A clustered ground-glass hepatocyte pattern represents a new prognostic marker for the recurrence of hepatocellular carcinoma after surgery

Authors

  • Hung-Wen Tsai MD,

    1. Department of Pathology, National Cheng Kung University, Tainan, Taiwan
    2. Graduate Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Yih-Jyh Lin MD,

    1. Graduate Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
    2. Department of Surgery, National Cheng Kung University, Tainan, Taiwan
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    • The first 2 authors contributed equally to this article.

  • Pin-Wen Lin MD,

    1. Department of Surgery, National Cheng Kung University, Tainan, Taiwan
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  • Han-Chieh Wu MD, MS,

    1. Division of Infectious Diseases, National Health Research Institutes, Tainan, Taiwan
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  • Kai-Hsi Hsu MD,

    1. Graduate Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
    2. Department of Surgery, Tainan Hospital, Tainan, Taiwan
    3. Department of Health, Executive Yuan, Tainan, Taiwan
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  • Chia-Jui Yen MD,

    1. Graduate Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
    2. Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Shih-Huang Chan MD, PhD,

    1. Department of Statistics, National Cheng Kung University, Tainan, Taiwan
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  • Wenya Huang MD, PhD,

    1. Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Ih-Jen Su MD, PhD

    Corresponding author
    1. Department of Pathology, National Cheng Kung University, Tainan, Taiwan
    2. Division of Infectious Diseases, National Health Research Institutes, Tainan, Taiwan
    3. Center of Excellence for Signal Transduction, National Cheng Kung University, Tainan, Taiwan
    • Department of Pathology, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan 704, Taiwan
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    • Fax: (011) 886-6-2083466


  • We thank the technical assistance of Microbial Genomics Core of National Taiwan University Research Center for Medical Excellence Division of Genomic Medicine for the virus quantification (and genotyping).

Abstract

BACKGROUND:

The recurrence of hepatocellular carcinoma (HCC) after hepatectomy is a serious event. It has been demonstrated that different ground-glass hepatocyte (GGH) patterns harbor specific hepatitis B virus (HBV) pre-S deletion mutants and represent preneoplastic lesions in chronic HBV infection. In the current study, the authors investigated whether a specific GGH pattern in nontumorous liver tissues was associated with the recurrence of HBV-related HCC after surgery.

METHODS:

Clinicopathologic data from 82 patients with HBV-related HCC were reviewed. GGH patterns were assessed on hematoxylin and eosin-stained sections. Tissue hepatitis B surface antigen (HBsAg) expression was evaluated by immunohistochemical staining. Serum profiles of pre-S status, viral load, and HBV genotype were determined and correlated with clinical recurrence and survival after surgery.

RESULTS:

The results indicated that the clustered pattern of GGHs or HBsAg expression was associated significantly with decreased local recurrence-free survival (LRFS) during a mean follow-up of 46.4 months (P<.001). This biomarker was comparable to or better than the prognostic value of other parameters, such as multifocal tumors (P = .022), satellite nodules (P = .005), small cell dysplasia (P = .045), or elevated viral load (P = .027), to predict recurrent HCC. Multivariate analysis also revealed that type II GGHs, which expressed marginal HBsAg and consistently clustered in nodules, were independent variables associated with LRFS (P<.001) and overall survival (P = .003).

CONCLUSIONS:

The current results indicated that the assessment of GGH patterns or HBsAg expression in nontumorous liver tissues provides an easily recognized, new risk marker for the recurrence of HBV-related HCC after hepatic resection. Cancer 2011. © 2011 American Cancer Society.

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