TY - JOUR
T1 - Steatohepatitic Variant of Hepatocellular Carcinoma Is Associated with Both Alcoholic Steatohepatitis and Nonalcoholic Steatohepatitis
T2 - A Study of 2 Cohorts with Molecular Insights
AU - Qin, Jia
AU - Higashi, Takaaki
AU - Nakagawa, Shigeki
AU - Fujiwara, Naoto
AU - Yamashita, Yo Ichi
AU - Beppu, Toru
AU - Baba, Hideo
AU - Kobayashi, Masahiro
AU - Kumada, Hiromitsu
AU - Gunasekaran, Ganesh
AU - Schiano, Thomas D.
AU - Thung, Swan N.
AU - Fiel, Maria Isabel
AU - Hoshida, Yujin
AU - Ward, Stephen C.
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Steatohepatitic hepatocellular carcinoma (SH-HCC) is a variant of hepatocellular carcinoma (HCC) with established association with nonalcoholic steatohepatitis (NASH), while its association with alcoholic steatohepatitis (ASH) is unclear. We studied 2 cohorts of patients who underwent resection for HCC in the setting of steatohepatitis. In our Mount Sinai (New York) cohort, we found SH-HCC in 17/24 (71%) patients with NASH and in 14/19 (74%) patients with ASH, while SH-HCC was the predominant tumor morphology in 12/24 (50%) in the NASH group and 9/19 (47%) in the ASH group. Upon review, 12/19 patients diagnosed with ASH also had diabetes and/or a body mass index >30. When these patients were removed, we still found similar rates of SH-HCC (6/7 [86%] showed SH-HCC, while SH-HCC was predominant in 3/7 [43%]. Interestingly, glycogenated hepatocyte nuclei were seen in the nontumor liver in 4/7 (57%) of these cases. In our Japan cohort, we also found similar rates of SH-HCC in NASH and ASH patients with HCC, 15/58 (26%), and 16/45 (36%), respectively. We determined molecular subclassification of tumors from the Japan cohort and found no difference in the distribution of S1, S2 and S3 subclasses among the ASH and NASH groups, though, among cases of SH-HCC, there was a trend toward an association of ASH with S1 (P=0.054) and NASH with S3 (P=0.052). Our study shows that SH-HCC is common in both ASH and NASH and that both underlying liver diseases produce tumors with similar molecular profiles, though different pathways may underlie the development of SH-HCC in ASH versus NASH.
AB - Steatohepatitic hepatocellular carcinoma (SH-HCC) is a variant of hepatocellular carcinoma (HCC) with established association with nonalcoholic steatohepatitis (NASH), while its association with alcoholic steatohepatitis (ASH) is unclear. We studied 2 cohorts of patients who underwent resection for HCC in the setting of steatohepatitis. In our Mount Sinai (New York) cohort, we found SH-HCC in 17/24 (71%) patients with NASH and in 14/19 (74%) patients with ASH, while SH-HCC was the predominant tumor morphology in 12/24 (50%) in the NASH group and 9/19 (47%) in the ASH group. Upon review, 12/19 patients diagnosed with ASH also had diabetes and/or a body mass index >30. When these patients were removed, we still found similar rates of SH-HCC (6/7 [86%] showed SH-HCC, while SH-HCC was predominant in 3/7 [43%]. Interestingly, glycogenated hepatocyte nuclei were seen in the nontumor liver in 4/7 (57%) of these cases. In our Japan cohort, we also found similar rates of SH-HCC in NASH and ASH patients with HCC, 15/58 (26%), and 16/45 (36%), respectively. We determined molecular subclassification of tumors from the Japan cohort and found no difference in the distribution of S1, S2 and S3 subclasses among the ASH and NASH groups, though, among cases of SH-HCC, there was a trend toward an association of ASH with S1 (P=0.054) and NASH with S3 (P=0.052). Our study shows that SH-HCC is common in both ASH and NASH and that both underlying liver diseases produce tumors with similar molecular profiles, though different pathways may underlie the development of SH-HCC in ASH versus NASH.
KW - alcoholic steatohepatitis
KW - hepatocellular carcinoma
KW - nonalcoholic steatohepatitis
UR - http://www.scopus.com/inward/record.url?scp=85091125580&partnerID=8YFLogxK
U2 - 10.1097/PAS.0000000000001533
DO - 10.1097/PAS.0000000000001533
M3 - Article
C2 - 32618599
AN - SCOPUS:85091125580
SN - 0147-5185
VL - 44
SP - 1406
EP - 1412
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
IS - 10
ER -