The male preponderance in incidence of hepatocellular carcinoma in cirrhotic patients may depend on the higher DNA synthetic activity of cirrhotic tissue in men

• Published in: Cancer 1993-07, Vol.72 (2), p.369-374
• Main Authors: Tarao, Kazuo, Ohkawa, Shinichi, Shimizu, Akio, Harada, Masaoki, Nakamura, Yoshiyasu, Ito, Yoshihiko, Tamai, Setsuo, Hoshino, Hiroshi, Okamoto, Naoyuki, Iimori, Kazuto, Inoue, Tohru, Kanisawa, Masayoshi
• Format: Article
• Language: English
• Subjects: Adult; Aged; alpha-Fetoproteins - analysis; Angiography; Biological and medical sciences; Biopsy; bromodeoxyuridine; Bromodeoxyuridine - metabolism; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - genetics; deoxyribonucleic acid synthesis; DNA - biosynthesis; DNA synthesis; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; hepatocellular carcinoma; Humans; Liver - metabolism; Liver Cirrhosis - complications; Liver Cirrhosis - genetics; Liver Neoplasms - complications; Liver Neoplasms - epidemiology; Liver Neoplasms - genetics; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Sex Characteristics; sex difference; Tumors; Ultrasonography
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19930715)72:2<369::AID-CNCR2820720210>3.0.CO;2-5

Background. The relationship between the DNA synthetic activity of hepatocytes from cirrhotic liver tissue and the incidence of hepatocellular carcinoma (HCC) during a 3‐year follow‐up period was studied in male and female patients with posthepatitic cirrhosis. Methods. The bromodeoxyuridine labeling index (BrdU LI) of hepatocytes was estimated in 38 cirrhotic patients (Child A stage, 23 men and 15 women) using a BrdU/anti‐BrdU in vitro method. The incidence of HCC was compared between male and female cirrhotic patients during a 3‐year follow‐up period. Results. Sixteen of 23 (69.6%) male patients belonged to the high‐DNA synthesis group (BrdU LI ⩽ 1.5%), and only 7 (30.4%) were in the low‐DNA synthesis group (BrdU LI < 1.5%). Among female patients, only 5 of 15 (33.3%) were in the high‐DNA synthesis group, and 10 of 15 (66.7%) were in the low‐DNA synthesis group (P < 0.05). Eleven of 23 (47.8%) male patients and 3 of 15 (20.0%) female patients had HCC develop. In the high‐DNA synthesis group, 10 of 16 (62.5%) of the men and 3 of 5 (60.0%) of the women had HCC develop during the follow‐up period. In contrast, only one of seven (14.3%) male patients and none of ten (0%) female patients in the low‐DNA synthesis group had HCC develop. Conclusions. It was concluded that HCC developed frequently (about 60% of the time within 3 years) in patients of both sexes who were in a high‐DNA synthesis group. Thus, the larger proportion of men in the high‐DNA synthesis group compared with the number of women in the group (69.6% versus 33.3%) might be one possible reason for the male predominance in the development of HCC in cirrhotic patients.