Liver cell dysplasia in association with hepatocellular carcinoma, cirrhosis and hepatitis b surface antigen in Hong Kong

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Abstract
Liver‐cell dysplasia was identified in 60% of 558 cases of cirrhosis with and without hepatocellular carcinoma (HCC) in Chinese coming to necropsy in Hong Kong from 1963 to 1978. A significant correlation was found between liver‐cell dysplasia and the identification of hepatitis B surface antigen (HBsAg) in the livers, suggesting that dysplasia may be causally related to hepatitis B virus (HBV). Applying Bayes' theorem to our series of male deaths, we calculated that for Chinese male non‐cirrhotics showing liver‐cell dysplasia at necropsy, compared with male non‐cirrhotics showing no liver‐cell dysplasia, the approximate risk factor for HCC is 13:1, whereas for male cirrhotics with liver‐cell dysplasia, compared with male cirrhotics without liver cell dysplasia, the risk factor for HCC is approximately 2:1. In the presence of dysplasia, the risk for HCC is increased two‐fold in males who are also HBsAg‐positive. Thus, the presence of liver‐cell dysplasia in cirrhotic or non‐cirrhotic livers accompanies a significantly higher risk of developing HCC, especially in the presence of HBsAg.