Journal of Gastroenterology

, Volume 45, Issue 11, pp 1172–1182 | Cite as

Laparoscopic findings of reddish markings predict hepatocellular carcinoma in patients with hepatitis B virus-related liver disease

  • Bon Shoji
  • Fusao Ikeda
  • Shin-ichi Fujioka
  • Haruhiko Kobashi
  • Tetsuya Yasunaka
  • Yasuhiro Miyake
  • Hidenori Shiraha
  • Akinobu Takaki
  • Kazuhiro Nouso
  • Yoshiaki Iwasaki
  • Kazuhide Yamamoto
Original Article—Liver, Pancreas, and Biliary Tract



For patients with chronic hepatitis due to hepatitis B virus (HBV), factors predicting hepatocellular carcinoma (HCC) other than high levels of HBV-DNA and alanine aminotransferase (ALT) are needed to prevent HCC development, as many patients with chronic HBV infection fulfill these conditions. The purpose of this study was to clarify factors predictive of HCC development for those patients.


The study was a systematic cohort analysis of 303 consecutive patients with hepatitis B e-antigen, receiving laparoscopic examination for assessment of liver disease. Laparoscopic, histological, and clinical characteristics were investigated as related to HCC development.


HCC occurred in 27 patients during a mean follow-up of 8.0 ± 5.0 years, at the age of 37–72 years. Significant associations with HCC development were shown for liver cirrhosis, histological activity grade, reddish markings, and older age. Multivariate analysis revealed that HCC development was strongly associated with older age and male gender (P = 0.002 and P = 0.043, respectively). HCC occurred more frequently in patients of age ≥30 years even with early stage than in patients of age <30 years (P = 0.031). Severe reddish markings, a laparoscopic finding of widespread parenchymal destruction, were highly associated with HCC development in patients of age ≥30 years at diagnosis (odds ratio = 1.67, P = 0.034), while histological activity grade and ALT level were not (P = 0.075 and P = 0.69, respectively).


HCC development is associated with older age, male gender, and liver cirrhosis. Reddish markings, rather than histological activity or ALT level, can be useful to predict HCC for HBV patients of age ≥30 years.


Hepatitis B virus Hepatocellular carcinoma Laparoscopy 



Hepatitis B virus


Hepatocellular carcinoma


Alanine aminotransferase


Hepatitis C virus


Aspartate aminotransferase


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Copyright information

© Springer 2010

Authors and Affiliations

  • Bon Shoji
    • 1
  • Fusao Ikeda
    • 1
    • 2
  • Shin-ichi Fujioka
    • 3
  • Haruhiko Kobashi
    • 1
  • Tetsuya Yasunaka
    • 1
  • Yasuhiro Miyake
    • 1
    • 2
  • Hidenori Shiraha
    • 1
  • Akinobu Takaki
    • 1
  • Kazuhiro Nouso
    • 1
    • 2
  • Yoshiaki Iwasaki
    • 1
  • Kazuhide Yamamoto
    • 1
    • 2
  1. 1.Department of Gastroenterology and HepatologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
  2. 2.Department of Molecular HepatologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
  3. 3.Department of Internal MedicineOkayama Saiseikai General HospitalOkayamaJapan

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