THE MALE PREPONDERANCE IN INCIDENCE OF HEPATOCELLULAR-CARCINOMA IN CIRRHOTIC-PATIENTS MAY DEPEND ON THE HIGHER DNA SYNTHETIC ACTIVITY OF CIRRHOTIC TISSUE IN MEN

Background. The relationship between the DNA synthetic activity of hep atocytes from cirrhotic liver tissue and the incidence of hepatocellul ar carcinoma (HCC) during a 3-year follow-up period was studied in mal e and female patients with posthepatitic cirrhosis. Methods. The bromo deoxyuridine labeling index (BrdU LI) of hepatocytes was estimated in 38 cirrhotic patients (Child A stage, 23 men and 15 women) using a Brd U/anti-BrdU in vitro method. The incidence of HCC was compared between male and female cirrhotic patients during a 3-year follow-up period. Results. Sixteen of 23 (69.6%) male patients belonged to the high-DNA synthesis group (BrdU LI greater-than-equal-to 1.5%), and only 7 (30.4 %) were in the low-DNA synthesis group (BrdU LI < 1.5%). Among female patients, only 5 of 15 (33.3%) were in the high-DNA synthesis group, a nd 10 of 15 (66.7%) were in the low-DNA synthesis group (P < 0.05). El even of 23 (47.8%) male patients and 3 of 15 (20.0%) female patients h ad HCC develop. In the high-DNA synthesis group, 10 of 16 (62.5%) of t he men and 3 of 5 (60.0%) of the women had HCC develop during the foll ow-up period. In contrast, only one of seven (14.3%) male patients and none of ten (0%) female patients in the low-DNA synthesis group had H CC develop. Conclusions. It was concluded that HCC developed frequentl y (about 60% of the time within 3 years) in patients of both sexes who were in a high-DNA synthesis group. Thus, the larger proportion of me n in the high-DNA synthesis group compared with the number of women in the group (69.6% versus 33.3%) might be one possible reason for the m ale predominance in the development of HCC in cirrhotic patients.