CHARACTERISTIC DIFFERENCE OF HEPATOCELLULAR-CARCINOMA BETWEEN HEPATITIS-B AND HEPATITIS-C VIRAL-INFECTION IN JAPAN

Characteristics of 205 consecutive patients with hepatocellular carcin oma (HCC) admitted during 1990 to 1993 have been analyzed from the sta ndpoint of hepatitis viral infection in Japan. Among 205 HCC patients, 71% of the patients showed positivity for hepatic C virus (HCV) antib ody alone, 13% showed positivity both for HCV and HBV (HCV/HBV) antibo dy, 11% demonstrated HBsAg alone, and negativity of both HCV and HBV a ntibody in 4% only. Positivity to both HCV antibody and HBsAg was demo nstrated in 1% only, Mean detection age of HCVAb-positive HCC as well as both HCV/HBV antibody-positive HCC was 62 +/- 7 years, in contrast to 52 +/- 13 years in HCC with HBsAg (P < .05). Male-to-female ratio a mong HCVAb-positive HCC was 3.3:1, in contrast to 5.5:1 among the HCV/ HBVAb-positive HCC and 7:1 among HBsAg-positive HCC, but there was no significant difference in the gender distribution between these groups . More than 60% of HCVAb-positive HCC and HCV/HBVAb-positive HCC were classified into the stage of Child B and C, whereas 65% of HBsAg-posit ive HCG was at the stage of Child A. The severity of liver disease was confirmed by liver histology, indicating that more than 70% of the HC VAb-positive HCC and the HCV/HBVAb-positive HCC showed cirrhosis, in c ontrast to 50% among the HBsAg-positive HCC. Three-year survival rate of HCV Ab-positive HCC and HBV/HCVAb-positive HCC was 68% and 56%, res pectively, in contrast to 47% in HBsAg-positive HCC. HCC was found at early stage among the patients receiving periodic medical checkups bef orehand, and the prognosis of these HCC patients was significantly bet ter than those who did not receive checkups. From these results, HCV-r elated HCC occupied over 80% of total HCC in Japan, which are characte rized by older age and more severe cirrhosis, as compared with HBsAg-p ositive HCC. Prognosis of HCV Ab-positive HCC was not significantly be tter than HBsAg-positive HCC, but the periodical screening naturally i mproves prognosis because the cases are found usually much earlier (le ad time bias) and mostly belong to slow progression type (length bias) .