ABSTRACT
We evaluated overall survivals (OSs) of alcohol-related hepatocellular carcinoma (HCC) patients without LC compared to those with LC.Between 2005 and 2015, 1343 patients were initially diagnosed as having HCC in our hospital. Of these, 186 alcohol-related HCC patients were enrolled in this study, and their medical records were retrospectively analyzed. Significant alcohol intake was defined as more than 210âgrams/week for men and more than 140âgrams/week for women.Non-cirrhotic HCC was observed in 37.1% of the 186 patients. Cumulative OS rates were significantly higher in non-cirrhotic patients (Pâ=â.006). For the 117 cirrhotic patients, cumulative OS rate was significantly higher in the CTP class A patients than in the CTP class B (Pâ<â.001) or CTP class C (Pâ<â.001) patients, respectively. In the 69 non-cirrhotic patients, cumulative OS rate was significantly higher in the CTP class A patients than in the CTP class C patients (Pâ<â.001), but, not than in the CTP class B patients (Pâ=â.157). Multivariate analyses revealed that CTP class B (Pâ<â.001), CTP class C (Pâ<â.001), and tumor size (Pâ=â.006) were significant predictors for OS in cirrhotic patients, and that CTP class C (Pâ=â.002) and tumor size (Pâ=â.023) were significant predictors for OS in non-cirrhotic patients.OS was found to be better for non-cirrhotic than cirrhotic patients with alcohol-related HCC. Survivals of alcohol-related HCC patients without cirrhosis were comparable between patients with CTP class A and B.
Subject(s)
Carcinoma, Hepatocellular/etiology , Carcinoma, Hepatocellular/mortality , Liver Cirrhosis/complications , Liver Diseases, Alcoholic/complications , Liver Neoplasms/etiology , Liver Neoplasms/mortality , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Time FactorsABSTRACT
BACKGROUND: This study was carried out to evaluate the association between nonalcoholic fatty liver disease (NAFLD) and the development of hepatocellular carcinoma (HCC) between 2005 and 2015 in a hepatitis B virus (HBV)-endemic area. PATIENTS AND METHODS: The medical records of 1327 patients initially diagnosed with HCC at our institution between January 2005 and December 2015 were analyzed retrospectively. Patients with other malignancies in addition to HCC were excluded. During the study period, changes in the proportion of NAFLD-associated HCC among all HCCs were assessed longitudinally. In addition, the clinical characteristics of NAFLD-associated HCC were evaluated. RESULTS: Among the 1327 patients, HBV was the most common (65.5%) cause of HCC, and the overall rate of NAFLD-associated HCC was 4.7%. Compared with HBV-associated HCC patients, NAFLD-associated HCC patients were older, had a higher median body mass index, and a larger median tumor size (P<0.05 for all). Liver cirrhosis was less frequent in NAFLD-associated than in HBV-associated HCC patients (P<0.05). The annual proportions of NAFLD-associated HCC patients were 3.4% in 2005, 3.6% in 2006, 3.5% in 2007, 3.2% in 2008, 4.2% in 2009, 4.4% in 2010, 5.6% in 2011, 5.2% in 2012, 5.8% in 2013, 7.0% in 2014, and 6.7% in 2015. From 2008 to 2015, these percentages increased steadily. CONCLUSION: The annual proportion of NAFLD-associated HCC patients among all HCC patients ranged from 3.2 to 3.5% before 2008, but thereafter, it increased gradually and had doubled to 7.0% by 2014.
Subject(s)
Carcinoma, Hepatocellular/epidemiology , Endemic Diseases , Hepatitis B/epidemiology , Liver Neoplasms/epidemiology , Non-alcoholic Fatty Liver Disease/epidemiology , Aged , Carcinoma, Hepatocellular/diagnosis , Carcinoma, Hepatocellular/virology , Early Detection of Cancer , Female , Hepatitis B/diagnosis , Hepatitis B/virology , Humans , Liver Neoplasms/diagnosis , Liver Neoplasms/virology , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/diagnosis , Republic of Korea/epidemiology , Retrospective Studies , Risk Factors , Time FactorsABSTRACT
INTRODUCTION: Bullous pemphigoid is a type of acute or chronic autoimmune disease that involves subepidermal skin lesions with bulla formation. Although viral infections, such as, human herpes virus (HHV), human immunodeficiency virus, cytomegalovirus, Epstein-Barr virus, HHV-6, hepatitis B virus (HBV), and hepatitis C virus (HCV), are known factors of bullous pemphigoid, HCV infection has only been rarely associated factor, especially in HBV endemic area. A 78-year-old man was admitted to our hospital due to erythematous bulla of onset 3 months before presentation affecting his entire body. Pathologic findings, that is, subepidermal bullae containing eosinophils and neutrophils with superficial perivascular lymphocytic and eosinophilic infiltration, were consistent with bullous pemphigoid. Anti-HCV was positive and HCV quantitative real-time polymerase chain reaction (PCR) was 1.25âxâ10âIU/mL. HCV genotype was 2a. After a diagnosis of bullous pemphigoid associated with chronic HCV infection was reached, he was treated with oral methylprednisolone for bullous pemphigoid, and his skin lesions improved. Oral direct-acting antiviral agents (sofosbuvir plus ribavirin) were prescribed for chronic hepatitis C, and sustained viral response was achieved. CONCLUSION: The authors report a rare case of bullous pemphigoid associated with chronic HCV infection in a HBV endemic area and advise that HCV should be considered in the differential diagnosis of factors precipitating bullous pemphigoid, even in HBV endemic areas.
