2021 Fiscal Year Final Research Report

Early diagnosis of viral-associated hepatocellular carcinoma and a challenge for non-B non-C hepatocellular carcinoma

Research Project

PDF

Project/Area Number	18K10065
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
Research Institution	Tottori University
Principal Investigator	Okano Jun-ichi 鳥取大学, 医学部, 特任教員 (00343278)
Co-Investigator(Kenkyū-buntansha)	的野智光鳥取大学, 医学部附属病院, その他 (60571841) 永原天知鳥取大学, 医学部附属病院, 助教 (00548860)
Project Period (FY)	2018-04-01 – 2022-03-31
Keywords	肝細胞癌 / サーベイランス / 糖尿病 / FIB-4 index
Outline of Final Research Achievements	For 414 cases diagnosed as primary hepatocellular carcinoma (HCC) at nine facilities in Tottori Prefecture from 2017 to 2019, surveillance for patients in the HCC high-risk group and risk factors for non-B non-C (NBNC) HCC were examined. The surveillance rate was 53.2% for hepatitis B virus (HBV), 32.8% for untreated hepatitis C virus (HCV), 95.5% for HCV (DAA-SVR), 68.8% for HCV (IFN-SVR), 14.0% for NBNC (non-ALD) (non-ALD; nonalcoholic), and 13.7% for NBNC (ALD). Patients who were HBV/HCV positive but were accidentally diagnosed with HCC didn't have a regular medical examination and had no history of HBV/HCV testing. The incidence of diabetes mellitus (DM) in 129 patients with NBNC (non-ALD) HCC was as high as 48.8%, and FIB-4 index 2.67 or higher was 35.7%. These results indicate that introduction of HCC surveillance for patients with DM and FIB-4 index 2.67 or higher may be able to diagnose about 30% of NBNC (non-ALD) HCC at early stages.
Free Research Field	肝臓病学
Academic Significance and Societal Importance of the Research Achievements	現在、非B非C型（NBNC）肝細胞癌（HCC）は偶発的に進行した状態で診断されることが多いが、FIB-4 index 2.67以上の糖尿病患者をその高危険群に設定してサーベイランスを行うことにより、NBNC HCC患者の予後改善が期待され、学術的・社会的意義は極めて大きいと考える。糖尿病かつFIB-4 index 2.67以上の条件を満たさないNBNC HCCやアルコール性HCCの早期診断対策は未解決の課題であり、今後の研究の進展が待たれる。