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Chen et al. Hepatoma Res 2019;5:25 Hepatoma Research
DOI: 10.20517/2394-5079.2019.12

Original Article Open Access

Hepatocellular carcinoma occurred in a Hepatitis B
carrier clinic cohort during a mean follow up of 10

years

Cheng-Jen Chen , Jennifer Tai , Dar-In Tai 1,2
2
1
1 Liver Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan.
2 Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan.

Correspondence to: Dr. Dar-In Tai, Liver Research Center, Chang Gung Memorial Hospital and Chang Gung University College
of Medicine, 199 Tung-Hwa North Road, Taipei 10591, Taiwan. E-mail: tai48978@cgmh.org.tw; imjenkid@gmail.com;
k85731@cgmh.org.tw

How to cite this article: Chen CJ, Tai J, Tai DI. Hepatocellular carcinoma occurred in a Hepatitis B carrier clinic cohort during a
mean follow up of 10 years. Hepatoma Res 2019;5:25. http://dx.doi.org/10.20517/2394-5079.2019.12

Received: 17 Feb 2019 First Decision: 7 Mar 2019 Revised: 12 Apr 2019 Accepted: 18 Apr 2019 Published: 11 Jul 2019
Science Editor: Jin-Lin Hou Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: Chronic persistent hepatitis B virus carriers are generally asymptomatic until the advanced stage of the
disease. The “Hepatitis B-Carrier Clinics” of Chang Gung Memorial Hospital has been using alpha-fetoprotein (AFP)
and liver ultrasound for early detection of hepatocellular carcinoma (HCC) in hepatitis B surface antigen (HBsAg)
carriers since 1980.

Methods: We evaluated the results of surveillance between 1980 and 2012 by collecting clinic data, matched cancer
registry status, and national mortality database status.

Results: Of 15,235 HBsAg carriers, 238 instances of HCC (1.5% or 156.2/100,000 person-years) were detected
over a mean follow-up period of 10.0 ± 7.6 years. There were more men (89.1%) and patients with liver cirrhosis
(70.2%) in the HCC group (P < 0.001), and both the initial and maximal alanine aminotransferase (ALT) levels
were higher in this group (P < 0.001). One hundred and thirty cases of HCC (54.6%) were identified during regular
follow-up sessions, 55 (23.1%) were detected after the regular schedule had lapsed (“out-of-schedule”), and 53
(22.3%) were lost to follow-up completely. The mean tumor size was smaller in the regular group than in the out-
of-schedule group (2.72 cm vs. 4.59 cm, P < 0.001), and the survival rate was higher (43.8% vs. 30.9%, P < 0.001).

Conclusion: The incidence of HCC was relatively low in the HBsAg-Carrier Clinics cohort. Surveillance for early

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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