Patients with dysplastic nodules due to chronic hepatitis B infection were more likely to progress to hepatocellular carcinoma with higher HBV viral loads in a study presented at the International Liver Cancer Association Annual Conference in Washington, DC.
Researchers evaluated clinical, radiologic and laboratory data from 52 patients with intrahepatic dysplastic nodules (DN) resulting from chronic hepatitis B, between January 2003 and December 2012, with a median follow-up of 26 months. The mean age of the cohort (71% men) was 59.1 years. Patients had a mean of 1.78 ± 1.2 DNs, with a mean size of 1 ± 0.1 cm per nodule. DNs were detected and diagnosed via abdominal computed tomography.
DNs developed into hepatocellular carcinoma (HCC) in 55% of cases, within a mean of 26.4 after DN diagnosis. Cumulative rates of HCC progression were 9.8% at 1 year, 40% at 3 years and 64.1% at 3 years.
Patients had Child-Pugh-Turcotte (CTP) class A in 59.6% of cases, B in 26.9% and C in 13.5%. Cumulative HCC development rates according to CTP class were 9.7% at 1 year, 27.7% at 3 and 53.1% at 5 years for class A; 0%, 57.6% and 71.7% for class B, respectively; and 28.6%, 52.4% and 100% for class C, respectively. Investigators noted a trend toward more frequent HCC development among patients with decompensated liver cirrhosis, with no significant difference according to CTP class (P=.096).
A low HBV load, defined as fewer than 10,000 copies/mL, was observed in 38.5% of the cohort. These participants had cumulative HCC development rates of 0% at 1 year, 7.7% at 3 years and 26.2% at 5 years, compared with 16%, 54.3% and 88.4%, respectively, among those with higher HBV loads (P=.002 for difference). Only an HBV load above 10,000 copies/mL was independently associated with DN progression to HCC in multivariate analysis (OR=6.969; 95% CI, 1.614-30.084).
“Maintenance of an inactive carrier state might be essential to reduce the risk of progression into HCC in HBV-associated DNs,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
For more information:
Jeong SY. P-100: Risk Factors for Progression from Dysplastic Nodules to Overt Hepatocellular Carcinomas in Patients with Chronic Hepatitis B Infection: Long Term Follow-Up in Korea. Presented at: The International Liver Cancer Association Annual Conference 2013; Sept. 13-15, Washington, DC.