Hepatocellular adenoma in Taiwan: Distinct ensemble of male predominance, overweight/obesity, and inflammatory subtype
Journal
Journal of Gastroenterology and Hepatology (Australia)
Journal Volume
35
Journal Issue
4
Pages
680-688
Date Issued
2020
Author(s)
Abstract
Background and Aim: The clinicopathologic features of hepatocellular adenoma in Asian populations have been poorly defined. The study aimed to characterize this rare entity in a single institution in Taiwan. Methods: In total, 45 hepatocellular adenomas from 1995 to 2018 were included and sent for pathologic review and molecular subtyping. Results: The numbers of patients with hepatocellular adenoma has doubled in the recent decade. Surprisingly, men outnumbered women in our cohort (n?=?26, 58% vs N?=?19, 42%). A collection of clinical information revealed that overweight/obesity accounts for most of the associated conditions of hepatocellular adenoma. Only three women took oral contraceptives. There were 34 inflammatory (75%), three LFABP-negative (7%), four β-catenin activated (9%), and four unclassified (9%) hepatocellular adenomas. Ten inflammatory hepatocellular adenomas demonstrated strong and homogeneous glutamine synthetase staining and were thus also β-catenin activated. Notably, overweight and obesity were significantly associated with inflammatory hepatocellular adenoma than other subtypes (P?=.029 and.056, respectively) and were strongly correlated with steatosis in background liver (P?=.028 and.007, respectively). Malignant transformation (four borderline tumors and two hepatocellular carcinomas) was identified in six adenomas (two women and four men). All six hepatocellular adenomas with malignancy were β-catenin activated; β-catenin activation could serve as a biomarker for malignant progression. Conclusions: The clinicopathologic features of hepatocellular adenoma in Taiwan are distinct from those reported in Western countries. Rare oral contraceptive usage and an emerging epidemic of overweight/obesity in Taiwan provides new insights into the pathogenesis of hepatocellular adenoma. ? 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
SDGs
Other Subjects
beta catenin; glutamate ammonia ligase; beta catenin; tumor marker; adult; Article; cancer growth; clinical article; clinical feature; disease classification; fatty liver; female; histopathology; human; human tissue; inflammation; liver adenoma; liver cell carcinoma; liver tumor; male; malignant transformation; obesity; priority journal; sex difference; Taiwan; adolescent; cell transformation; cohort analysis; inflammation; liver adenoma; liver tumor; metabolism; middle aged; pathology; sex factor; young adult; Adenoma, Liver Cell; Adolescent; Adult; beta Catenin; Biomarkers, Tumor; Cell Transformation, Neoplastic; Cohort Studies; Female; Humans; Inflammation; Liver Neoplasms; Male; Middle Aged; Obesity; Overweight; Sex Factors; Taiwan; Young Adult
Publisher
Blackwell Publishing
Type
journal article