AIH does not have a single diagnostic test. The diagnosis is by different scoring systems based on combination of biochemical, autoimmune, and histological parameters, and exclusion of other liver diseases. Autoantibodies are hallmark of autoimmune hepatitis and constitute an important part of the diagnostic work-up. We

aim to study the serological profile of AIH in a Sri Lankan cohort. Methods: AIH database of Gastroenterology clinic, Colombo North Teaching Hospital was analyzed Maraviroc order retrospectively. The Revised Original Scoring System of the International Autoimmune Hepatitis Group was applied to define the cases of (definite or probable) AIH. Results: 18 Patients who had complete data were analyzed. 11/17 fulfilled the criteria for definite AIH and 7/18 fulfilled the criteria for

probable AIH. Of 18 patients with AIH mean age was 40.25 (SD 9.1) years and 14 (77.7%) were females. Dorsomorphin cell line Among these 18 patients only 3 (28.3%) were positive for antinuclear antibodies (ANA), 2 (11.1%) had smooth muscle antibodies (SMA) but none of these patients were positive for antibodies to liver/kidney microsome type 1 (anti-LKM-1). All these 18 patients were treated with prednisolone and azathioprine and 16 responded to treatment, but 2 patients did not respond to treatment and progressed to cirrhosis. Conclusion: Autoimmune markers appear to be less common in this cohort of patients with probable or definite AIH. Key Word(s): 1. autoimmune hepatitis autoantibodies Presenting Author: IMELDA REY Additional Authors: ELIAS TARIGAN, RUSTAM EFFENDI YS, LUKMAN HAKIM ZAIN Corresponding Author: IMELDA REY Affiliations: Medical Faculty, University of North Sumatera, Medical Faculty, University

of North Sumatera, Medical Faculty, University of North Sumatera Objective: Non invasive test have been constructed and evaluated mainly for binary diagnoses such as significant fibrosis. Recently detail fibrosis classification for several non invasive test such as Fib4 index have been develop but their accuracy have not been thoroughly evaluated in comparison to liver biopsy. The aim of this study was to evaluate the accuracy of the detail 上海皓元医药股份有限公司 fibrosis classification available for fib4 index with liver biopsy in Chronic Hepatitis B and C patients. Methods: In this cross sectional study, 71 patients confirmed with Hepatitis B and C, underwent liver biopsy in Adam Malik Hospital Medan since January 2011 to September 2013. Laboratory was taken such AST, ALT, platelet and personal data. Fib4 index was computed. We used predictive value, AUROC to assess the accuracy of fib4 index with liver biopsy. Results: The Fib4 index (cut off >1,45) compared to Metavir to diagnose severe fibrosis had sensitivity 78,8%, specificity 57,9%, PPV 61,9%, NPV 75,9%, LR(+) 1,87 and LR(-) 0,37. Accuracy diagnostic was 67,6%, AUROC 0,683 (95% CI:0,558–0,809) with p < 0,05 Conclusion: Fib4 index can be used for fibrosis degree classification in chronic Hepatitis B and C patients.

In order to inhibit mature hepatocytes regeneration and increase check details hepatic progenitor cell expansion and differentiation, the treated rats were fed with 2-AAF during the period of cirrhosis progression. The results showed that the expressions of hepatic oval cell markers (OV6 and CK19) were increased significantly during fibrosis progression. In the CCl4/ 2-AAF treated rats, OV6 positive cells

and CK19 positive cells extended across the liver lobule, formed bridges between portal tracts and divided the parenchyma into smaller pseudolobules, as determined by immunohistochemitry. Double staining showed that OV6 was largely colocated with α-SMA positive cells, and the number of cells positive for both OV6 and α-SMA was obviously increased after administration of 2-AAF. The expressions of Wnt4, Wnt5b, frizzled2, frizzled3 and frizzled6 were markedly increased after administration of 2-AAF (p<0.01). Immunohistochemistry showed that p-catenin protein was

mostly localized to the nucleus of cells before administration of 2-AAF; however, p-catenin was found predominantly within the cytoplasm after administration of 2-AAF. In addition, the expression level of p catenin was not changed by the administration of 2-AAF, suggesting that the activation of Wnt pathways was not mediated through the classical p-catenin pathway. Moreover, after administration of 2-AAF, gene expression of frizzled1 and frizzled4 was markedly decreased (p<0.01); however frizzled5 expression was not significantly changed, indicating that non-canonical Wnt signaling rather Lenvatinib mw than Wnt/p-catenin signaling was primarily activated. We also determined that the expression of TGF-β1 was markedly increased in vivo after administration of 2-AAF. Expression of α-SMAand F-actin, as well as collagen types 上海皓元医药股份有限公司 I and IV were significantly increased after the WB-F344 cell line, was treated with TGB-p1 for 24 hours. Additional investigation revealed that both Wnt5b and frizzled2 expression were significantly

increased in WB-F344 cells after treatment with TGF-β1 (p < 0.01), and p-catenin expression was not up-regulated during the treatment. Thus, these in vitro results confirmed our finding in vivo. In conclusion, our results indicate that hepatic progenitor cells appear to transdifferentiate into myofibroblasts and exhibit a profibrotic effect in the fibrogenic process through activating the non-canonical Wnt signaling pathway. Disclosures: The following people have nothing to disclose: Jiamei Chen, Yongping Mu, Yuyou Duan, Ping Liu Background: Activation of the FXR and TGR5 bile acid receptor pathways with the dual agonist INT-767 has been shown to improve non-alcoholic fatty liver disease (NAFLD) in a murine diet-induced obesity model. While the mechanisms of the liver improvement remain to be fully elucidated direct effects of these pathways on hepatocyte and macrophage function have been demonstrated.

[6] The group performed a series of tests evaluating executive function, including working memory and vigilance before and after therapy with a standard

interferon and ribavirin regimen. The article is important in that it shows that in a “real-life” cohort of patients, there was improvement in cognitive function in patients who had a sustained virological response but not in those who failed to clear the infection. This suggests that, after the established adverse effects on interferon and ribavirin have receded, at least 12 months postcompletion of therapy an improvement in cognitive function MAPK Inhibitor Library chemical structure attributable to viral eradication per se is evident. This reinforces the notion of a biological effect of HCV infection within the RO4929097 order CNS. Although it is possible that knowledge of the treatment outcome might have affected cognitive performance in some way, it would not be feasible in a prospective study of this nature to blind patients to their treatment outcome for 12 months after the end of treatment. The cohort that was studied had a relatively high sustained virological response rate and presumably did not include patients with multiple negative predictors of interferon response such as African Americans, obese individuals, and a high burden of advanced fibrosis. Although some patients with cirrhosis were studied, post-hoc analyses did not show

this to be important in predicting cognitive dysfunction. This is important, as it suggests that preexisting MHE in cirrhosis nonresponders

was not a confounding variable. The finding of cognitive improvement that is independent of cirrhotic morphology is important because it adds impetus to further evaluating cognitive function as an indication for and as an outcome measure of antiviral therapy at a precirrhotic stage. Disentangling 上海皓元医药股份有限公司 the relative contributions of HCV, cirrhosis, comorbid conditions, and concomitant medications can be challenging since available tests are sensitive but not specific.[7] MHE uniquely affects visuo-construction skills, motor speed, and motor accuracy, while precirrhosis HCV infection affects working memory and the domains of attention, executive function, and processing speed are affected in both.[8] The authors applied a relatively narrow battery of only four tests (alertness, divided attention, vigilance, and working memory), which were previously shown to be sensitive to the effect of interferon but are not specific to this or the effect of HCV infection itself. In this study, there was no comparison of baseline function with normative control data and the clinical significance of the improvement was not defined. Indeed, in future studies it will be important to link neurocognitive test performance with outcomes that affect daily life such as cognitive health-related quality of life, e.g.

[6] The group performed a series of tests evaluating executive function, including working memory and vigilance before and after therapy with a standard

interferon and ribavirin regimen. The article is important in that it shows that in a “real-life” cohort of patients, there was improvement in cognitive function in patients who had a sustained virological response but not in those who failed to clear the infection. This suggests that, after the established adverse effects on interferon and ribavirin have receded, at least 12 months postcompletion of therapy an improvement in cognitive function Tanespimycin attributable to viral eradication per se is evident. This reinforces the notion of a biological effect of HCV infection within the Ku 0059436 CNS. Although it is possible that knowledge of the treatment outcome might have affected cognitive performance in some way, it would not be feasible in a prospective study of this nature to blind patients to their treatment outcome for 12 months after the end of treatment. The cohort that was studied had a relatively high sustained virological response rate and presumably did not include patients with multiple negative predictors of interferon response such as African Americans, obese individuals, and a high burden of advanced fibrosis. Although some patients with cirrhosis were studied, post-hoc analyses did not show

this to be important in predicting cognitive dysfunction. This is important, as it suggests that preexisting MHE in cirrhosis nonresponders

was not a confounding variable. The finding of cognitive improvement that is independent of cirrhotic morphology is important because it adds impetus to further evaluating cognitive function as an indication for and as an outcome measure of antiviral therapy at a precirrhotic stage. Disentangling MCE公司 the relative contributions of HCV, cirrhosis, comorbid conditions, and concomitant medications can be challenging since available tests are sensitive but not specific.[7] MHE uniquely affects visuo-construction skills, motor speed, and motor accuracy, while precirrhosis HCV infection affects working memory and the domains of attention, executive function, and processing speed are affected in both.[8] The authors applied a relatively narrow battery of only four tests (alertness, divided attention, vigilance, and working memory), which were previously shown to be sensitive to the effect of interferon but are not specific to this or the effect of HCV infection itself. In this study, there was no comparison of baseline function with normative control data and the clinical significance of the improvement was not defined. Indeed, in future studies it will be important to link neurocognitive test performance with outcomes that affect daily life such as cognitive health-related quality of life, e.g.

[11, 15] Transition from olive-oil–based PN lipid to fish-oil–based www.selleckchem.com/products/GDC-0449.html PN lipid emulsion may result in reversal of biochemical indicators of cholestasis.[37] However, 2 patients with persisting liver fibrosis 3 and 11 months after transition to fish-oil–based PN have been reported on.[38] In this study, we found abnormal liver histology, including mainly fibrosis (Metavir stage 2 in 50%) and steatosis with occasional portal inflammation, in 77% of patients after weaning off PN an average of 8.8 years before. Interestingly,

degree of liver fibrosis was comparable during and after weaning off PN, although the weak inverse correlation between Metavir stage and time after weaning off PN suggest that some resolution of fibrosis may occur over time. Bacterial overgrowth, epithelial changes, and impaired local immunity of the small intestine selleck inhibitor may provide potential mechanisms causing and maintaining liver injury in IFALD, both during and after weaning off PN.[39] In a mouse model of IF, PN-induced increase in intestinal permeability promotes Toll-like receptor 4–dependent Kupffer cell activation and liver injury, presumably caused by bacterial translocation.[42] In short bowel syndrome, loss of barrier function of the ileocecal valve, adaptation-induced bowel dilatation, and impaired motility after massive intestinal

resection are known risk factors for bacterial overgrowth.[41] Together with increased intestinal permeability,[43] these alterations may promote bacterial translocation and subsequent liver injury also in IF patients.[44] Here, the number of blood culture-positive septic episodes, reflecting both central venous catheter- and bacterial translocation-related septic episodes, correlated positively with liver fibrosis and chronic cholestasis (periportal CK7 staining). Moreover,

the patients with the shortest 上海皓元 remaining small bowel and those without an ileocecal valve had the most advanced liver fibrosis stage. The exact mechanism of liver protection exerted by the small intestine is most likely multifactorial, but may involve enterohepatic circulation of bile acids.[45] Short length of the remaining small intestine also reflects decreased enteral absorption with increased and prolonged PN requirements. Accordingly, duration of PN and extensive small intestinal resection positively correlated with both fibrosis and steatosis. The fact that liver fibrosis stage was inversely related to young starting age of PN emphasizes the vulnerability of newborn liver function. In a multivariate analysis, age-adjusted small bowel length, portal inflammation, and absence of an ileocecal valve were the most significant predictors of Metavir fibrosis stage. Although APRI correlated with histological liver fibrosis, any of the conventional liver function tests were off normal limits only in 63% of patients on PN and in 18% of patients weaned off PN, whereas liver US was abnormal only in 4 patients.

1 The authors noted that the initial viremia level in subjects with IL28B-C allele at rs12979860 and clearance was higher than that in subjects with IL28B-T allele and persistence (P = 0.001).1 However, these results require confirmation in a larger cohort and especially in Asian populations, in which IL28B favorable genotype is much more prevalent.2 Temsirolimus purchase To address the role of the rs12979860 single nucleotide polymorphism (SNP) in spontaneous HCV clearance among Asian populations, we genotyped 2,318 individuals comprised

of individuals who cleared virus (n = 156) and those with persistent infection (n = 2,162). The distribution of the alleles of rs12979860 was in accordance with Hardy-Weinberg equilibrium in both individuals of HCV clearance and persistence (P = 1.0 and Hedgehog antagonist 0.32, respectively). Patients with HCV clearance and HCV persistence were similar regarding age and sex. However, the frequency of the C allele was significantly

greater among individuals of HCV clearance (97%) than those of HCV persistence (93%) (P = 0.001) (Table 1). In addition, hepatitis B surface antigen (HBsAg) status was also associated with spontaneous HCV clearance. Multivariate logistic regression analysis demonstrated that rs12979860 CC genotype and HBV coinfection were independent factors associated with spontaneous HCV clearance, with odds ratios of 3.06 (95% confidence interval [CI] 1.47-6.37, P = 0.003) and 6.67 (95% CI 4.48-9.90, P < 0.001), respectively. Our data in agreement with Liu etal.'s finding confirmed a key role for IL28B genetic variation in determining spontaneous clearance.1 Alternatively, the frequency of the rs12979860 CC genotype in our study was substantially

higher than that reported in Caucasians.2 The limited published data have indicated that 14%-42% of acute HCV-infected individuals recover spontaneously.3-6 Given the high prevalence of favorable MCE IL28B genotype in Asian populations, it may be expected that spontaneous clearance of HCV is common in our patients. However, this is in contrast to our previous observation that a high percentage of subjects developed chronic disease following acute HCV infection.6 Also, this cannot explain that there are several HCV hyperendemic areas with an anti-HCV prevalence of up to 58% in southern Taiwan.7, 8 Based on the findings by Liu etal.,1 further investigation will be valuable to study the viral kinetics and evolution during the early phase of acute HCV infection in our populations. Chao-Hung Hung X.X.*, Kuo-Chin Chang X.X.*, Sheng-Nan Lu X.X.*, Jing-Houng Wang X.X.*, Chien-Hung Chen X.X.*, Chuan-Mo Lee X.X.*, Tsung-Hui Hu X.X.*, * Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

1 The authors noted that the initial viremia level in subjects with IL28B-C allele at rs12979860 and clearance was higher than that in subjects with IL28B-T allele and persistence (P = 0.001).1 However, these results require confirmation in a larger cohort and especially in Asian populations, in which IL28B favorable genotype is much more prevalent.2 PD0325901 purchase To address the role of the rs12979860 single nucleotide polymorphism (SNP) in spontaneous HCV clearance among Asian populations, we genotyped 2,318 individuals comprised

of individuals who cleared virus (n = 156) and those with persistent infection (n = 2,162). The distribution of the alleles of rs12979860 was in accordance with Hardy-Weinberg equilibrium in both individuals of HCV clearance and persistence (P = 1.0 and Decitabine ic50 0.32, respectively). Patients with HCV clearance and HCV persistence were similar regarding age and sex. However, the frequency of the C allele was significantly

greater among individuals of HCV clearance (97%) than those of HCV persistence (93%) (P = 0.001) (Table 1). In addition, hepatitis B surface antigen (HBsAg) status was also associated with spontaneous HCV clearance. Multivariate logistic regression analysis demonstrated that rs12979860 CC genotype and HBV coinfection were independent factors associated with spontaneous HCV clearance, with odds ratios of 3.06 (95% confidence interval [CI] 1.47-6.37, P = 0.003) and 6.67 (95% CI 4.48-9.90, P < 0.001), respectively. Our data in agreement with Liu etal.'s finding confirmed a key role for IL28B genetic variation in determining spontaneous clearance.1 Alternatively, the frequency of the rs12979860 CC genotype in our study was substantially

higher than that reported in Caucasians.2 The limited published data have indicated that 14%-42% of acute HCV-infected individuals recover spontaneously.3-6 Given the high prevalence of favorable medchemexpress IL28B genotype in Asian populations, it may be expected that spontaneous clearance of HCV is common in our patients. However, this is in contrast to our previous observation that a high percentage of subjects developed chronic disease following acute HCV infection.6 Also, this cannot explain that there are several HCV hyperendemic areas with an anti-HCV prevalence of up to 58% in southern Taiwan.7, 8 Based on the findings by Liu etal.,1 further investigation will be valuable to study the viral kinetics and evolution during the early phase of acute HCV infection in our populations. Chao-Hung Hung X.X.*, Kuo-Chin Chang X.X.*, Sheng-Nan Lu X.X.*, Jing-Houng Wang X.X.*, Chien-Hung Chen X.X.*, Chuan-Mo Lee X.X.*, Tsung-Hui Hu X.X.*, * Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

1B). The feeding sequence was consistent in all observations (Fig. 1, C–L and Video S1 in the Supporting Information). Initially, the Esoptrodinium cell attached to the prey cell with what appeared

to be a cytoplasmic extension associated with the ABP (Fig. 1C). As the ABP swung outward the peduncle opening broadened, the dorsal side of the episome deformed noticeably, and the prey cell was drawn through the peduncle and deposited in a nascent episomal food vacuole (Fig. 1, D–I). Once the prey cell was fully ingested, the ABP returned to its nonfeeding proximal position along the margin of the ventral episome, closing the peduncle like the shutting of a hatch door (Fig. 1, J–L). The full phagocytic process from contact with a prey cell to complete ingestion normally lasted 5–15 s, but varied depending

on Metformin prey cell size. In dense cultures, it was common to observe numerous Esoptrodinium cells attempting to ingest a single prey cell. In these cases, a single Esoptrodinium cell normally succeeded in ingesting the entire prey cell, but occasionally the prey cell lysed and the fragments were split among multiple Esoptrodinium cells. In the absence of food cells, light intensity had a significant positive influence on the biomass of isolate UNCCP, but no influence find more on the biomass of isolates RP and HP (Fig. 2). Isolate UNCCP survived 7 d longer in high light than low light, and maintained a higher population biomass from day 2 onward. Isolates RP and HP showed no difference in biomass or survival between high light and low light, and populations of both isolates died or encysted by day 7 in each light treatment. All isolates declined in population biomass and eventually died or encysted in the absence of food, regardless of light treatment (Fig. 2). By the end of the experiment, encysted cells 上海皓元 accounted for only a small proportion (0.2%–6.7%) of the original flagellate

cell population. Cyst abundance varied by strain more than treatment, however, isolates UNCCP and RP produced a significantly higher proportion of cysts in high light than low light treatments (Fig. 3). Light had a significant positive influence on the population growth/biomass of all tested Esoptrodinium isolates in batch culture with food cells (Fig. 4). Growth curves varied by strain, but in each case Esoptrodinium grew for a greater length of time and to significantly higher biomass yields in light compared to darkness. In light, UNCCP, RP, and HP reached their maximum biomass yields on days 4, 5, and 7, respectively, whereas in darkness the maximum yields were on days 3, 3, and 1, respectively. C. ovata (food) populations in both light and darkness treatments declined in number and reached zero within 4–7 d, apparently due to grazing by the dinoflagellates. C. ovata control populations grew in light and declined in darkness, however, did not reach zero as in experimental treatments (data not shown).

The total cohort was split by year of diagnosis into two groups, 2000–2006 and 2007–2013 and the groups compared to evaluate trends. T-test was used to compare means and Fisher’s exact test was used to compare between groups with significance determined by p < 0.05. Results: 231 patients were diagnosed with HCC, 197 males (84.4%) with mean age of 64.1 years. 107 were diagnosed between 2000 and 2006 and 124 between 2007–2013. The groups were not statistically different with regards to age, gender, presence of cirrhosis and tumor characteristics (size and number of lesions). In the 2000–2006 group, 71%

of patients had underlying cirrhosis with an average of 1.59 lesions and average largest lesion measuring 57 mm. In the latter

group, 77% of patients had cirrhosis with an average of 1.71 lesions and average PARP inhibitor largest lesion measuring 49 mm. In patients diagnosed between 2000 and 2006, Hepatitis B (HBV) was the most common risk factor for HCC, n = 29 (27.1%) followed by Hepatitis AZD1208 chemical structure C, n = 22 (20.6%). There was a decline in diagnosed HBV-related HCC, with n = 22 (17.7%) in the 2007–2013 group, although not statistically significant. There was a statistically significant increase in Hepatitis C (HCV) related HCC over time [OR: 2.21, 95% CI: 1.21 to 3.99, p = 0.009]. Numbers of HCCs secondary to Non Alcoholic Fatty Liver Disease (NAFLD) also increased significantly [OR: 7.31, 95% CI: 0.89 to 59.46 p = 0.04]. There were no significant change in the numbers of detected alcohol related

HCC’s MCE公司 between the two groups. Conclusion: There has been a decrease in Hepatitis B related HCC over time which may be attributable to the introduction of potent nucleos(t)ide analogues at our center in 2006. In contrast, there was a significant increase in HCV related HCCs and the development of strategies focused on early detection and treatment including the early implementation of more efficacious direct acting antivirals remains vital. CB RANAWEERA,1 OT AYONRINDE,2,3,4 L MOLLISON,1,3 S GALHENAGE,2 JK OLYNYK2,4,5 1Department of General Medicine, Fremantle Hospital, Fremantle, WA, Australia, 2Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia, 3School of Medicine and Pharmacology (Fremantle Hospital Campus), The University of Western Australia, WA, Australia, 4Faculty of Health Sciences, Curtin University, Bentley, WA, Australia, 5Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia. Background: The severity of liver fibrosis in patients with chronic hepatitis C virus infection (CHC) influences treatment decisions and surveillance for complications. In Western Australia, non-invasive assessment of liver fibrosis using transient elastography (TE) and/ or Hepascore has largely replaced liver biopsy.

16.5 days; p = 0.02). Preoperative lower GI endoscopy was performed in 215/223 (96%) elective presentations with an overall median time from endoscopy to primary treatment of 40 days. When compared to current Australian clinical guidelines, only 40% of elective patients

were referred to lower GI endoscopy within four weeks of GP referral. Secondary referrals compared with tertiary referrals were twice as likely to meet this guideline (OR 2.23, 95% CI 1.21–4.13). Referral to a colorectal surgeon occurred in 70% of tertiary elective referrals within two weeks of lower GI endoscopy. Conclusions: Emergency CHIR-99021 price presentations of CRC are managed promptly and secondary elective referrals in a C646 mouse timely manner. However, tertiary referrals continue to present a challenge due to the unavoidable delay associated with the inclusion of an additional secondary care provider, since shorter times from colorectal appointment to treatment do not offset the prolonged wait from GP referral to colorectal consultation. Further, measures to reduce waiting times for lower GI endoscopy are required to achieve better performance against suggested guidelines. “
“To investigate whether the patients with hypovascular liver nodules determined on the arterial phase and hypointensity on the hepatocyte phase gadoxetic acid-enhanced magnetic resonance imaging (hypovascular hypointense nodules) are

at increased risk of hepatocarcinogenesis, we assessed subsequent typical hepatocellular carcinoma (HCC) development at any sites of the liver with and without such nodules. One hundred and twenty-seven patients with chronic hepatitis B or C and without a history of HCC, including 68 with liver cirrhosis, were divided into those with (non-clean liver group, n = 18) and without (clean liver group, n = 109) hypovascular hypointense nodules.

All the patients were followed up for 3 years, and HCC development rates medchemexpress and risk factors were analyzed with the Kaplan–Meier method and the Cox proportional hazard model, respectively. A total of 17 patients (10 in the non-clean liver group and seven in the clean liver group) developed typical HCC. Cumulative 3-year rates of HCC development were 55.5% in the non-clean liver group and 6.4% in the clean liver group (P < 0.001), and those at the different sites from the initial nodules was also higher in the non-clean liver group (22.2%) than the clean liver group (6.4%) (P = 0.003). Multivariate analysis identified older age (P = 0.024), low platelet counts (P = 0.017) and a non-clean liver (P < 0.001) as independent risk factors for subsequent HCC development. Patients with hypovascular hypointense liver nodules are at a higher risk for HCC development at any sites of the liver than those without such nodules. "
“Cholangiocarcinoma (CCA) carries a severe prognosis because of its strong invasiveness and early metastasization.