Time trends of clinical characteristics in hepatocellular carcinoma patients with chronic hepatitis B virus infection: A field survey between 2000 and 2012

Abstract

Abstract. The hepatitis B virus (HBV) carrier rate has decreased in Japan; however, the incidence of HBV infection among hepatocellular carcinoma (HCC) patients has not decreased accordingly. In this study, we aimed to assess the time trends of the clinical characteristics in HCC patients with chronic HBV infection. Between 2000 and 2012, we enrolled a total of 156 HCC patients with chronic HBV infection in our field survey. The HCC risk was evaluated using the HCC prediction score, which is constructed from the characteristics of age, presence of liver cirrhosis and serum levels of albumin, bilirubin and HBV DNA. Lifestyle factors and the presence of diabetes mellitus were also evaluated. The time trends of patient characteristics were analyzed using the Jonckheere-Terpstra proportion trend test. Among HCC patients with chronic HBV infection, the proportion of patients at high risk according to the HCC prediction score significantly decreased during the study period (P=0.0005). Similarly, the proportion of patients with liver cirrhosis, ≤3.5 g/dl serum albumin level, >4 log copies/ml serum HBV DNA level and ≥60 g/day alcohol intake were also significantly decreased. The proportion of male and obese patients was not significantly altered, whereas the proportion of elderly (≥65 years) and diabetic patients tended to increase during the study period (P=0.0654 and P=0.0528, respectively). In this study, we analyzed the time trends of the clinical characteristics in HCC patients with chronic HBV infection and demonstrated that aging and diabetes mellitus may be involved in the hepatocarcinogenesis in patients with chronic HBV infection.

Complications Requiring Hospital Admission and Causes of In-Hospital Death over Time in Alcoholic and Nonalcoholic Cirrhosis Patients

“…On the other hand, HCC has become a common cause of admission in cirrhotic patients. Early detection by virtue of increased HCC surveillance 15 , 16 or an aging cohort of patients with HBV or HCV 15 , 17 could partly explain this finding.…”

Diabetes Mellitus and Risk of Hepatocellular Carcinoma

“…Gao et al found that DM is an independent risk factor for cirrhosis progression to HCC in patients with simple HBV infection [ 83 ], and Hsiang et al found that T2DM was predictor of liver-related complications and HCC in patients with HBV cirrhosis [ 84 ]. A Japanese study of 156 HCC patients with chronic HBV infection also suggested the involvement of T2DM in hepatocarcinogenesis in HBV-positive patients [ 85 ]. In 2012, a case-control study conducted in Taiwan concluded that synergistic interactions between T2DM and HBV infection increased the risk of HCC [ 86 ].…”

Diabetes and cancer: A comprehensive review

“…[49] Supportingly, a study by Amano et al ., 2014 on HCC patients with HBV infection found T2DM to be significantly related to HCC in HBV patients. [50] Contradictorily, a cross-sectional study on cirrhotic patients with HBV with and without HCC found that diabetes was not a significant risk factor for HCC. [51] Similarly, Gao et al ., 2013 found that diabetes was analyzed to be independent of the prospect of HCC in cirrhotic patients with HBV infection.…”