Journal of Hepatocellular Carcinoma (May 2021)

Clinical, Pathological and Genetic Characteristics of Pediatric Hepatocellular Carcinoma Associated with Hepatitis B Virus Infection

  • Zhao P,
  • Lu Y,
  • Wang C,
  • Wang L,
  • Li J,
  • Li M

Journal volume & issue
Vol. Volume 8
pp. 361 – 367

Abstract

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Pan Zhao,1 Yinying Lu,1 Chunya Wang,2 Limin Wang,3 Jinfeng Li,1 Meina Li4 1The Fifth Medical Center (formerly Beijing 302 Hospital), Chinese PLA General Hospital, Beijing, 100039, People’s Republic of China; 2Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, People’s Republic of China; 3Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, 102218, People’s Republic of China; 4Department of Health Service, Second Military Medical University, Shanghai, 200433, People’s Republic of ChinaCorrespondence: Limin Wang; Pan Zhao Tel +86 10 56119097; +86 10 66933464Email [email protected]; [email protected]: Hepatocellular carcinoma (HCC) remains the major challenge in the management of patients with hepatitis B virus (HBV) infection. To date, limited studies have been done on pediatric HBV-associated HCC specifically.Methods: Pediatric patients younger than 16 years with HBV-associated HCC were included in the study. HBV integration detection was performed using a high-throughput viral integration detection (HIVID) method.Results: Among the 13 included pediatric patients, boys predominated (10, 76.9%). The median age at diagnosis of HCC was 13 years and the youngest age was 6 years. Nine patients had initially seronegative hepatitis B e antigen (HBeAg) and 4 had seropositive HBeAg. All patients had cirrhosis and elevated alpha-fetoprotein. Splenomegaly was present in all patients. Intrahepatic HBsAg was not detected in any tumor tissues from 5 patients who underwent biopsy or excision, while it was positive in all matched non-tumor tissues. In the tumor and matched non-tumor tissues from 3 individuals, HBV integration was identified except in the neoplastic specimen from 1 patient. Integration into the reported genes associated with hepatocarcinogenesis was not found in the tumor tissues from the 3 patients.Discussion: Hypervigilance for HCC development is required in HBeAg-negative cirrhotic children. The findings based on the immunohistochemical and genetic results expand the knowledge of pediatric HCC development.Keywords: hepatitis B virus, hepatocellular carcinoma, children

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