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Clinicopathological features of Non-B and Non-C HCC 

  • Chronic viral hepatitis and liver cirrhosis following hepatitis B virus (HBV) or hepatitis C virus (HCV) infection had been reported to be responsible for most HCCs.
  • A nationwide follow-up survey by the Liver Cancer Study Group of Japan found that the number of other HCC patients (mostly non-B non-C HCC: NBNC-HCC) had more than doubled during the previous decade.
  • Nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) have recently assumed increasing attention for their relationship with HCC.
  • It remains controversial whether NBNC-HCC patients have comparable prognosis to HCC patients with HBV or HCV because the clinicopathological characteristics in NBNC patients still remain unclear.
  • There have been few reports examining the prevalence of steatohepatitis in NBNC-HCC patients and/or regarding the relationship between their surgical outcomes and degree of steatohepatitis.


  • The patients in group NBNC had significantly higher prevalence of hypertension and DM than those in the other groups. 
  • The platelet counts and PT were the highest and ICG R15 was the lowest in group NBNC. 
  • The 5-year OS rate in group NBNC was better than those in the other groups.
  • In the subgroup analysis of group NBNC, there were no significant differences in the patient background and the histopathological factors including NAS except for the proportions of female and noncigarette smokers.
  • The 5-year OS and RFS rates in group NALP were  better than those in group ALP.
  • The multivariate analysis demonstrated Child-Pugh B/C, im(+) and extrahepatic recurrence were   identified as independent indicators of OS in group NBNC.


  • Our study suggested that the NBNC-HCC patients were characterized by association with lifestyle-related diseases and preserved liver function and they could have better prognosis than the virus-related HCC patients. 
  • In the NBNC-HCC patients, there were no significant differences in histopathological factors in the non-cancerous regions, including NAS between alcohol drinker and non-drinker. 
  • NBNC-HCC patients who don’t drink alcohol could have better prognosis than those who drink alcohol. 
 ©Shuji Isaji 2019