{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:04:03Z","timestamp":1761919443625,"version":"3.44.0"},"reference-count":45,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2011,3,24]]},"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Longstanding liver inflammation leads to hepatic regeneration and fibrosis, which subsequently progresses to cirrhosis in some patients with chronic hepatitis B virus (HBV) infection. It remains unclear, however, if the histological severity of chronic hepatitis B (CHB) may determine the development of hepatocellular carcinoma (HCC). The aim of this study was to evaluate the effects of necroinflammation and fibrosis at presentation of CHB on the development of HCC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Medical records and radiographs of 796 biopsy-confirmed CHB patients were reviewed retrospectively for a median period of 107\u2005months (6\u2013218) (median age 34\u2005years (18\u201364), male:female 636:160). Eighty-five per cent (680\/796) of patients were treated with antiviral agents such as interferon alpha and\/or lamivudine. All the patients were followed at a regular interval of 3\u20136\u2005months with routine laboratory tests. Abdominal imagings together with serum alpha-fetoprotein were checked every 6\u201312\u2005months to detect new HCC. Necroinflammation and fibrosis were assessed semiquantitatively. Univariate and multivariate analyses were performed to identify significant risk factors for HCC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>HCC developed in 3.4% (27\/796) of patients during follow-up. The overall cumulative occurrence rates of HCC were 0.5% and 3.5% at 5 and 10\u2005years, respectively. In multivariate analysis, age over 40\u2005years (p&lt;0.001), advanced fibrosis (p=0.006) and severe lobular activity (p=0.038) at presentation were independent risk factors for the development of HCC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Advanced fibrosis and severe lobular activity rather than porto\u2013periportal activity on histology at presentation of CHB are independent predisposing risk factors for the development of HCC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jclinpath-2011-200036","type":"journal-article","created":{"date-parts":[[2011,5,14]],"date-time":"2011-05-14T20:25:40Z","timestamp":1305404740000},"page":"599-604","source":"Crossref","is-referenced-by-count":8,"title":["Histological characteristics predisposing to development of hepatocellular carcinoma in patients with chronic hepatitis 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