Hepatocellular carcinoma with steatohepatitic features: a clinicopathological study of Japanese patients

Aims The aim of this study was to investigate the clinicopathological significance of steatohepatitic features in hepatocellular carcinomas ( HCC s) using a large‐scale analysis. Methods and results Retrospective clinicopathological analysis was performed on HCC s treated surgically at the U niversity of T okyo H ospital between 2005 and 2010. The diagnosis of HCC with steatohepatitic features ( SH ‐ HCC ) was made if the tumour fulfilled four of the following five criteria: steatosis (>5% tumour cells), ballooning or M allory– D enk body formation, interstitial fibrosis and inflammatory infiltrates. There were 120 HCC s (31.4%) from 106 patients (36.3%) that met the criteria of SH ‐ HCC . Patients with SH ‐ HCC were characterized by a higher frequency of diabetes mellitus and hypertension, along with higher serum levels of cholesterol and triglycerides, than those with conventional HCC ( P < 0.01). The background liver of SH ‐ HCC patients showed steatosis and steatohepatitis more frequently ( P < 0.01). SH ‐ HCC s were smaller, relatively more differentiated and had a higher frequency of bile duct invasion ( P < 0.05). Multivariate analysis failed to show prognostic significance of steatohepatitic features in HCC s. Conclusions SH ‐ HCC is a subcategory of HCC associated with the patient's metabolic condition and the presence of steatosis or steatohepatitis in the background liver. Steatohepatitic features were not a significant prognostic factor for HCC s.