Metabolic risk factors are associated with non-hepatitis B non-hepatitis C hepatocellular carcinoma in Taiwan, an endemic area of chronic hepatitis B
Journal
Hepatology communications
Journal Volume
2
Journal Issue
6
Date Issued
2018-06
Author(s)
Huang, Shiu-Feng
Chang, Il-Chi
Hong, Chih-Chen
Yen, Tseng-Chang
Wu, Cheng-Chung
Tsai, Cheng-Chung
Lee, Wei-Chen
Yu, Hsien-Chung
Shen, Ying-Ying
Eng, Hock-Liew
Wang, John
Tseng, Hui-Hwa
Yeh, Chau-Ting
Chen, Chi-Ling
Liaw, Yun-Fan
Abstract
Metabolic risk factors, such as obesity, fatty liver, high lipidemia, and diabetes mellitus are associated with increased risk for nonviral hepatocellular carcinoma (HCC); however, few nonviral HCC studies have stratified patients according to underlying etiologies. From 2005 to 2011, 3,843 patients with HCC were recruited into the Taiwan Liver Cancer Network. Of these patients, 411 (10.69%) who were negative for hepatitis B virus (HBV), surface antigen, HBV DNA, and anti-hepatitis C virus (HCV) antibody were classified as non-HBV non-HCV (NBNC)-HCC. Detailed clinical analyses of these patients were compared with age- and sex-matched patients with HBV-HCC or HCV-HCC for the associated metabolic risk factors. For this comparison, 420 patients with HBV-HCC and 420 patients with HCV-HCC were selected from the 3,843 patients with HCC. Multivariate analyses showed fatty liver (by echography), high triglyceride levels (>160 mg/dL), and diabetes mellitus history to be significantly associated only with NBNC-HCC and not with the matched patients with HBV- or HCV-HCC. When the patients with HCC were further divided into four groups based on history of alcoholism and cirrhotic status, the group without alcoholism and without cirrhosis exhibited the strongest association with the metabolic risk factors. Based on trend analyses, patients with NBNC-HCC with or without alcoholism were significantly different from the matched patients with HBV- or HCV-HCC, except for patients with alcoholism and cirrhosis, in having more than two of the above three risk factors. Conclusion: Metabolic risk factors are significantly associated with nonviral HCC, especially for patients without alcoholism in Taiwan. Because the prevalence of viral HCC is decreasing due to the success of universal vaccination and antiviral therapy, strategies for cancer prevention, prediction, and surveillance for HCC will require modification. (Hepatology Communications 2018;2:747-759).
SDGs
Other Subjects
hepatitis B surface antigen; hepatitis C antibody; triacylglycerol; virus DNA; virus RNA; adult; aged; alcoholism; Article; body mass; cancer risk; cholesterol blood level; clinical feature; controlled study; diabetes mellitus; disease association; echography; fatty liver; female; hepatitis B; Hepatitis B virus; hepatitis C; histopathology; human; human tissue; liver cell carcinoma; liver cirrhosis; major clinical study; male; medical history; nonalcoholic fatty liver; nonhuman; prevalence; priority journal; Taiwan; triacylglycerol blood level; virus load
Type
journal article