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Perihepatic lymph node enlargement is a negative predictor of liver cancer development in chronic hepatitis C patients

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Perihepatic lymph node enlargement (PLNE) is a common ultrasound finding in chronic hepatitis C patients. Although PLNE is considered to reflect the inflammatory response to hepatitis C virus (HCV), its clinical significance remains unclear.

Methods

Between December 2004 and June 2005, we enrolled 846 chronic hepatitis C patients in whom adequate ultrasound examinations had been performed. PLNE was defined as a perihepatic lymph node that was at least 1 cm in the longest axis by ultrasonography. We analyzed the clinical features of patients with PLNE and prospectively investigated the association between PLNE and hepatocellular carcinoma (HCC) development.

Results

We detected PLNE in 169 (20.0 %) patients. Female sex, lower body mass index (BMI), and HCV serotype 1 were independently associated with the presence of PLNE. However, there were no significant differences in liver function tests, liver stiffness, and hepatitis C viral loads between patients with and without PLNE. During the follow-up period (mean 4.8 years), HCC developed in 121 patients. Unexpectedly, patients with PLNE revealed a significantly lower risk of HCC development than those without PLNE (p = 0.019, log rank test). Multivariate analysis revealed that the presence of PLNE was an independent negative predictor of HCC development (hazard ratio 0.551, p = 0.042). In addition, the sustained viral response rate in patients who received interferon (IFN) therapy was significantly lower in patients with PLNE than in patients without PLNE.

Conclusions

Patients with PLNE had a lower risk of HCC development than those without PLNE. This study may provide new insights into daily clinical practice and the pathophysiology of HCV-induced hepatitis and hepatocarcinogenesis.

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Abbreviations

ALT:

Alanine aminotransferase

AFP:

α-Fetoprotein

PLNE:

Perihepatic lymph node enlargement

HCV:

Hepatitis C virus

HCC:

Hepatocellular carcinoma

IFN:

Interferon

LN:

Lymph node

US:

Ultrasonography

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Acknowledgments

This study was not supported by any grants.

Conflict of interest

The authors have no conflicts of interest regarding this study.

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Authors and Affiliations

  1. Department of Clinical Laboratory Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Hiromi Hikita, Hayato Nakagawa, Kenichiro Enooku, Yoko Soroida, Mamiko Sato, Hiroaki Gotoh, Atsushi Suzuki, Tomomi Iwai, Hiromitsu Yokota, Yutaka Yatomi & Hitoshi Ikeda

  2. Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Hayato Nakagawa, Ryosuke Tateishi, Ryota Masuzaki, Kenichiro Enooku, Haruhiko Yoshida, Kazuhiko Koike & Hitoshi Ikeda

  3. Yamanashi Prefectural Hospital Organization, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan

    Masao Omata

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  1. Hiromi Hikita
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  2. Hayato Nakagawa
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Corresponding author

Correspondence to Hayato Nakagawa.

Additional information

H. Hikita and H. Nakagawa contributed equally to this work.

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Hikita, H., Nakagawa, H., Tateishi, R. et al. Perihepatic lymph node enlargement is a negative predictor of liver cancer development in chronic hepatitis C patients. J Gastroenterol 48, 366–373 (2013). https://doi.org/10.1007/s00535-012-0635-7

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  • DOI: https://doi.org/10.1007/s00535-012-0635-7

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