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

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 casually 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, 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.