Hepatocellular Carcinoma

Anisha Jain, Benjamin Mazer, Yanhong Deng, Maria Ciarleglio, Dhanpat Jain, Tamar Taddei, Xuchen Zhang

Research output: Contribution to journalArticlepeer-review


Objectives: The pathologic differences between hepatocellular carcinoma (HCC) arising in noncirrhotic and cirrhotic livers have not been well studied. Methods: We performed a retrospective analysis of 378 HCC cases (95 in noncirrhotic, 283 in cirrhotic livers) from pathology archives (2010-2017). Results: Patients without cirrhosis were more likely to have hepatitis B (13.68% vs 2.83%, P<.001) or no known liver disease (30.53% vs 4.24%, P<.001), while hepatitis C was more common in patients with cirrhosis (65.72% vs 30.53%, P<.001). HCCs in noncirrhotic livers were larger in size (P<.001); were more likely to have a macrotrabecular histologic pattern (13.68% vs 4.95%, P<.01); were more likely to have fibrolamellar (3.16% vs 0%, P=.02), macrotrabecular-massive (13.68% vs 6.01%, P=.03), and clear cell (16.84% vs 6.71%, P<.01) subtypes; have a higher histologic grade (P<.01); be anaplastic tumor cells (P<.001); have a higher rate of vascular invasion (P<.01); and have a higher tumor stage (P=.04). Conclusions: The findings indicate that HCCs in noncirrhotic livers demonstrate a larger tumor size; have a more macrotrabecular histologic pattern; have fibrolamellar, macrotrabecular-massive, and clear cell subtypes; have a higher tumor grade and stage; have a higher rate of vascular invasion; and have more anaplastic tumor cells compared with cirrhotic livers. Further studies to explore different pathways that promote oncogenesis in noncirrhotic livers are needed to better understand the pathogenesis of HCC.

Original languageEnglish (US)
Pages (from-to)305-313
Number of pages9
JournalAmerican journal of clinical pathology
Issue number2
StatePublished - Feb 1 2022
Externally publishedYes


  • Cirrhosis
  • Hepatocellular carcinoma
  • Noncirrhosis
  • Subtype

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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