Hepatocellular carcinoma in noncirrhotic young adult patients with chronic hepatitis B viral infection

J Gastroenterol. 2004 Jun;39(6):550-6. doi: 10.1007/s00535-003-1341-2.

Abstract

Background: The aims of this study were to define the clinical characteristics of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) in young adult patients without cirrhosis and to evaluate the efficacy of interferon (IFN) therapy on HCC recurrence.

Methods: Of 187 patients with HBV-related HCC treated at our hospital, 4 had no liver cirrhosis and were less than 30 years of age (10, 22, 23, and 26 years).

Results: At the time of diagnosis of HCC, all cases had antibody to hepatitis B e antigen (anti-HBe) and histological staging of nontumorous liver was F0 or F1, i.e., low-grade hepatitis. The mothers of all 4 young adult patients with HCC had HBV-related liver disease. Three cases developed recurrence of HCC. In these patients, long-term intermittent IFN therapy after reresection of HCC resulted in long-term survival without recurrence for more than 3 years of follow-up.

Conclusions: (1) Young adult patients with HCC are positive for anti-HBe, lack cirrhosis, and the route of infection seems to be mother-to-infant transmission. Transplacental transmission of HBV and HBV DNA integration into the cellular genomic DNA during fetal life is a possible explanation of HBV-related hepatocarcinogenesis in young adults; and (2) long-term IFN therapy seems to be useful for prevention of tumor recurrence after radical operation for HBV-related HCC.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / virology*
  • Child
  • DNA, Viral
  • Female
  • Hepatitis B / genetics
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / epidemiology
  • Hepatitis B, Chronic / genetics
  • Hepatitis B, Chronic / transmission
  • Humans
  • Infectious Disease Transmission, Vertical
  • Liver Diseases / genetics
  • Liver Neoplasms / virology*
  • Male
  • Middle Aged
  • Placenta / virology

Substances

  • DNA, Viral