LIVER-CELL DYSPLASIA IS A MAJOR RISK FACTOR FOR HEPATOCELLULAR-CARCINOMA IN CIRRHOSIS - A PROSPECTIVE-STUDY

Background/Aims: In humans, the role of liver cell dysplasia as a pren eoplastic lesion is still debated. A prospective, long-term, multicent er study was performed to establish whether liver cell dysplasia in ci rrhosis is associated with an increased risk for hepatocellular carcin oma (HCC). Methods: A cohort of 307 consecutive patients in whom liver cirrhosis was diagnosed by histology was investigated for development of HCC at 6-month intervals by ultrasonography and determination of a lpha-fetoprotein levels. Results: At enrollment, liver cell dysplasia was found in 75 patients (24%) and in 53% (P < 0.01) of those positive for hepatitis B surface antigen (HBsAg). After a mean follow-up of 46 months, HCC was detected in 45 cases, and it was significantly more f requent in patients with liver cell dysplasia (P < 0.01) and HBsAg-ser um positivity (P < 0.01). Multivariate analysis showed that liver cell dysplasia was the most important risk factor correlated with HCC deve lop ment. HBsAg positivity and age over 60 years were also independent risk factors for HCC. Conclusions: These results indicate that liver cell dysplasia is a major risk factor for HCC, and it should be looked for carefully by pathologists in liver biopsy specimens to identify p atients requiring more intensive observation.