We analyzed the clinical characteristics and survival of 185 patients with hepatitis B virus-related hepatocellular carcinoma (HBV group) and 1033 with hepatitis C virus-related hepatocellular carcinoma (HCV group) by multi center study. The patients in the HBV group (mean age 52.1 yr) were about 10 years younger than those in the HCV group (mean age 62.9 yr). Liver function, as measured by indocyanine green retention at 15 min, was better in the HBV group (17.5%) than in the HCV group (25.4%). A higher proportion of the HBV group (55%) than the HCV group (44%) had clinical stage I, T-factor differed significantly between the groups: 53% of the HBV group were T3-4 compared with 41% of the HCV group. Furthermore, a higher proportion of the HBV group were graded 2-3 for tumor thrombus in the portal vein (20.3%) and had poorly differentiated hepatocellular carcinoma (7%) compared with the HCV group (7.1% and 5% respectively). Univariate analysis identified poor prognostic factors for hepatocellular carcinoma as HBV, age < or = 50 yr, clinical stage II-III, a high AFP level, higher number of tumors, larger tumor size, tumor thrombus in the portal vein 2-3 and in the hepatic vein 2-3. On multivariate analysis, poor prognostic factors were a high AFP level, higher number of tumors, tumor thrombus in the portal vein 2-3 and in the hepatic vein 2-3, but not HBV, age, clinical stage or tumor size. These results suggest that HBV itself is not a stronger prognostic factor than HCV.

A 42-year-old womanwith biopsy-proven chronic hepatitis B, who had been treated with human leukocyte-derived interferon-alpha (huLe-IFNoc) therapy for two months was found to have liver tumors on routine abdominal ultrasonography examination. She underwentlaparotomy, and partial hepatectomy was performed under the clinical diagnosis of hepatocellular carcinoma. The lesions were diagnosed histologically as pseudolymphoma based on the massive infiltration of small mature lymphocytes and the presence of hyperplastic lymph follicles with germinal centers. Immunohistochemistry revealed polyclonal origin of the involved lymphocytes. The possible association between IFNa treatment and chronic hepatitis B with the development of pseudolymphomais discussed.

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We report a case of early duodenal cancer (2.5 cm in diameter, located in the proximal part) in a 65-year-old female whom segmental resection was performed and a 7-year disease-free survival was achieved. The surgical specimen, showed and a 2.5 x 1.5 • 1.0cm exophytic lesion histopathological examination revealed highly differentiated intramucosal adenocarcinoma. We also report or our review of 122 cases of early duodenal cancer reported in Japan. Intramucosal carcinoma was found in 66%, and submucosal carcinoma in 34% of the patients. The location of the lesion was bulbar in 73 patients (60%), supraampullary in 33 (27%), periamupllary in 5 (4%), and infraampullary in 11 (9%). Distal gastrectomy, including the bulb, was performed in 46 patients, pancreatoduodenectomy in 23, partial resection in 24, endoscopic polypectomy in 25, and segmental resection in 4, including our patient. The frequency of lymph node metastasis is low in early duodenal cancer, so that segmental resection appears to be a reasonable treatment method.

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