studies

444A AASLD ABSTRACTS HEPATOLOGY, October, 2015
(31.5 mm), followed by HBV-HCC (40.0 mm) and NBNC-HCC
(46.4 mm). Serum AFP and DCP were significantly higher in
HBV-HCC than in HCV-HCC. Macroscopically, the percentage
of HCC with indistinct margin was significantly higher
in HCV-HCC (10.7%) compared with HBV-HCC (3.2%) and
NBNC-HCC (3.6%). On the other hand, HBV-HCC (20.7%) significantly
more frequently showed confluent multinodular type
compared with HCV-HCC (11.2%) and NBNC-HCC (8.7%).
The number of well-differentiated HCC and poorly differentiated
HCC were significantly higher in HCV-HCC (11.1%) and
in HBV-HCC (22.1%), respectively. Portal vein invasion was
significantly more frequent in HBV-HCC (67.4%) compared
with HCV-HCC (46.1%) and NBNC-HCC (56.5%). Patients
with NBNC-HCC significantly had higher rate of a history of
diabetes and alcohol intake. Out of 228 NBNC-HCC patients,
21.3% showed steatohepatitis in the background liver. About
half of them (11.2%) had a history of alcohol intake. The
residual cases (10.1%) were defined as non-alcoholic steatohepatitis.
Also, 19.7% of NBNC-HCC showed positivity of at
least one of serum HBV-related markers except HBs-Ag. [conclusions]
HBV-HCC, HCV-HCC and NBNC-HCC had different
clinicopathologic features. HBV-HCC showed aggressive biologic
features. NBNC-HCC was closely associated with not
only diabetes and alcohol intake but also HBV infection.
Disclosures:
The following authors have nothing to disclose: Jun Akiba, Osamu Nakashima,
Yoshiki Naito, Hironori Kusano, Reiichiro Kondo, Hirohisa Yano
466
The presence of histological abnormalities even after the
elimination of hepatitis C virus
Nobuhiro Aizawa 1 , Kyohei Kishino 1 , Yoshihiro Shimono 1 , Chikage
Nakano 1 , Kunihiro Hasegawa 1 , Ryo Takata 1 , Kazunori
You 1 , Akio Ishii 1 , Tomoyuki Takashima 1 , Yoshiyuki Sakai 1 , Naoto
Ikeda 1 , Takashi Nishimura 1 , Hiroki Nishikawa 1 , Yoshinori Iwata 1 ,
Hirayuki Enomoto 1 , Hiroko Iijima 1 , Seikan Hai 2 , Jiro Fujimoto 2 ,
Shuhei Nishiguchi 1 ; 1 Division of Hepatobiliary and Pancreatic Diseases,
Department of Internal Medicine, Hyogo collage of medicine,
Nishinomiya, Japan; 2 Division of surgery, Hyogo college of
medicine, Nishinomiya, Japan
Background: Despite the improved histological findings in the
liver after hepatitis C virus (HCV) eradication, hepatocellular
carcinoma (HCC) occurs in some patients with a sustained
virological response (SVR) to interferon therapy. However, the
mechanism of carcinogenesis in virus-eliminated liver tissues
remains unclear. The aim of this study is to clarify the characteristics
of SVR-related hepatocarcinogenesis. Subjects and
Methods: A total of 43 patients with SVR were enrolled. Fifteen
patients had HCC (Group A), and the remaining 28 patients
did not (Group B). We pathologically examined the non-cancerous
hepatic tissues of Group A patients, and compared those
tissues with the liver tissues of Group B patients by electron
microscopy (EM). We evaluated the degree of the dilatation of
vesicular endoplasmic reticulum on a scale of 0 to 3. We also
evaluated the mitochondrial alterations on a scale of 0 to 10
according to the following points: (1) Dense granules, (2) Paracrystalline
inclusions, (3) Vacuole formation, (4) Irregularity
of mitochondrial shapes, and (5) Lack of mitochondrial membrane.
This study was conducted in accordance with the Helsinki
declaration and written informed consents were obtained
from all patients before the study. Results: Regarding dilatation
of vesicular endoplasmic reticulum, elevated scores (> 2 points)
were found in 14.3% (4/28) of the Group B patients and
in 92.9% (13/15) of the Group A patients. Regarding the
morphological mitochondrial alterations, elevated scores (>
4 points) were found in 3.6% (1/28) of the Group B patients
and in 80.0% (12/15) of the Group A patients. Scores of
the alterations regarding the mitchondria and the vesicular
endoplasmic reticulum were higher in the HCC Group than in
the non-HCC Group. The morphological abnormalities were
not associated with the histological findings, including activity
grade and fibrosis stage. Conclusion: The EM findings
revealed the presence of histological abnormalities even after
the elimination of HCV. In particular, remarkable morphological
abnormalities were observed in non-cancerous hepatic
tissues of HCC patients. Their histological alterations after SVR
should be correlated with hepatocarcinogenesis.
Disclosures:
The following authors have nothing to disclose: Nobuhiro Aizawa, Kyohei
Kishino, Yoshihiro Shimono, Chikage Nakano, Kunihiro Hasegawa, Ryo Takata,
Kazunori You, Akio Ishii, Tomoyuki Takashima, Yoshiyuki Sakai, Naoto Ikeda,
Takashi Nishimura, Hiroki Nishikawa, Yoshinori Iwata, Hirayuki Enomoto,
Hiroko Iijima, Seikan Hai, Jiro Fujimoto, Shuhei Nishiguchi
467
Prognostic Score predicting overall survival of Patients
with Intermediate Stage of Hepatocellular Carcinoma
after Transarterial Chemoembolization
Saharat Jarupongprapa, Supot Nimanong, Siwaporn Chainuvati,
Phunchai Charatcharoenwitthaya, Tawesak Tanwandee, Watcharasak
Chotiyaputta; Gastroenterology, Internal Medicine, Siriraj
Hospital, Mahidol University, Bangkok, Thailand
Background: Transarterial chemoembolization (TACE) is the
standard of care for patients (pts) with intermediate stage
of hepatocellular carcinoma (HCC). Multiple TACE sessions
are common in treatment of HCC which can result in shorten
survival. Several baseline characteristics and dynamic tumor
response after the first TACE were studied to select the patients
who are not beneficial form repeated TACE. Objectives: To
determine factors associated with overall survival (OS) after first
TACE and to develop a prognostic score to identify candidates
who have benefit form repeated TACE. Methods: A retrospective
study between 2007 and 2012, all HCC pts underwent
at least two consecutive TACE within 90 days. Pts with Child-
Pugh (CTP) C, Barcelona Clinic Liver Cancer (BCLC) stage C
and ruptured HCC at presentation were excluded. Baseline
characteristics, liver function and dynamic tumor response after
first TACE were analyzed on the median OS. Results: 216
pts were included in this study. 75% were male, mean age
was 59.2 years, and 74.5% were viral associated HCC. At
baseline, mean tumor size was 7.9 cm, 62.5% was unilobar,
and 60.6% was multifocal HCC. The median OS was 17.6
months (15.3-19.9). 89.8% of pts (n=194) died during study
period. On multivariate analysis, five parameters were significant
factors to predict OS including baseline CTP B [HR1.77,
p=0.04], BCLC stage B [HR1.95, p=0.001], increased CTP
score after TACE [+1 (HR2.29), +2 (HR11.74), p 200 IU/L with < 50% reduction after TACE
[HR2.07, p=0.003], and radiologic response (stable or progressive
disease on mRECIST) [HR1.56, p=0.01]. A prognostic
score using five parameters was developed and divided into
two groups (