[Current status and therapeutic strategy for hepatocellular carcinoma].

It is reported that the number of hepatocellular carcinoma (HCC) in Japan is increasing and this is mainly due to the increase of HBsAg negative HCC patients with history of blood transfusion. However 80% of HCC patients are positive for HBV related serum markers. HBV DNA is detected by PCR method in 15% of HBsAg negative HCC patients with other HBV marker. These findings indicated that at least 40% of HCC patients in Japan are closely related to HBV infection. Several hypotheses on the mechanism of carcinogenesis by HBV have been proposed, however none of these has yet to be established. The type C hepatitis virus (HCV) reported by Chiron Co. is thought to be the majority of viruses which cause chronic non A non B hepatitis in Europe, United States and also Japan. The rate of anti-HCV in HBsAg negative HCC patients is about 70% in Japan. As strategies for HCC, the following 3 steps should be established; 1) prophylaxis against infection, 2) prevention of progression of liver cirrhosis, and 3) early detection of HCC. Though the role of hepatitis virus in hepatocarcinogenesis has not yet been established, it is thought that HBV and HCV are responsible for about 85% of HCC patients in terms of the development of liver cirrhosis which frequently associates with HCC. A marked decrease of HCC in Japan is forthcoming through the establishment of prophylaxis against HBV and HCV infection.