TY - JOUR
T1 - Type II ground-glass hepatocytes as a marker of hepatocellular carcinoma in chronic hepatitis B
AU - Mathai, Alka Mary
AU - Alexander, Jacob
AU - Kuo, Fang Ying
AU - Torbenson, Michael
AU - Swanson, Paul E.
AU - Yeh, Matthew M.
PY - 2013/8
Y1 - 2013/8
N2 - Ground-glass hepatocytes are seen in chronic hepatitis B virus (HBV) infection and are known to harbor pre-S mutants, which are implicated in the pathogenesis of hepatocellular carcinoma (HCC). However, the association between ground-glass hepatocytes and HCC has yet to be clearly elucidated. The aim in the present study was to investigate the association of ground-glass hepatocytes with (1) the histologic characteristics of HBV-related HCC and (2) the grade of inflammation, stage of fibrosis, serologic markers of HBV infection, HBV viral load, and α-fetoprotein levels. We evaluated 45 hepatectomy specimens from chronic HBV-infected patients: 25 with HCC and 20 without. In comparison with those without HCC, cases with HCC had a significantly higher prevalence of type II ground-glass hepatocytes (84% versus 55%, P =.0488), demonstrating a geographically clustered pattern (84% versus 45%, P =.0102) and exceeding type I in the individual samples (84% versus 35%, P =.0005). Type II ground-glass hepatocytes also had a statistically significant association with higher stages of fibrosis, being present in 21 cases (66%) with Ishak fibrosis stages 3 to 6 as compared with only 4 cases (31%) without type II ground-glass hepatocytes (P =.0176). In conclusion, type II ground-glass hepatocytes are more likely to be present in cases of HCC, growing in a clustered pattern, and are also associated with advanced fibrosis in chronic HBV infection. Our data suggest that a growth advantage or clonal proliferation of hepatocytes with mutant hepatitis B surface antigen may play a role in the pathogenesis of HBV-related HCC with clinical relevance.
AB - Ground-glass hepatocytes are seen in chronic hepatitis B virus (HBV) infection and are known to harbor pre-S mutants, which are implicated in the pathogenesis of hepatocellular carcinoma (HCC). However, the association between ground-glass hepatocytes and HCC has yet to be clearly elucidated. The aim in the present study was to investigate the association of ground-glass hepatocytes with (1) the histologic characteristics of HBV-related HCC and (2) the grade of inflammation, stage of fibrosis, serologic markers of HBV infection, HBV viral load, and α-fetoprotein levels. We evaluated 45 hepatectomy specimens from chronic HBV-infected patients: 25 with HCC and 20 without. In comparison with those without HCC, cases with HCC had a significantly higher prevalence of type II ground-glass hepatocytes (84% versus 55%, P =.0488), demonstrating a geographically clustered pattern (84% versus 45%, P =.0102) and exceeding type I in the individual samples (84% versus 35%, P =.0005). Type II ground-glass hepatocytes also had a statistically significant association with higher stages of fibrosis, being present in 21 cases (66%) with Ishak fibrosis stages 3 to 6 as compared with only 4 cases (31%) without type II ground-glass hepatocytes (P =.0176). In conclusion, type II ground-glass hepatocytes are more likely to be present in cases of HCC, growing in a clustered pattern, and are also associated with advanced fibrosis in chronic HBV infection. Our data suggest that a growth advantage or clonal proliferation of hepatocytes with mutant hepatitis B surface antigen may play a role in the pathogenesis of HBV-related HCC with clinical relevance.
KW - Ground-glass hepatocytes
KW - Hepatitis B surface antigen
KW - Hepatitis B virus infection
KW - Hepatocellular carcinoma
KW - Histopathology
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U2 - 10.1016/j.humpath.2013.01.020
DO - 10.1016/j.humpath.2013.01.020
M3 - Article
C2 - 23574780
AN - SCOPUS:84880330401
SN - 0046-8177
VL - 44
SP - 1665
EP - 1671
JO - Human Pathology
JF - Human Pathology
IS - 8
ER -