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Abstract: Background & Aims: Diabetes mellitus (DM) has been found to be strongly associated with an increased risk of hepatocellular carcinoma (HCC) among chronic hepatitis C (CHC) patients. Several studies have also found an association between metabolic steatosis and the risk of HCC in CHC patients, whether this latter association has been accounted for by the known relationship between DM and HCC is still unknown. Methods: A cohort consisting of 976 non‐genotype 3 patients histologically proven to have CHC and treated with interferon and ribavirin was studied. Cumulative incidence and HCC risk were analysed using the Kaplan‐Meier method and Cox proportional hazard analysis. Results: Hepatocellular carcinoma developed in 140 subjects over a median follow‐up period of 97.3 months, while 699 patients achieved sustained virological response (SVR). According to multivariate analyses, age ≥ 60 years, advanced fibrosis and genotype 1 were identified as independent factors significantly associated with HCC development in SVR patients. Furthermore, using the absence of steatosis and absence of DM as references, the presence of steatosis without DM (HR = 2.09, 95% CI = 1.12‐3.9, P = .021), the presence of DM without steatosis (HR = 2.78, 95% CI = 1.3‐5.92, P = .008) and the combined presence of steatosis and DM (HR = 3.25, 95% CI = 1.44‐7.33, P = .004) were identified as independent factors significantly associated with HCC development in the SVR patients. In contrast, steatosis alone, DM alone and the combined presence of steatosis and DM were not associated with HCC development in non‐SVR patients. Conclusions: Steatosis and DM may be associated with HCC development in non‐genotype 3 CHC patients with SVR. [ABSTRACT FROM AUTHOR]

Aim: To determine the incidence of needle tract seeding after fine needle aspiration (FNA) or percutaneous ethanol injection (PEI) and compare iatrogenic or spontaneous soft tissue metastasis (STM) by hepatocellular carcinoma (HCC) postradiotherapy (RT) in responses. Methods: From November 1997 to January 2006, those who presented with STM by HCC after our invasive procedures or developed spontaneously were enrolled into this retrospective study. Metastatic lesions could be divided into procedure related (PR), which were located at the liver span and were related to invasive procedures, and non-procedure related (NPR), which were in extrahepatic areas. STM was treated with an electron or photon beam. Results: A total of 39 HCC cases with developed STM were referred for RT, including 17 in the PR group and 22 in the NPR group. During the same period, a total of 18 227 person-times of FNA or PEI were performed on these HCC patients. The overall incidence of HCC with STM that was caused by invasive procedures was estimated at 0.13%. According to the Cox' regression model, the initial treatment modality influences the time duration after the initial diagnosis of HCC when STM has not occurred. None of these patients' soft tissue tumor increased in size during RT. The PR group had lower rates of bone metastasis ( P=0.003) and coexisting extrahepatic metastasis ( P=0.011) and a longer survival rate ( P=0.003) than the NPR group. The estimated rates of 18-gauge and 22-gauge needle-induced HCC-related STM were 0.60% and 0.11%, respectively ( P=0.064). Conclusion: The PR group bears a better prognosis than the NPR group post-RT. [ABSTRACT FROM AUTHOR]

Salmonellosis with liver abscess in a cirrhotic liver is extremely rare. We report the first case of Salmonellosis with septic shock and liver abscess in a diabetic and cirrhotic patient. The image studies of liver initially favored hepatocellular carcinoma. But no definite focus of sepsis was found. After close follow-up of the liver space-occupied lesion, ultrasound examination revealed the features of liver abscesses at space-occupied lesion later. Ultrasound-guided liver aspiration proved abscess. The clinical and radiological responses were good after antibiotics treatment. [ABSTRACT FROM AUTHOR]