Hepatitis C-associated hepatocellular carcinomas in non-cirrhotic livers

Matthew M. Yeh, Hubert Darius J. Daniel, Michael Torbenson

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Chronic hepatitis C viral infection can lead to cirrhosis and hepatocellular carcinoma. It is generally believed that hepatitis C infection is not oncogeneic per se, but that the presence of cirrhosis determines the increased risk for hepatocellular carcinoma. However, a search of surgical pathology files from two large tertiary care centers for the years 2001-2008 identified a total of 18 hepatocellular carcinomas in non-cirrhotic livers with chronic hepatitis C infection. In six cases the background livers showed bridging fibrosis, while the remainder showed lower stages of fibrosis. Cases were negative for clinical and serological evidence of hepatitis B co-infection, and occult hepatitis B test was negative by PCR of formalin-fixed, paraffin embedded tissues. The tumors were also negative for TP53, exon 7, codon 249 mutations, a characteristic mutation strongly linked to aflatoxin exposure. The hepatocellular carcinomas had typical histology with no enrichment for unusual growth patterns or histological features. Among all resected hepatocellular carcinomas in non-cirrhotic livers over this time period, the prevalence of 16% with HCV infection was significantly greater than that expected by chance. In conclusion, these results demonstrate that hepatocellular carcinomas can arise in livers chronically infected with hepatitis C but without cirrhosis. These findings raise the possibility that in some cases hepatitis C infection and inflammation can be directly oncogeneic. It is also possible that established cirrhosis may have regressed in some cases. Regardless of the mechanism, these findings highlight an important and previously under-recognized risk for hepatocellular carcinoma in HCV-infected individuals who do not have cirrhosis.

Original languageEnglish (US)
Pages (from-to)276-283
Number of pages8
JournalModern Pathology
Volume23
Issue number2
DOIs
StatePublished - Feb 1 2010
Externally publishedYes

Fingerprint

Hepatitis C
Hepatocellular Carcinoma
Fibrosis
Liver
Chronic Hepatitis C
Infection
Hepatitis B
Surgical Pathology
Mutation
Aflatoxins
Virus Diseases
Coinfection
Tertiary Care Centers
Codon
Paraffin
Formaldehyde
Exons
Histology
Inflammation
Polymerase Chain Reaction

Keywords

  • Hepatitis C virus
  • Hepatocellular carcinoma
  • Non-cirrhotic liver

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Hepatitis C-associated hepatocellular carcinomas in non-cirrhotic livers. / Yeh, Matthew M.; Daniel, Hubert Darius J.; Torbenson, Michael.

In: Modern Pathology, Vol. 23, No. 2, 01.02.2010, p. 276-283.

Research output: Contribution to journalArticle

Yeh, Matthew M. ; Daniel, Hubert Darius J. ; Torbenson, Michael. / Hepatitis C-associated hepatocellular carcinomas in non-cirrhotic livers. In: Modern Pathology. 2010 ; Vol. 23, No. 2. pp. 276-283.
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