RELATIONSHIP BETWEEN THE RECURRENCE OF HEPATOCELLULAR-CARCINOMA (HCC)AND SERUM ALANINE AMINOTRANSFERASE LEVELS IN HEPATECTOMIZED PATIENTS WITH HEPATITIS-C VIRUS-ASSOCIATED CIRRHOSIS AND HCC

BACKGROUND. The relationship between the recurrence of hepatocellular carcinoma (HCC) and the serum alanine aminotransferase (ALT) level was studied in hepatectomized patients with hepatitis C virus (HCV)-assoc iated cirrhosis and HCC.METHODS. Twenty-six hepatectomized patients wi th HCV-associated cirrhosis and HCC whose resected specimens showed ne ither portal vein nor hepatic vein invasion by HCC histologically were divided into 2 groups: 15 patients who had no recurrence 3 years afte r surgery (Group A) and 11 patients whose disease recurred 1-3 years a fter surgery (Group B). The patients' serum ALT levels during this per iod were examined. RESULTS. In Group A, serum ALT generally showed sus tained low levels <80 international units (INU) in 12 patients (80%). In contrast, ALT levels in Group B showed several peaks or plateaus >8 0 INU in all patients except 2. The recurrence rate of HCC in tile hep atectomized patients with sustained low levels of ALT was 14.3% (2 of 14 patients) at 3 years, and was significantly lower (P <0.01) than th at in those patients whose ALT levels showed several peaks or plateaus >80 INU (9 of 12 patients; 75.0%). The average level of mode of ALT i n Group A (48.8+/-26.0 INU) was significantly smaller than that in Gro up B (101.1+/-47.3 INU) (P <0.005). CONCLUSIONS. The importance of hep atocytic necrosis in the recurrence of HCC in hepatectomized patients with cirrhosis and HCC of HSV origin was demonstrated and the signific ance of subsiding hepatic necroinflammatory process in the prevention of HCC recurrence suggested. (C) 1997 American Cancer Society.