E-poster Presentation 2014 World Cancer Congress

Rapidly changing causal factors of hepatocellular carcinoma (HCC) in Japan (#824)

Hiroaki Kanda 1 , Noriko Yamamoto 1 , Akio Saiura 2 , Yo Kato 1 , Yuichi Ishikawa 1 , Tomoyuki Kitagawa 1
  1. Department of Pathology, the Cancer Institute of Japanese Foundation for Cancer Research(JFCR), Tokyo, Japan
  2. Department of Surgery, the Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan

Background: Previously, about 70% of HCCs in Japan developed on the basis of hepatitis C virus (HCV) infection. However, the establishment of HCV screening system for blood transfusion resulted in a remarkable decrease of the chronic HCV hepatitis followed by a general reduction of HCV-related HCCs. The problem we now have is that we are observing not only a distinct increment of non-B non-C (NBNC) HCCs, not only proportionally but also absolutely.  

Aim: To clarify the causal background of NBNC HCCs.

Methods: A total of 348 patients surgically treated for a HCC at C.I.H. from 2005 to 2014 were examined in terms of serological virus markers and clinicopathological features.

Results: Viral status: 81 hepatitis B virus(HBV),  137 HCV, 3 Double infection, 126 NBNC, 1 others. HCV(including double infection)/NBNC ratio were 1.43(43/30) and 0.59(26/44) for 2005- 2007 and 2012- 2014, respectively (p<0.05).  

M/F ratio were 6.4(109/17) for NBNC and 2.5(100/40) for HCV, respectively (p<0.05).

Since metabolic disorder(MD)is thought to be an important cause of NBNC HCCs,  NBNC patients were divided into MD+ and MD- groups. MD was defined as positive therapeutic history for any of following diseases; alcoholic liver disease, diabetes mellitus(DM), hypertension(HT), cardiovascular disease and/or hyperlipidemia and/or obesity (BMI>25).

Of 113 MD+ NBNC patients, 102 were male with average age(aa) of 68.5 and 11 were female with aa of 71.1. Of 13 MD- patients, 7 male with aa of 63.7 and 6 female with aa of 56.3. Thus, most of NBNC HCC patients suffered MD. MD+ patients were older and male predominant in comparison with MD- (both p<0.05).

Among MD, DM(54) and HT(50) were most frequent(including double).

 Conclusions: While HCV-related HCCs are rapidly and remarkably decreasing in recent years, MD appears to have become a quite important causal factor of HCC and thus a target of HCC prevention in Japan.