Close association between high serum ALT and more rapid recurrence of hepatocellular carcinoma in hepatectomized patients with HCV-associated liver cirrhosis and hepatocellular carcinoma
K. Tarao et al., Close association between high serum ALT and more rapid recurrence of hepatocellular carcinoma in hepatectomized patients with HCV-associated liver cirrhosis and hepatocellular carcinoma, INTERVIROLO, 43(1), 2000, pp. 20-26
We investigated whether or not a high serum alanine aminotransferase (ALT)
level is associated with a more rapid recurrence of hepatocellular carcinom
a (HCC) in hepatectomized patients with hepatitis C virus (HCV)-associated
liver cirrhosis (LC) (HCV-LC) and HCC. Thirty-three hepatectomized patients
with HCV-LC and HCC of a single nodule who had no histologic evidence of p
ortal or hepatic vein invasion and who had been followed up for more than 3
years were included in the study. They were subdivided into two groups acc
ording to their serum ALT levels, ALT being a well-known marker of inflamma
tory necrosis in the liver. Seventeen patients whose serum ALT levels showe
d several peaks or plateaus above 80 international units (IU) were designat
ed as the high ALT group, and 16 patients whose serum ALT levels showed a s
ustained low level below 80 IU until the first recurrence were designated a
s the low ALT group, and the interval between hepatectomy and the first rec
urrence was observed. In the high ALT group, HCC recurred within 3 years in
70.6% of the patients. In contrast, it recurred in only 18.8% of the low A
LT group within the same period (p < 0.05). There was a significant differe
nce (p = 0.0201) between the two groups in the cumulative nonrecurrence rat
e. The mean interval in recurrent patients between hepatectomy and the firs
t recurrence in the high ALT group (23.6 +/- 2.8 months; mean +/- SE) was s
ignificantly (p < 0.02) shorter than that in the low ALT group (49.3 +/- 9.
7 months). The expected interval between hepatectomy and recurrence was as
short as 2.8 +/- 0.5 years (mean +/- SE) in the high ALT group, compared wi
th 5.8 +/- 0.7 years in the low ALI group (p < 0.05). These results showed
that the recurrence of HCC was accelerated in the high ALT group, suggestin
g that suppression of the rise in ALT level after hepatectomy by treatment
with anti-inflammatory drugs may prolong the interval until recurrence by a
bout 2 years in hepatectomized patients with HCC and HCV-LC.
Copyright (C) 2000 S. Karger AG, Basel.