Kusakabe Atsunori, Tanaka Yasuhito, Orito Etsuro, Sugauchi Fuminaka, Kurbanov Fuat, Sakamoto Tomoyuki, Shinkai Noboru, Hirashima Noboru, Hasegawa Izumi, Ohno Tomoyoshi, Ueda Ryuzo, Mizokami Masashi
Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan.
J Gastroenterol. 2007 Apr;42(4):298-305. doi: 10.1007/s00535-006-1999-3. Epub 2007 Apr 26.
In Japan, approximately 10% of hepatocellular carcinoma (HCC) patients are negative for both hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C virus (anti-HCV), i.e., they constitute the so-called category of non-B non-C (NBNC) HCC. Little is known about the characteristics of NBNC-HCC.
Potential risk factors for carcinogenesis (including occult HBV infection [HBsAg is negative but HBV DNA is positive by polymerase chain reaction (PCR)], obesity, and diabetes) were assessed in 233 HCC patients grouped according to hepatitis virus serological status (152 with HCV-HCC, 36 with HBV-HCC, and 45 with NBNC-HCC).
The prevalence of patients with obesity or diabetes was significantly higher in the NBNC-HCC group than in the HBV-HCC group. The same trend was observed even when patients with massive alcohol intake were excluded from the analysis. Only 8 patients (18%) in the NBNC-HCC group had detectable serum HBV DNA, and this was at very low levels (HBV/Ce/C2 and HBV/D were determined in 7 and 1 patients, respectively). In the NBNC-HCC group, the determined nucleotide sequences of the enhancer II/core promoter/precore/core region did not contain any HCC-associated mutations, whereas 25 of 30 patients in the HBV-HCC group carried strains with C1653T, T1753V, and/or A1762T/G1764A mutations.
A weak association between occult HBV infection and HCC development was observed in the NBNC patients. This study indicates that nonalcoholic steato-hepatitis should be further investigated to assess its contribution to HCC development in this category of patients.
在日本，约10%的肝细胞癌（HCC）患者的乙型肝炎表面抗原（HBsAg）和丙型肝炎病毒抗体（抗-HCV）均为阴性，即他们属于所谓的非B非C（NBNC）HCC类别。关于NBNC-HCC的特征知之甚少。
对233例根据肝炎病毒血清学状态分组的HCC患者（152例HCV-HCC患者、36例HBV-HCC患者和45例NBNC-HCC患者）评估致癌的潜在危险因素（包括隐匿性HBV感染[HBsAg阴性但聚合酶链反应（PCR）检测HBV DNA阳性]、肥胖和糖尿病）。
NBNC-HCC组肥胖或糖尿病患者的患病率显著高于HBV-HCC组。即使在分析中排除大量饮酒的患者，也观察到相同趋势。NBNC-HCC组中只有8例患者（18%）血清HBV DNA可检测到，且水平非常低（分别在7例和1例患者中检测到HBV/Ce/C2和HBV/D）。在NBNC-HCC组中，增强子II/核心启动子/前核心/核心区域的测定核苷酸序列未包含任何与HCC相关的突变，而HBV-HCC组的30例患者中有25例携带C1653T、T1753V和/或A1762T/G1764A突变的毒株。
在NBNC患者中观察到隐匿性HBV感染与HCC发生之间存在弱关联。本研究表明，应进一步研究非酒精性脂肪性肝炎，以评估其在这类患者中对HCC发生的作用。
