BOSTON — Ki-67 immunohistochemical staining may predict the risk for developing noncirrhotic hepatocellular carcinoma in patients with HCV, according to data published at the Liver Meeting 2012.
Researchers compared 26 patients with noncirrhotic hepatocellular carcinoma (HCC) and no HBV infection with four control groups, including 10 patients with cirrhosis with HCC, 10 patients with cirrhosis without HCC, 10 HCV-positive patients with fibrosis less than stage 3 and no HCC, and 11 patients with normal liver. Hematoxylin and eosin (H&E) stains of the background liver were evaluated, with mean inflammation, fibrosis and steatosis grades of 1 each measured for the study cohort. Investigators also performed Ki-67 immunohistochemistry to assess liver proliferation.
“HCC arising in the absence of underlying cirrhosis or HBV infection is increasingly recognized, particularly in HCV-infected persons,” the researchers wrote. “We performed a case-control study to evaluate clinical and histologic characteristics associated with noncirrhotic HCC.”
Background inflammation was significantly lower within the study group compared with patients with cirrhosis and HCC (P<.01), while steatosis also was less frequent (P=.06). Noncirrhotic patients with HCC also were less likely to be obese or frequently consume alcohol (P<.01).
Hypertension and hyperlidemia were more common in the study group than among HCV-positive, noncirrhotic patients with no HCC (P<.01), but investigators noted no significant differences between the groups in routine histology.
Obesity (P=.04), steatosis (P=.04) and diabetes (P<.01) were more common in the study group than among patients with normal liver. Hypertension also was more frequent in the study group, with the difference approaching statistical significance (P=.06).
With the exception of normal liver patients, Ki-67 staining results were not significantly different between the control and study groups, with P values ranging from .45 to .98. Researchers noted increased Ki-67 staining in the background liver among HCV-positive patients within the study group compared with HCV-positive, noncirrhotic patients with no HCC (P=.04).
“It remains to be more established in a larger prospective study, but this study generates a hypothesis that performing Ki-67 staining on liver biopsies for patients with hepatitis C may help to predict those patients at risk for liver cancer in the absence of cirrhosis,” researcher Barry Schlansky, MD, a transplant hepatology fellow at Oregon Health and Science University in Portland, told Healio.com. “It may be possible to target surveillance for liver cancer in patients with HCV without cirrhosis based on increased proliferation in the background liver on biopsy.”
Disclosure: Researcher Atif Zaman received grants/research support from Zymogenetics, Genentech and Vertex, and has provided speaking and teaching services for Genentech, Salix, Gilead Sciences, Bristol-Meyers Squibb, Vertex and Merck.
For more information:
Schlansky B. #557: Hepatocellular Proliferation and Metabolic Syndrome Risk Factors are Increased in Non-Cirrhotic Hepatocellular Carcinoma: A Case-Control Study. Presented at: the Liver Meeting 2012; Nov. 9-13, Boston.