Postoperative interferon-alpha therapy appears to decrease recurrence after resection of hepatitis C virus-related hepatocellular carcinoma.

. Semiquantitative analysis of expression levels demonstrated a significant correlation between CK7 and CK19 expression. Of various clinicopathologic parameters, tumor differentiation exhibited a significant correlation with CK7 and CK19 expression. All 15 patients with CK19-positive HCC also had anti-HBc. Log-rank test revealed that CK7 expression, CK19 expression, high aspartate aminotransferase (AST) activity, low albumin concentration, portal invasion, intrahepatic metastasis, and severe fibrosis (cirrhosis) reduced the tumor-free survival rate. Multivariate analysis demonstrated that CK19 expression, intrahepatic metastasis, and severe fibrosis were independent predictors of postoperative recurrence, while CK7 expression was not. Twelve of 15 patients with CK19-positive HCC had tumor recurrence within 2 years after surgery, a significantly higher incidence of early recurrence than for CK19-negative HCC. The incidence of extrahepatic disease, especially lymph node metastasis, was significantly higher for patients with CK19-positive HCC. These findings indicate that CK19 expression is a predictor of early postoperative recurrence due to increased invasiveness. atients with intrahepatic cholangiocarcinoma (ICC), including combined hepatocellular and cholangiocarcinoma (cHCC-CC), exhibit poorer postoperative prognosis than those with hepatocellular carcinoma (HCC) due to more aggressive invasion and higher frequency of extrahepatic metastasis. [1][2][3][4][5][6] Thus, it is important for surgeons to take into account the presence of CC components within hepatic tumors in selecting a surgical strategy. 6) Cytokeratins (CK) are cytoskeletal intermediate filaments present in both normal and malignant epithelial cells.7) Characteristic combinations of CK polypeptides are expressed in different epithelia depending on the organ and/or type of differentiation. 7,8) In normal human liver, hepatocytes express CK8 and CK18, while bile duct cells also contain CK7 and CK19. [8][9][10][11] Since this CK pattern has been believed to be preserved during neoplastic transformation, HCC would be expected to express CK8 and CK18, but not CK7 or CK19. [8][9][10][11] Thus, expression of biliary-specific CK (CK7 and CK19) is widely used to distinguish ICC from HCC. 6,[8][9][10][11][12] Maeda et al. 6) recommended that HCC with "suggestive" CC components (incomplete gland formation without mucin production) should be categorized as cHCC-CC when "suggestive" CC components are positive for biliary markers. However, some HCCs have been reported to express biliary markers even with typical HCC growth pattern and morphologic appearance, [13][14][15][16][17] although the histogenesis of such biliary marker-positive HCC is not wellunderstood. A previous report indicated that without treatment, the prognosis is poorer for patients with biliary differentiation marker [AE1-AE3, cytokeratin (CK) 19]-positive HCC than for those without it.16) There have, however, been no studies on the clinical usefulness of biliary marker expression by HC...

The present results showed that cholangiocarcinomas occurred at a high incidence in relatively young workers of a printing company, who were exposed to chemicals including chlorinated organic solvents.

Although hepatitis C virus (HCV)-related cirrhosis has been suggested as a risk factor for intrahepatic cholangiocarcinoma (ICC), few sizeable studies have tested this hypothesis. We investigated ICC risk factors, with special reference to HCV infection. We conducted a hospital-based case-control study including 50 ICC patients and 205 other surgical patients without primary liver cancer. HCV seropositivity was detected in 36% of ICC patients and 3% of controls. By univariate analysis, the odds ratio (OR) for association of anti-HCV antibodies with development was 16.87 (95% confidence interval (CI), 5.69 to 50.00). History of blood transfusion or diabetes mellitus, elevated serum total bilirubin, elevated aspartate aminotransferase and alanine aminotransferase, decreased serum albumin and decreased platelet count were identified as other possible ICC risk factors. By multivariate analysis, anti-HCV antibodies (adjusted OR, 6.02; 95% CI, 1.51 to 24.1), elevated alanine aminotransferase, decreased serum albumin, and decreased platelet count were found to be independent risk factors for ICC development. As liver status worsened, the adjusted OR for ICC tended to increase. HCV infection is a likely etiology of ICC in Japan. ntrahepatic cholangiocarcinoma (ICC), a malignant tumor arising from bile duct epithelium, is the second most common primary liver cancer, following hepatocellular carcinoma (HCC). Established risk factors for HCC include chronic active hepatitis, and hepatic fibrosis induced by hepatitis virus infection or heavy alcohol intake. On the other hand, risk factors for ICC remain uncertain. Hepatitis C virus (HCV)-related cirrhosis has been suggested as a risk factor for ICC, 1, 2) but confirmation is required. We therefore investigated risk factors for ICC, with special reference to HCV infection. Patients and MethodsWe conducted a hospital-based study using a matched case-control design, including 50 patients with pathologically diagnosed ICC and 205 other surgical patients without primary liver cancer including ICC.Patients. Fifty patients were treated for ICC between January 1991 and December 2002 in the two major medical centers of Osaka City (Department of Gastroenterological and HepatoBiliary-Pancreatic Surgery, Osaka City University Hospital; Department of Gastrointestinal Surgery, Osaka City General Hospital). ICC was diagnosed by pathologic examination. Two to five control patients at the two medical centers were matched with each ICC patient according to gender, 5-year age group, and operation date (within 1 year). Patients with HCC were excluded from the control group since hepatitis B virus (HBV) infection and HCV infection are established etiologic agents of HCC. In all, control patients numbered 205. This study was conducted in accordance with the Helsinki Declaration and the guidelines of the ethics committees at our institutions.Etiologic factors and data collection. Factors evaluated for association with ICC risk included habits such as alcohol consumption and smoking; family histor...