TY - JOUR
T1 - Perihepatic lymph node enlargement is a negative predictor of liver cancer development in chronic hepatitis C patients
AU - Hikita, Hiromi
AU - Nakagawa, Hayato
AU - Tateishi, Ryosuke
AU - Masuzaki, Ryota
AU - Enooku, Kenichiro
AU - Yoshida, Haruhiko
AU - Omata, Masao
AU - Soroida, Yoko
AU - Sato, Mamiko
AU - Gotoh, Hiroaki
AU - Suzuki, Atsushi
AU - Iwai, Tomomi
AU - Yokota, Hiromitsu
AU - Koike, Kazuhiko
AU - Yatomi, Yutaka
AU - Ikeda, Hitoshi
PY - 2013/3
Y1 - 2013/3
N2 - 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 followup 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 studymayprovide new insights into daily clinical practice and the pathophysiology of HCV-induced hepatitis and hepatocarcinogenesis.
AB - 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 followup 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 studymayprovide new insights into daily clinical practice and the pathophysiology of HCV-induced hepatitis and hepatocarcinogenesis.
KW - Chronic hepatitis C
KW - Hepatocarcinogenesis
KW - Perihepatic lymph node enlargement
UR - http://www.scopus.com/inward/record.url?scp=84884632188&partnerID=8YFLogxK
U2 - 10.1007/s00535-012-0635-7
DO - 10.1007/s00535-012-0635-7
M3 - Article
C2 - 22790352
AN - SCOPUS:84884632188
SN - 0944-1174
VL - 48
SP - 366
EP - 373
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
IS - 3
ER -