Clinicopathological examination of nonalcoholic steatohepatitis (NASH) leading to hepatocellular carcinoma (HCC)

Abstract

Among 389 hepatocellular carcinoma (HCC) cases treated in our institution, 29 cases (7.5%) were HBV antigen and HCV antibody negative. Of them, ten cases (2.6%) were clinicopathologically diagnosed as NASH. In those patients, we examined host factors, background liver pathology, blood work, liver function, and tumor analysis. Seven males and three females had an average age of 70.9 ±8.1 years. Body Mass Index (BMI) was greater than 25 Kg/m2 in six, and six had diabetes mellitus Associated liver disease was pathologically steatohepatitis in six, and cirrhosis in four. Half of patients with steatohepatitis revealed the slight to moderate fibrotic change according to Brunt classification. Nine patients (90%) had multiple tumors, and multicentric growth was suspected in six. In our series, 60% of HCCs developed from patients with steatohepatitis, and 67% of multiple HCCs showed multicentric growth. We should follow NASH patients carefully, even for patient with only early stage steatohepatitis. © 2009 The Japan Society of Hepatology.