcinoma, Hepatology, High prevalence, Histological, Histological activity, Hopital, Hopital beaujon, Hopital guillaume, Hopital jean verdier, Hotel dieu, Inflammation, Iron overload, Large cell dysplasia, Liver, Liver carcinogenesis, Liver cell dysplasia, Nantes cedex, Noncirrhotic liver, Normal liver, Normal livers, Oral contraceptives, Other patients, Overload, Pathological changes, Pathological liver changes, Present study, Primary liver cancer, Risk factor, Risk factors, Serological, Serological hepatitis, Serological markers, Steatosis, Strasbourg cedex, Tobacco consumption, Viral infection.
Abstract
Abstract: Background/Aim: In the West, hepatocellular carcinoma rarely occurs in patients without cirrhosis. In these patients, epidemiological factors and the histopathology of the non-neoplastic liver are not well known. The aim of this study was to clarify these points. Methods: We studied 30 patients (26 men, 28–87 years) with hepatocellular carcinoma and histologically-proven non-cirrhotic livers. Serological markers of HBV and HCV infection, as well as alcohol and tobacco consumption were evaluated. Pathological changes in the non-tumorous liver (fibrosis, inflammation, steatosis, alcoholic hepatitis lesions, iron overload, and large cell dysplasia) were systematically assessed using semi-quantitative scores. Results: Twenty patients had alcohol intake ≥30 g/d and 16 were smokers. Serological HBV or HCV markers were positive in 10 patients. Only four patients had no exposure to alcohol or tobacco and no serological markers of HBV or HCV. Histological examination showed that all livers had pathological changes. Seventeen patients (57%) had clearly-identified chronic liver disease: chronic hepatitis (n=10) or alcoholic liver disease (n=7). Non-specific and moderate pathological changes were observed in the 13 other patients (43%), with different degrees of fibrosis, activity, steatosis, and iron overload. Large cell dysplasia was present in 12 patients (40%). Conclusions: In our study, all patients with hepatocellular carcinoma and non-cirrhotic livers had non-tumorous pathological liver changes, especially iron overload and large cell dysplasia. These results suggest that hepatocellular carcinoma originates from an abnormal histological background, even in non-cirrhotic liver.
Url:
DOI: 10.1016/S0168-8278(99)80044-0
Affiliations:
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<term>Epidemiological factors</term>
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<term>Hepatitis</term>
<term>Hepatocellular</term>
<term>Hepatocellular carcinoma</term>
<term>Hepatology</term>
<term>High prevalence</term>
<term>Histological</term>
<term>Histological activity</term>
<term>Hopital</term>
<term>Hopital beaujon</term>
<term>Hopital guillaume</term>
<term>Hopital jean verdier</term>
<term>Hotel dieu</term>
<term>Inflammation</term>
<term>Iron overload</term>
<term>Large cell dysplasia</term>
<term>Liver</term>
<term>Liver carcinogenesis</term>
<term>Liver cell dysplasia</term>
<term>Nantes cedex</term>
<term>Noncirrhotic liver</term>
<term>Normal liver</term>
<term>Normal livers</term>
<term>Oral contraceptives</term>
<term>Other patients</term>
<term>Overload</term>
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<term>Pathological liver changes</term>
<term>Present study</term>
<term>Primary liver cancer</term>
<term>Risk factor</term>
<term>Risk factors</term>
<term>Serological</term>
<term>Serological hepatitis</term>
<term>Serological markers</term>
<term>Steatosis</term>
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<front><div type="abstract" xml:lang="en">Abstract: Background/Aim: In the West, hepatocellular carcinoma rarely occurs in patients without cirrhosis. In these patients, epidemiological factors and the histopathology of the non-neoplastic liver are not well known. The aim of this study was to clarify these points. Methods: We studied 30 patients (26 men, 28–87 years) with hepatocellular carcinoma and histologically-proven non-cirrhotic livers. Serological markers of HBV and HCV infection, as well as alcohol and tobacco consumption were evaluated. Pathological changes in the non-tumorous liver (fibrosis, inflammation, steatosis, alcoholic hepatitis lesions, iron overload, and large cell dysplasia) were systematically assessed using semi-quantitative scores. Results: Twenty patients had alcohol intake ≥30 g/d and 16 were smokers. Serological HBV or HCV markers were positive in 10 patients. Only four patients had no exposure to alcohol or tobacco and no serological markers of HBV or HCV. Histological examination showed that all livers had pathological changes. Seventeen patients (57%) had clearly-identified chronic liver disease: chronic hepatitis (n=10) or alcoholic liver disease (n=7). Non-specific and moderate pathological changes were observed in the 13 other patients (43%), with different degrees of fibrosis, activity, steatosis, and iron overload. Large cell dysplasia was present in 12 patients (40%). Conclusions: In our study, all patients with hepatocellular carcinoma and non-cirrhotic livers had non-tumorous pathological liver changes, especially iron overload and large cell dysplasia. These results suggest that hepatocellular carcinoma originates from an abnormal histological background, even in non-cirrhotic liver.</div>
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