HCV-RNA DETECTION IN ULTRASOUND-GUIDED FINE-NEEDLE BIOPSIES OF LIVER NODULES AND SURROUNDING TISSUE

HCV-RNA was examined in serum and liver tissue obtained from 8 hepatit is B surface antigen (HBsAg) negative patients with liver nodules rang ing in size from 2 to 11 cm. Histological examination of ultrasound-gu ided fine needle biopsies revealed the presence of hepatocellular carc inoma (HCC) in six patients (5 of whom were anti-HCV positive), cholan giocarcinoma in 1 patient (anti-HCV positive) and dysplastic regenerat ive nodule in 1 patient (anti-HCV negative). The HCCs were surrounded by cirrhosis (3 cases), chronic active hepatitis (CAH) (n=2) and post hepatitic fibrosis (n=1), the cholangiocarcinoma by CAH and the regene rative nodule by cirrhotic liver. Total and replicative intermediate H CV-RNA was analyzed by reverse-transcription-nested PCR of the 5'-untr anslated region. The five patients with HCC had HCV-RNA in serum, in t umorous and surrounding liver tissues. The viral nucleic acid was also detected in the cirrhotic tissue surrounding the cholangiocarcinoma b ut not in the tumor. Two out of 5 HCC patients had replicative interme diate RNA (negative strand) in tumorous tissue, 4 in nontumorous tissu e and 3 in serum. These results demonstrate that fine needle biopsy ca n provide sufficient material for both histological examination and HC V-RNA determination and suggest the existence of continuous viral repl ication during the carcinogenic process.