Clinical

Dysplastic liver nodules may be precancerous

Last Updated: 2006-03-10 13:42:00 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In patients with chronic viral hepatitis and cirrhosis, dysplastic nodules frequently develop into hepatocellular carcinoma, Japanese researchers report.

In the February issue of Cancer, Dr. Masahiro Kobayashi of Toranomon Hospital, Tokyo and colleagues note that advances in imaging have led to detection of small nodular lesion in patients with liver disease.

To determine what factors might be associated with the development of hepatocellular carcinoma in these circumstances, the researchers observed 154 patients. None had hepatocellular carcinoma at baseline.

Over a median of 2.8 years follow-up, 29 (18.8%) of the nodules became cancerous. The rate of development was significantly higher in high-grade than low-grade dysplastic nodules.

For example, at 1 year, the development rate in high-grade nodules was 46.2% and at 5 years, 80.8%. Corresponding rates in low-grade nodules were 2.6% and 36.6%.

The annual development rate was 20% in patients with high-grade nodules and 10% in those with low-grade nodules. Cumulative rates overall, were 7.0% at 1 year, 19.9% at 3 years and 27.4% at 5 years.

Histopathologic diagnosis, a tumor diameter of more than 14 mm, age more than 60 years and having a decrease in portal blood flow in the hepatic nodule were among factors associated with cancer development.

Moreover, in conclusion, the researchers point out that on the basis of changes seen during follow-up, "enlargement of tumor diameter was the most important factor suggesting malignant transformation."

Cancer 2006;106:636-647.