論文名 | Stagnation of histopathological improvement is a predictor of hepatocellular carcinoma development after hepatitis C virus eradication |
記事種別等 | Research Article |
著者名 | Motoyama, Hiroyuki / Tamori, Akihiro / Kubo, Shoji / Uchida-Kobayashi, Sawako / Takemura, Shigekazu / Tanaka, Shogo / Ohfuji, Satoko / Teranishi, Yuga / Kozuka, Ritsuzo / Kawamura, Etsushi / Hagihara, Atsushi / Morikawa, Hiroyasu / Enomoto, Masaru / Murakami, Yoshiki / Kawada, Norifumi |
著者名(別言語) | 元山, 宏行 / 田守, 昭博 / 久保, 正二 / 打田(小林), 佐和子 / 竹村, 茂一 / 田中, 肖吾 / 大藤, さとこ / 寺西, 優雅 / 小塚, 立蔵 / 川村, 悦史 / 萩原, 淳司 / 森川, 浩安 / 榎本, 大 / 村上, 善基 / 河田, 則文 |
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抄録・内容(英) | Background: Hepatocellular carcinoma (HCC) develops in some patients who achieve sustained virological response (SVR) against hepatitis C virus (HCV) infection via anti-HCV therapy. To examine the pathogenesis of HCC development after HCV eradication, histopathological changes and clinical markers were evaluated in SVR patients. / Methods: Of 654 SVR patients treated with interferon (IFN)-based therapies, 34 patients who had undergone liver biopsy before initiating IFN therapy and after SVR achievement were enrolled: 11 patients with HCC and 23 patients without HCC (male/female, 9/2 and 8/15, respectively: age, 58 ± 5 and 54 ± 11 years, respectively). We compared the clinical and histopathological factors between the two groups. Immunohistochemistry for Cytoglobin (CYGB) and α smooth muscle actin (α-SMA) was also performed. / Results: At baseline, prior to initiating the IFN-based therapy, there were significant differences between the SVR-non-HCC and SVR-HCC groups in the male gender, HBc antibody positivity, prothrombin activity, and histological inflammatory grade. Histopathological evaluation, using the new Inuyama classification system, revealed an improvement in the inflammatory grade, from 2.1 ± 0.6 to 1.0 ± 0.6 (p < 0.0001), whereas the fibrosis stage remained unchanged, from 2.3 ± 0.9 to 2.0 ± 1.2 (p = 0.2749), during the 97 ± 72-month observation period in the SVR-HCC group. Both the grade and stage scores were significantly improved in the SVR-non-HCC group. The area of collagen deposition, evaluated using Sirius red staining, showed a marked decrease, from 18.6 ± 7.6% to 7.7 ± 4.6%, in the SVR-non-HCC group, with no change in the SVR-HCC group. CYGB- and α-SMA-positive hepatic stellate cells (HSCs), indicative of the HSC activated phenotype, remained in the fibrotic tissue of livers among patients in the SVR-HCC group. / Conclusion: Stagnation of fibrosis regression is associated with a high risk for HCC after SVR. HSC activation may inhibit improvement in fibrosis after SVR and potentially contribute to hepatocarcinogenesis. |
備考 | This study was supported in part by the Japan Society for the Promotion of Science grant (JSPS Grant No. 15K09019, No.17H04124) |
言語 | eng |
ページ開始 | e0194163 |
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著者版フラグ | publisher |
著者所属(英) | Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University / Osaka City University |
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刊行年月 | 2018-03-13 |
出版社 | Public Library of Science |
ISSN | 1932-6203 |
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資料種別(英語) | Journal Article |
DOI | https://doi.org/10.1371/journal.pone.0194163 |
CCライセンス(BY) | この作品はクリエイティブ・コモンズ 表示 4.0 国際 ライセンスの下に提供されています。 |
権利 | © 2018 Motoyama et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |