Hepatocellular carcinoma in Israel: relationship to hepatitis B virus infection

The possible relationship between hepatocellular carcinoma (HCC) and hepatitis B virus infection in Israel was evaluated. A retrospective study of 40 cases with HCC in Israel revealed irregular (macronodular) cirrhosis in 37 of 40 cases (92.5%). Hepatitis B surface antigen (HBsAg), demonstrated by the immunoperoxidase technique, was found in the nontumorous liver tissue of 20 of 40 (62.5%) of the patients. alpha-Fetoprotein was positive in the tumor cells by the immunoperoxidase method in 22 of 40 (55%) of cases. Population subgroups with relatively high HBsAg carrier rates did not show a higher incidence of HCC. However, an inexplicably high rate of HCC was found in patients of Rumanian origin, regardless of HBsAg expression. The present study indicates that in Israeli patients with HCC, there is a relatively higher incidence of HBsAg in the liver tissue than in patients in other countries with a similarly low incidence of HCC.