Usefulness of viral concentration measurement by transcription-mediated amplification and hybridization protection as a prognostic factor for recurrence after resection of hepatitis B virus-related hepatocellular carcinoma

We examined the usefulness of a transcription-mediated amplification and hybridization protection assay (TMA-HPA) for the evaluation of the degree of active hepatitis and estimation of recurrence after resection of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). We compared results obtained with TMA-HPA with results obtained with a branched DNA assay. Fifty-two patients with HBV-related HCC were divided into two groups; group I consisted of 28 patients with a high serum concentration of HBV (greater than or equal to3.7 LGE/ml) and group 2 consisted of 14 patients with a low serum concentration of HBV (<13.7 LGE/ml). Serum activities of aspartate and alanine aminotransferases were higher in group 1 than in 2 (P = 0.0002, P = 0.0020, respectively). The proportion of patients with mildly or moderately active hepatitis, evaluated by histologic examination, was higher in group 1 than in 2 (P = 0.0025). The tumor-free survival rate was significantly lower in group 1 than in 2 (P = 0.0014). In multivariate analysis, a high viral concentration (risk ratio, 6.37; 95% CI, 1.46-27.78), young age, and multiple tumors were independent risk factors for recurrence. The serum HBV concentration obtained with TMA-HPA seemed to correlate with the degree of active hepatitis more closely than that obtained with the branched DNA assay. The serum concentration of HBV, measured with TMA-HPA, is closely related to the degree of active hepatitis, and the measurement of the serum concentration of HBV is useful for estimating recurrence after resection of HBV-related HCC. (C) 2002 Elsevier Science B.V. All rights reserved.