Hepatocellular carcinoma in patients cured of chronic hepatitis C: Minimal steatosis
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Le résumé fourni par la source
Abstract Background Successful treatment of hepatitis C reduces liver inflammation and fibrosis; however, patients remain at risk of developing hepatocellular carcinoma (HCC). Aims To identify risk factors for new‐onset HCC in patients cured of hepatitis C. Methods Imaging, histological, and clinical data on patients whose first HCC was diagnosed >12 months of post‐SVR were analyzed. Histology of 20 nontumor tissues was analyzed in a blinded manner using the Knodel/Ishak/HAI system for necroinflammation and fibrosis/cirrhosis stage and the Brunt system for steatosis/steatohepatitis. Factors associated with post‐SVR HCC were identified by comparison with HALT‐C participants who did not develop post‐SVR HCC. Results Hepatocellular carcinoma was diagnosed in 54 patients (45 M/9F), a median of 6 years of post‐SVR [interquartile range (IQR) =1.4‐10y] at a median age of 61 years (IQR, 59–67). Approximately one‐third lacked cirrhosis, and only 11% had steatosis on imaging. The majority (60%) had no steatosis/steatohepatitis in histopathology. The median HAI score was 3 (1.25–4), indicating mild necroinflammation. In a multivariable logistic regression model, post‐SVR HCC was positively associated with non‐Caucasian race (p = 0.03), smoking (p = 0.03), age > 60 years at HCC diagnosis (p = 0.03), albumin<3.5 g/dL (p = 0.02), AST/ALT>1 (p = 0.05), and platelets <100 × 103 cells/μL (p < 0.001). Alpha fetoprotein ≥4.75 ng/mL had 90% specificity and 71% sensitivity for HCC occurrence. Noncirrhotic patients had larger tumors (p = 0.002) and a higher prevalence of vascular invasion (p = 0.016) than cirrhotic patients. Conclusions One‐third of patients with post‐SVR HCC did not have liver cirrhosis; most had no steatosis/steatohepatitis. Hepatocellular carcinomas were more advanced in noncirrhotic patients. Results support AFP as a promising marker of post‐SVR HCC risk.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Hepatocellular carcinoma in patients cured of chronic hepatitis C: Minimal steatosis
- Date Crossref
- 20/04/2023
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Icahn School of Medicine at Mount Sinai Division of Liver Diseases pays non établi dans la noticeUniversité ou école supérieure
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Dalhousie University Department of Pathology pays non établi dans la noticeUniversité ou école supérieure
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Tisch Hospital pays non établi dans la noticeÉtablissement de santé
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Danbury Hospital Division of Gastroenterology Department of Medicine pays non établi dans la noticeÉtablissement de santé
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Columbia University Department of Radiology pays non établi dans la noticeUniversité ou école supérieure
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University of Michigan Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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The University of Texas Southwestern Medical Center Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
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Department of Internal Medicine University of Texas Southwestern Medical Center Dallas Texas USA pays non établi dans la noticeUniversité ou école supérieure
Division of Liver Diseases — Icahn School of Medicine at Mount Sinai, Department of Pathology — Dalhousie University et Tisch Hospital, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.