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http://dx.doi.org/10.7314/APJCP.2014.15.2.637

Impact of Chronic Hepatitis B and Hepatitis C on Adverse Hepatic Fibrosis in Hepatocellular Carcinoma Related to Betel Quid Chewing  

Jeng, Jen-Eing (Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Tsai, Meng-Feng (Department of Pediatrics, Sinchu MaKay Memorial Hospital)
Tsai, Hey-Ru (Department of Internal Medicine, Madow Sin-Lau Hospital)
Chuang, Lea-Yea (Department of Biochemistry, Kaohsiung Medical University)
Lin, Zu-Yau (Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Hsieh, Min-Yuh (Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Chen, Shinn-Chern (Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Chuang, Wan-Lung (Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Wang, Liang-Yen (Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Yu, Ming-Lung (Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Dai, Chia-Yen (Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Tsai, Jung-Fa (Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.15, no.2, 2014 , pp. 637-642 More about this Journal
Abstract
The pathogenesis of hepatocellular carcinoma (HCC) related to habitual betel quid (BQ) chewing is unclear. Risk of HCCis increased with adverse hepatic fibrosis. This study aimed to assess the impact of chronic viral hepatitis on adverse hepatic fibrosis in HCC related to BQ chewing. This hospital-based case-control study enrolled 200 pairs of age- and gender-matched patients with HCC and unrelated healthy controls. Serologic hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV), ${\alpha}$-fetoprotein (AFP), and surrogate markers for significant hepatic fibrosis were measured. Information on substance-use habits was obtained with a questionnaire. By analysis of surrogate markers for hepatic fibrosis, the prevalence of significant hepatic fibrosis in patients chewing BQ was between 45.8% and 91.7%, whereas that for patients without BQ chewing was between 18.4% and 57.9%. The difference was significant (P <0.05 for each surrogate marker). Multivariate analysis indicated that cirrhosis with Child-Pugh C (odds ratio (OR) = 3.28; 95% confidence interval (CI), 1.29-8.37), thrombocytopenia (OR = 3.92, 95% CI, 1.77-8.68), AFP >400 mg/L (OR = 2.21, 95% CI, 1.05-4.66) and male gender (OR = 4.06, 95% CI, 1.29-12.77) were independent factors associated with habitual BQ chewing. In conclusion, adverse hepatic fibrosis and severe liver damage play important roles in the pathogenesis of BQ-related HCC, which could be aggravated by chronic hepatitis B and hepatitis C. BQ-cessation programs and prevention of chronic HBV/HCV infection are needed to prevent HCC related to BQ chewing.
Keywords
HCC; chronic hepatitis B and C; betel quid chewing; risk factor; surrogate markers for hepatic fibrosis;
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