C型慢性肝炎に対するインターフェロン療法著効12年後に発症した破裂肝細胞癌の1切除例  [in Japanese] A Hepatocellular Carcinoma Developed Following 12 Years from Sustained Virologic Response to Interferon Therapy in a Patient with Hepatitis C  [in Japanese]

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Author(s)

Abstract

C型慢性肝炎に対するインターフェロン(以下,IFN)治療後にHCV-RNAの持続的陰性化とALT値の正常化が得られる著効例からの肝細胞癌(以下,HCC)の発生率は少ないとされる.患者は65歳の男性で,C型慢性肝炎に対してIFN-βによる治療により著効を得た.IFN著効12年後の肝S<sub>7</sub>の破裂HCCに対し,動脈塞栓術による止血後にS7亜区域切除を施行した.切除標本では,IFN開始時,新犬山分類のF3/A2であった線維化と壊死,炎症所見が切除時にはF0/A0まで改善していた.また,極めて多くのMib-1陽性細胞を有する低分化型肝細胞癌であった.IFN長期著効例であっても発癌の可能性を十分に考慮した経過観察が必要であると考えられた.<br>

We successfully resected hepatocellular carcinoma (HCC) that developed 12 years after the achievement of sustained virologic response (SVR) to interferon (IFN) therapy in a 65-year-old man with an unknown transmission route of hepatitis C virus (HCV). In 1992, he was found to have chronic hepatitis C and treated by IFN-β and after which, SVR was obtained. Twelve years after therapy, he reported sudden abdominal pain. CT led to a diagnosis of ruptured HCC of segment 7, necessitating emergency hepatic arterial embolization, followed by hepatic S7 subsegmentectomy. He recovered without complications. This case showed the longest period from achievement of SVR to development of HCC carcinogenesis among those reported in Japan, and features poorly differentiated HCC, carcinogenesis from the eradicated fibrosis liver by IFN therapy with numerous positive cells stained by Mib-1. In conclusion, close observation is required for patients who obtained SVR of HCV even after 10 years.<br>

Journal

  • Kanzo

    Kanzo 48(2), 48-56, 2007-02-25

    The Japan Society of Hepatology

References:  41

Cited by:  5

Codes

  • NII Article ID (NAID)
    10018587107
  • NII NACSIS-CAT ID (NCID)
    AN00047770
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    04514203
  • NDL Article ID
    8729120
  • NDL Source Classification
    ZS21(科学技術--医学--内科学)
  • NDL Call No.
    Z19-130
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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