Time trends of clinical characteristics in hepatocellular carcinoma patients with chronic hepatitis B virus infection: A field survey between 2000 and 2012

Amano,Keisuke; Kawaguchi,Takumi; Kuromatsu,Ryoko; Kawaguchi,Atsushi; Miyajima,Ichiro; Ide,Tatsuya; Kakuma,Tatsuyuki; Sata,Michio

doi:10.3892/mco.2014.398

Time trends of clinical characteristics in hepatocellular carcinoma patients with chronic hepatitis B virus infection: A field survey between 2000 and 2012

Authors:
- Keisuke Amano
- Takumi Kawaguchi
- Ryoko Kuromatsu
- Atsushi Kawaguchi
- Ichiro Miyajima
- Tatsuya Ide
- Tatsuyuki Kakuma
- Michio Sata
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Affiliations: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan, Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto 606-8501, Japan, Biostatistics Center, Kurume University, Kurume, Fukuoka 830-0011, Japan
Published online on: August 21, 2014 https://doi.org/10.3892/mco.2014.398
Pages: 927-934

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Abstract

The hepatitis B virus (HBV) carrier rate has decreased in Japan; however, the incidence of HBV infection among hepatocellular carcinoma (HCC) patients has not decreased accordingly. In this study, we aimed to assess the time trends of the clinical characteristics in HCC patients with chronic HBV infection. Between 2000 and 2012, we enrolled a total of 156 HCC patients with chronic HBV infection in our field survey. The HCC risk was evaluated using the HCC prediction score, which is constructed from the characteristics of age, presence of liver cirrhosis and serum levels of albumin, bilirubin and HBV DNA. Lifestyle factors and the presence of diabetes mellitus were also evaluated. The time trends of patient characteristics were analyzed using the Jonckheere‑Terpstra proportion trend test. Among HCC patients with chronic HBV infection, the proportion of patients at high risk according to the HCC prediction score significantly decreased during the study period (P=0.0005). Similarly, the proportion of patients with liver cirrhosis, ≤3.5 g/dl serum albumin level, >4 log copies/ml serum HBV DNA level and ≥60 g/day alcohol intake were also significantly decreased. The proportion of male and obese patients was not significantly altered, whereas the proportion of elderly (≥65 years) and diabetic patients tended to increase during the study period (P=0.0654 and P=0.0528, respectively). In this study, we analyzed the time trends of the clinical characteristics in HCC patients with chronic HBV infection and demonstrated that aging and diabetes mellitus may be involved in the hepatocarcinogenesis in patients with chronic HBV infection.

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1	El-Serag HB: Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology. 142:1264–1273. e12612012. View Article : Google Scholar : PubMed/NCBI
2	Yoshikawa A, Suzuki K, Abe A, et al: Effect of selective vaccination on a decrease in the rate of hepatitis B virus-positive Japanese first-time blood donors. Transfus Med. 19:172–179. 2009. View Article : Google Scholar : PubMed/NCBI
3	Hosaka T, Suzuki F, Kobayashi M, et al: Long-term entecavir treatment reduces hepatocellular carcinoma incidence in patients with hepatitis B virus infection. Hepatology. 58:98–107. 2013. View Article : Google Scholar : PubMed/NCBI
4	Matsumoto A, Tanaka E, Rokuhara A, et al; Inuyama Hepatitis Study Group. Efficacy of lamivudine for preventing hepatocellular carcinoma in chronic hepatitis B: A multicenter retrospective study of 2795 patients. Hepatol Res. 32:173–184. 2005. View Article : Google Scholar : PubMed/NCBI
5	Taura N, Fukushima N, Yastuhashi H, et al: The incidence of hepatocellular carcinoma associated with hepatitis C infection decreased in Kyushu area. Med Sci Monit. 17:PH7–PH11. 2011. View Article : Google Scholar : PubMed/NCBI
6	McMahon BJ: The natural history of chronic hepatitis B virus infection. Hepatology. 49(Suppl 5): S45–S55. 2009. View Article : Google Scholar : PubMed/NCBI
7	Chen CJ, Yang HI, Su J, et al; REVEAL-HBV Study Group. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA. 295:65–73. 2006. View Article : Google Scholar : PubMed/NCBI
8	Kao JH, Chen PJ, Lai MY and Chen DS: Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B. Gastroenterology. 118:554–559. 2000. View Article : Google Scholar : PubMed/NCBI
9	Wong VW, Chan SL, Mo F, et al: Clinical scoring system to predict hepatocellular carcinoma in chronic hepatitis B carriers. J Clin Oncol. 28:1660–1665. 2010. View Article : Google Scholar : PubMed/NCBI
10	Wong GL and Wong VW: Risk prediction of hepatitis B virus-related hepatocellular carcinoma in the era of antiviral therapy. World J Gastroenterol. 19:6515–6522. 2013. View Article : Google Scholar : PubMed/NCBI
11	Purohit V, Rapaka R, Kwon OS and Song BJ: Roles of alcohol and tobacco exposure in the development of hepatocellular carcinoma. Life Sci. 92:3–9. 2013. View Article : Google Scholar : PubMed/NCBI
12	Farrell G: Insulin resistance, obesity and liver cancer. Clin Gastroenterol Hepatol. 12:117–119. 2014. View Article : Google Scholar
13	Kawaguchi T, Izumi N, Charlton MR and Sata M: Branched-chain amino acids as pharmacological nutrients in chronic liver disease. Hepatology. 54:1063–1070. 2011. View Article : Google Scholar : PubMed/NCBI
14	Kawaguchi T, Kakuma T, Yatsuhashi H, et al: Data mining reveals complex interactions of risk factors and clinical feature profiling associated with the staging of non-hepatitis B virus/non-hepatitis C virus-related hepatocellular carcinoma. Hepatol Res. 41:564–571. 2011. View Article : Google Scholar
15	Asahina Y, Tsuchiya K, Tamaki N, et al: Effect of aging on risk for hepatocellular carcinoma in chronic hepatitis C virus infection. Hepatology. 52:518–527. 2010. View Article : Google Scholar : PubMed/NCBI
16	Yamada S, Kawaguchi A, Kawaguchi T, et al: Serum albumin level is a notable profiling factor for non-B, non-C hepatitis virus-related hepatocellular carcinoma: A data-mining analysis. Hepatol Res. Jul 2–2013.(Epub ahead of print). View Article : Google Scholar
17	Kawaguchi T, Shiba N, Maeda T, et al: Hybrid training of voluntary and electrical muscle contractions reduces steatosis, insulin resistance, and IL-6 levels in patients with NAFLD: a pilot study. J Gastroenterol. 46:746–757. 2011. View Article : Google Scholar
18	Kudo M, Izumi N, Kokudo N, et al; HCC Expert Panel of Japan Society of Hepatology. Management of hepatocellular carcinoma in Japan: Consensus-Based Clinical Practice Guidelines proposed by the Japan Society of Hepatology (JSH) 2010 updated version. Dig Dis. 29:339–364. 2011. View Article : Google Scholar
19	Kawaguchi T, Ide T, Taniguchi E, et al: Clearance of HCV improves insulin resistance, beta-cell function, and hepatic expression of insulin receptor substrate 1 and 2. Am J Gastroenterol. 102:570–576. 2007. View Article : Google Scholar : PubMed/NCBI
20	Wai CT, Greenson JK, Fontana RJ, et al: A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 38:518–526. 2003. View Article : Google Scholar : PubMed/NCBI
21	Seino Y, Nanjo K, Tajima N, et al: Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. Diabetol Int. 1:2–20. 2010. View Article : Google Scholar : PubMed/NCBI
22	Nakajima T, Nakashima T, Yamaoka J, et al: Greater age and hepatocellular aging are independent risk factors for hepatocellular carcinoma arising from non-B non-C non-alcoholic chronic liver disease. Pathol Int. 61:572–576. 2011. View Article : Google Scholar : PubMed/NCBI
23	Plentz RR, Schlegelberger B, Flemming P, et al: Telomere shortening correlates with increasing aneuploidy of chromosome 8 in human hepatocellular carcinoma. Hepatology. 42:522–526. 2005. View Article : Google Scholar : PubMed/NCBI
24	Plentz RR, Park YN, Lechel A, et al: Telomere shortening and inactivation of cell cycle checkpoints characterize human hepatocarcinogenesis. Hepatology. 45:968–976. 2007. View Article : Google Scholar : PubMed/NCBI
25	Wang Y, Cheng J, Xu C, et al: Quantitative methylation analysis reveals gender and age differences in p16INK4a hypermethylation in hepatitis B virus-related hepatocellular carcinoma. Liver Int. 32:420–428. 2012.PubMed/NCBI
26	Chen CT, Chen JY, Wang JH, et al: Diabetes mellitus, metabolic syndrome and obesity are not significant risk factors for hepatocellular carcinoma in an HBV- and HCV-endemic area of Southern Taiwan. Kaohsiung J Med Sci. 29:451–459. 2013. View Article : Google Scholar : PubMed/NCBI
27	Gao C, Zhao HC, Li JT and Yao SK: Diabetes mellitus and hepatocellular carcinoma: comparison of Chinese patients with and without HBV-related cirrhosis. World J Gastroenterol. 16:4467–4475. 2010. View Article : Google Scholar : PubMed/NCBI
28	Chen CL, Yang HI, Yang WS, et al: Metabolic factors and risk of hepatocellular carcinoma by chronic hepatitis B/C infection: a follow-up study in Taiwan. Gastroenterology. 135:111–121. 2008. View Article : Google Scholar : PubMed/NCBI
29	Hotta N, Nakamura J, Iwamoto Y, Ohno Y, Kasuga M, Kikkawa R and Toyota T: Causes of death in Japanese diabetics: A questionnaire survey of 18,385 diabetics over a 10-year period. J Diabetes Investig. 1:66–76. 2010.PubMed/NCBI
30	Eslam M, Aparcero R, Kawaguchi T, Del Campo JA, Sata M, Khattab MA and Romero-Gomez M: Meta-analysis: insulin resistance and sustained virological response in hepatitis C. Aliment Pharmacol Ther. 34:297–305. 2011. View Article : Google Scholar : PubMed/NCBI
31	Kawaguchi T, Yoshida T, Harada M, et al: Hepatitis C virus down-regulates insulin receptor substrates 1 and 2 through up-regulation of suppressor of cytokine signaling 3. Am J Pathol. 165:1499–1508. 2004. View Article : Google Scholar : PubMed/NCBI
32	Calle EE and Kaaks R: Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 4:579–591. 2004. View Article : Google Scholar : PubMed/NCBI
33	Kobayashi M, Hosaka T, Ikeda K, et al: Highly sensitive AFP-L3% assay is useful for predicting recurrence of hepatocellular carcinoma after curative treatment pre- and postoperatively. Hepatol Res. 41:1036–1045. 2011.
34	Inoue T, Kudo M, Komuta M, et al: Assessment of Gd-EOB-DTPA-enhanced MRI for HCC and dysplastic nodules and comparison of detection sensitivity versus MDCT. J Gastroenterol. 47:1036–1047. 2012. View Article : Google Scholar : PubMed/NCBI
35	Koga H, Ide T, Oho K, et al: Lamivudine treatment-related morphological changes of esophageal varices in patients with liver cirrhosis. Hepatol Res. 37:503–509. 2007. View Article : Google Scholar : PubMed/NCBI
36	Chang TT, Liaw YF, Wu SS, et al: Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B. Hepatology. 52:886–893. 2010. View Article : Google Scholar
37	Tateishi R, Shiina S, Teratani T, et al: Percutaneous radiofrequency ablation for hepatocellular carcinoma. An analysis of 1000 cases. Cancer. 103:1201–1209. 2005.PubMed/NCBI
38	Ando E, Kuromatsu R, Tanaka M, et al: Surveillance program for early detection of hepatocellular carcinoma in Japan: results of specialized department of liver disease. J Clin Gastroenterol. 40:942–948. 2006. View Article : Google Scholar : PubMed/NCBI
39	Nakano M, Ando E, Kuromatsu R, et al: Recent progress in the management of hepatocellular carcinoma detected during a surveillance program in Japan. Hepatol Res. 40:989–996. 2010. View Article : Google Scholar