Journal of Gastroenterology

, Volume 48, Issue 3, pp 366–373 | Cite as

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

  • Hiromi Hikita
  • Hayato Nakagawa
  • Ryosuke Tateishi
  • Ryota Masuzaki
  • Kenichiro Enooku
  • Haruhiko Yoshida
  • Masao Omata
  • Yoko Soroida
  • Mamiko Sato
  • Hiroaki Gotoh
  • Atsushi Suzuki
  • Tomomi Iwai
  • Hiromitsu Yokota
  • Kazuhiko Koike
  • Yutaka Yatomi
  • Hitoshi Ikeda
Original Article—Liver, Pancreas, and Biliary Tract

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.

Keywords

Perihepatic lymph node enlargement Chronic hepatitis C Hepatocarcinogenesis 

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

Notes

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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Copyright information

© Springer 2012

Authors and Affiliations

  • Hiromi Hikita
    • 1
  • Hayato Nakagawa
    • 1
    • 2
  • Ryosuke Tateishi
    • 2
  • Ryota Masuzaki
    • 2
  • Kenichiro Enooku
    • 1
    • 2
  • Haruhiko Yoshida
    • 2
  • Masao Omata
    • 3
  • Yoko Soroida
    • 1
  • Mamiko Sato
    • 1
  • Hiroaki Gotoh
    • 1
  • Atsushi Suzuki
    • 1
  • Tomomi Iwai
    • 1
  • Hiromitsu Yokota
    • 1
  • Kazuhiko Koike
    • 2
  • Yutaka Yatomi
    • 1
  • Hitoshi Ikeda
    • 1
    • 2
  1. 1.Department of Clinical Laboratory Medicine, Graduate School of MedicineUniversity of TokyoTokyoJapan
  2. 2.Department of Gastroenterology, Graduate School of MedicineUniversity of TokyoTokyoJapan
  3. 3.Yamanashi Prefectural Hospital OrganizationKofuJapan

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