Hepatocellular carcinoma in the absence of cirrhosis in patients with chronic hepatitis B virus infection

Abstract

could be from differences in patients' age, body mass index, and other liver co-morbidities such as fatty liver that were not controlled for. We believe that ethnic differences in the performance characteristics of FIB-4 score is unlikely to explain the observed association between race and non-cirrhotic HCC in chronic hepatitis B, as seen in our study. Moreover, the rate of chronic hepatitis B-related HCC in the absence of cirrhosis shown in our study is comparable with the results from other studies in the U.S. and Australia that used different methods to diagnose cirrhosis status. 3,4

Albumin-to-alkaline phosphatase ratio as a predictor of tumor recurrence and prognosis in patients with early-stage hepatocellular carcinoma undergoing radiofrequency ablation as initial therapy

“…In addition, recent studies have demonstrated that the ALBI grade is associated with higher levels of AFP and more advanced tumor stage, which is correlated with malignant biological behavior and poor prognosis [32], similar to the association of AAPR in HCC. Moreover, HCC patients without cirrhosis, in whom HCC is presumably attributed to the direct carcinogenic effect of HBV infection, tend to harbor larger-sized or poorly differentiated tumors, contributing to the unfavorable prognosis of early-stage HCC [33,34]. In our series, since the presence of liver cirrhosis or the CP grade was not associated with the prognosis of earlystage HCC, we speculated that patients in the low-AAPR group might exhibit more aggressive tumor behaviors, indicated by AAPR or the ALBI grade, due to the direct development of HCC in the absence of liver cirrhosis.…”

County Differences in Liver Mortality in the United States: Impact of Sociodemographics, Disease Risk Factors, and Access to Care

“…In contrast to the Tapper and Parikh study, 2 this study did not include HCC deaths in the cirrhosis and chronic liver disease category, even though >90% of cases of HCC occur in the setting of cirrhosis/ advanced fibrosis and did not account for data in the era of direct-acting antiviral therapy for HCV. [1][2][3][4][5][6] Neither of these studies, however, explored the determinants of the variability in liver disease mortality rates. By focusing on county-level data, we demonstrated significant differences in mortality among counties within the same state and specific hotspots of liver disease mortality even after accounting for important county-level sociodemographic and access to care variables.…”

“…2 In contrast to study by Tapper and Parikh, 1 this study did not include HCC deaths in the cirrhosis and chronic liver disease category, even though >90% of cases of HCC occur in the setting of cirrhosis/advanced fibrosis, and did not account for data in the era of direct-acting antiviral therapy for hepatitis C virus (HCV). [1][2][3][4][5][6][7][8][9] Additionally, neither of these studies explored the impact of sociodemographic factors and measures of access to care (eg, insurance, proximity to a liver transplant center) on geographic variability in liver disease-related mortality.…”

Role of epigenetic alterations in aflatoxin‐induced hepatocellular carcinoma

“…In Asia and Africa, the HBV infection is prevalent, and 30%-50% of patients develop HCC without cirrhosis, whereas in the USA, wherein the HBV is not endemic, >90% of patients with HBVassociated HCC have the cirrhotic liver disease. 15,16 Metabolic disorders contribute to a major segment (32%) of the population attributable fractions over time that result in HCC development. 17 Metabolic disorders and genetic diseases associated with HCC include Porphyrias, α-1 antitrypsin disease, tyrosinemia, hemochromatosis, glycogen-storage disease types I and II, as well as Wilson's disease.…”