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. 2021 May 10:8:361-367.
doi: 10.2147/JHC.S306963. eCollection 2021.

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

Pan Zhao  1 , Yinying Lu  1 , Chunya Wang  2 , Limin Wang  3 , Jinfeng Li  1 , Meina Li  4
Affiliations

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

Pan Zhao et al. J Hepatocell Carcinoma. .

Abstract

Introduction: 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: children; hepatitis B virus; hepatocellular carcinoma.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
HBsAg expression in tumor tissues and matched non-tumor tissues from 2 pediatric patients with HBV-associated hepatocellular carcinoma. (A) Histological pictures of resected tumor tissues and adjacent non-tumor tissues stained by Hematoxylin-Eosin (× 200) and immunohistochemistry (× 200). (B) HBsAg in biopsy tumor tissues and paired non-tumor tissues (immunohistochemical staining, × 200). Brown particles represent HBsAg.
Figure 2
Figure 2
Survival curve of the patients in the study based on Kaplan-Meier analysis.
See this image and copyright information in PMC

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