Chang Hun Lee, Gwang Hyeon Choi, Hwa Young Choi, Sojung Han, Eun Sun Jang, Young Eun Chon, Young Chang, Kyung-Ah Kim, Do Young Kim, Hyung Joon Yim, Hye-Lin Kim, Sook-Hyang Jeong, In Hee Kim
Clin Mol Hepatol 2023;29(3):779-793. Published online May 15, 2023
Background/Aims To eliminate hepatitis B virus (HBV) and hepatitis C virus (HCV) according to the World Health Organization (WHO) criteria in 2021, this study investigated the national core indicators representing the current status of viral hepatitis B and C in South Korea.
Methods We analyzed the incidence, linkage-to-care, treatment, and mortality rates of HBV and HCV infection using the integrated nationwide big data of South Korea.
Results According to data from 2018–2020, the incidence of acute HBV infection in South Korea was 0.71 cases per 100,000 population; tthe linkage-to-care rate was only 39.4%. Among those who need hepatitis B treatment, the treatment rate was 67.3%, which was less than 80% reported in the WHO program index. The annual liver-related mortality due to HBV was 18.85 cases per 100,000 population, exceeding the WHO target of four; the most frequent cause of death was liver cancer (54.1%). The annual incidence of newly diagnosed HCV infection was 11.9 cases per 100,000 population, which was higher than the WHO impact target of five. Among HCV-infected patients, the linkage-to-care rate was 65.5% while the treatment rate was 56.8%, which were below the targets of 90% and 80%, respectively. The liver-related annual mortality rate due to HCV infection was 2.02 cases per 100,000 population.
Conclusions Many of the current indicators identified in the Korean population did not satisfy the WHO criteria for validation of viral hepatitis elimination. Hence, a comprehensive national strategy should be urgently developed with continuous monitoring of the targets in South Korea.
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Background/Aims Global distribution of dominant liver cancer aetiologies has significantly changed over the past decades. This study analyzed the updated temporal trends of liver cancer aetiologies and sociodemographic status in 204 countries and territories from 1990 to 2019.
Methods The Global Burden of Disease 2019 report was used for statistical analysis. In addition, we performed stratification analysis to five quintiles using sociodemographic index and 21 geographic regions.
Results The crude numbers of liver cancer disease-adjusted life years (DALYs) and deaths significantly increased during the study period (DALYs; 11,278,630 in 1990 and 12,528,422 in 2019, deaths; 365,215 in 1990 and 484,577 in 2019). However, the Age-standardized DALY and mortality rates decreased. Hepatitis B virus (HBV) remains the leading cause of liver cancer DALYs and mortality, followed by hepatitis C virus (HCV), alcohol consumption, and non-alcoholic steatohepatitis/non-alcoholic fatty liver disease (NASH/NAFLD). Although Age-standardized DALY and mortality rates of liver cancer due to HBV and HCV have decreased, the rates due to alcohol consumption and NASH/NAFLD have increased. In 2019, the population of the East Asia region had the highest Age-standardized DALY and mortality rates, followed by high-income Asia-Pacific and Central Asia populations. Although East Asia and high-income Asia-Pacific regions showed a decrease during the study period, Age-standardized DALY rates increased in Central Asia. High-income North American and Australasian populations also showed a significant increase in Age-standardized DALY.
Conclusions Liver cancer remains an ongoing global threat. The burden of liver cancer associated with alcohol consumption and NASH/NAFLD is markedly increasing and projected to continuously increase.
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Background/Aims A comprehensive analysis of trends in the incidence of hepatocellular carcinoma (HCC) is important for planning public health initiatives. We aimed to analyze the trends in HCC incidence in South Korea over 10 years and to predict the incidence for the year 2028.
Methods Data from patients with newly diagnosed HCC between 2008 and 2018 were obtained from Korean National Health Insurance Service database. Age-standardized incidence rates (ASRs) were calculated to compare HCC incidence. A poisson regression model was used to predict the future incidence of HCC.
Results The average crude incidence rate (CR) was 22.4 per 100,000 person-years, and the average ASR was 17.6 per 100,000 person-years between 2008 and 2018. The CR (from 23.9 to 21.2 per 100,000 person-years) and ASR (from 21.9 to 14.3 per 100,000 person-years) of HCC incidence decreased during the past ten years in all age groups, except in the elderly. The ASR of patients aged ≥80 years increased significantly (from 70.0 to 160.2/100,000 person-years; average annual percent change, +9.00%; P<0.001). The estimated CR (17.9 per 100,000 person-years) and ASR (9.7 per 100,000 person-years) of HCC incidence in 2028 was declined, but the number of HCC patients aged ≥80 years in 2028 will be quadruple greater than the number of HCC patients in 2008 (from 521 to 2,055), comprising 21.3% of all HCC patients in 2028.
Conclusions The ASRs of HCC in Korea have gradually declined over the past 10 years, but the number, CR, and ASR are increasing in patients aged ≥80 years.
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Background/Aims The early detection and prevention of non-alcoholic fatty liver disease (NAFLD) has been emphasized considering the burden of this disease. Both hepatic and peripheral insulin resistances are strongly associated with NAFLD. We aimed to compare the predictive powers of a hepatic insulin resistance index, the homeostatic model assessment for insulin resistance (HOMA-IR), and a novel peripheral insulin resistance index, the metabolic score for insulin resistance (METS-IR), for the prediction of prevalent and incident NAFLD.
Methods Data from 8,360 adults aged 40–69 years at baseline and 5,438 adults without NAFLD who were followed-up at least once after the baseline survey in the Korean Genome and Epidemiology Study were analyzed. The survey was performed biennially, up to the eighth follow-up.
Results The predictive powers of the METS-IR and HOMA-IR for prevalent NAFLD were not significantly different (area under the receiver operating characteristic [ROC] curve [95% confidence interval]: METS-IR, 0.824 [0.814–0.834]; HOMAIR, 0.831 [0.821–0.842]; P=0.276). The area under the time-dependent ROC curve (Heagerty’s integrated area under the curve) of the METS-IR for incident NAFLD was 0.683 (0.671–0.695), significantly higher than that of the HOMA-IR (0.551 [0.539–0.563], P<0.001).
Conclusions The METS-IR is superior to the HOMA-IR for the prediction of incident NAFLD and is not inferior to the HOMA-IR for the prediction of prevalent NAFLD. This suggests that the METS-IR can be a more useful insulin resistance index than the HOMA-IR for the early detection and prevention of NAFLD in Korean population.
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Jong Man Kim, Deok Gie Kim, Jihyun Kim, Keunsung Lee, Kwang-Woong Lee, Je Ho Ryu, Bong-Wan Kim, Dong Lak Choi, Young Kyoung You, Dong-Sik Kim, Yang Won Nah, Koo Jeong Kang, Jai Young Cho, Geun Hong, Hee Chul Yu, Ju Ik Moon, Dongho Choi, Shin Hwang, Myoung Soo Kim
Clin Mol Hepatol 2021;27(3):451-462. Published online February 2, 2021
Background/Aims To analyze the incidence and risk factors of outcomes after liver transplantation (LT) in the Korean population.
Methods This study analyzed data from the liver cohort of Korean Organ Transplantation Registry (KOTRY) who had LT between May 2014 and December 2017. Study measures included the incidence of post-LT outcomes in recipients of living donor LT (LDLT) and deceased donor LT (DDLT). Cox multivariate proportional hazards model was used to determine the potential risk factors predicting the outcomes.
Results A total of 2,563 adult recipients with LT (LDLT, n=1,956; DDLT, n=607) were included, with mean±standard deviation age of 53.9±8.9 years, and 72.2% were male. The post-LT outcomes observed in each LDLT and DDLT recipients were death (4.0% and 14.7%), graft loss (5.0% and 16.1%), rejection (7.0% and 12.0%), renal failure (2.7% and 13.8%), new onset of diabetes (12.5% and 15.4%), and hepatocellular carcinoma (HCC) recurrence (both 6.7%). In both LDLT and DDLT recipients, the most common post-LT complications were renal dysfunction (33.6% and 51.4%), infection (26.7% and 48.4%), and surgical complication (22.5% and 23.9%). Incidence of these outcomes were generally higher among recipients of DDLT than LDLT. Multivariate analysis indicated recipient age and DDLT as significant risk factors associated with death and graft loss. DDLT and ABO incompatible transplant were prognostic factors for rejection, and HCC beyond Milan criteria at pre-transplant was a strong predictor of HCC recurrence.
Conclusions This study is a good indicator of the post-LT prognosis in the Korean population and suggests a significant burden of post-LT complications.
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Liver cancer is the sixth most common cancer (fourth in men and sixth in women) and the second largest cause of cancer mortality in South Korea. The crude incidence rate of liver cancer was 31.9/100,000 (47.5/100,000 in men and 16.2/100,000 in women) and the age-standardized incidence rate was 19.9/100,000 (32.4/100,000 in men and 8.8/100,000 in women) in 2014. The crude incidence rate increased from 1999 to 2011 and thereafter showed a subtle decreasing tendency. The crude prevalence rate was 113.6/100,000 (170.2/100,000 in men and 57.1/100,000 in women) and the age-standardized prevalence rate was 72.6/100,000 (115.7/100,000 in men and 33.7/100,000 in women) in 2014, which increased from 2010 to 2014. Survival from liver cancer has improved over the last two decades. The 5-year relative survival rate was markedly increased from 10.7% in those diagnosed with liver cancer between 1993 and 1995 to 32.8% in those diagnosed between 2010 and 2014. The epidemiology of liver cancer is influenced by that of underlying liver diseases such as viral hepatitis. Substantial progress has been made in the prevention and treatment of viral hepatitis; however, uncontrolled alcoholic liver disease, obesity and diabetes appears to have the potential to emerge as major causes for liver cancer. Depending on the success of the control of risk factors, the epidemiology of liver cancer in Korea may change.
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Altered microRNA expression profile in hepatitis B virus-related hepatocellular carcinoma Keon Uk Park, Young-Su Seo, Yun-Han Lee, Jungwook Park, Ilseon Hwang, Koo Jeong Kang, Jehyun Nam, Sang-Woo Kim, Jin Young Kim Gene.2015; 573(2): 278. CrossRef
The Effect of the Curcumae Longae Rhizoma (CLR) Extract on the Hepatocellular Carcinogenesis and Acute Liver Damage Induced by Diethylnitrosamine (DENA) and CCl4in Rats Tae-San Jung, Chang-Won Choi Herbal Formula Science.2014; 22(1): 177. CrossRef
Radiologic response to transcatheter hepatic arterial chemoembolization and clinical outcomes in patients with hepatocellular carcinoma Chang Joon Kim, Hong Joo Kim, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Min‐Ji Kim Liver International.2014; 34(2): 305. CrossRef
Burden of disease in Korea during 2000-10 K. S. Lee, J. H. Park Journal of Public Health.2014; 36(2): 225. CrossRef
Oral antiviral therapy improves the diagnostic accuracy of alpha‐fetoprotein levels in patients with chronic hepatitis B Jae‐Jun Shim, Jung Wook Kim, Chang Kyun Lee, Jae Young Jang, Byung‐Ho Kim Journal of Gastroenterology and Hepatology.2014; 29(9): 1699. CrossRef
miR-429 represses cell proliferation and induces apoptosis in HBV-related HCC Huijie Gao, Chao Liu Biomedicine & Pharmacotherapy.2014; 68(8): 943. CrossRef
Comparison of Clinical Manifestations and Outcomes between Hepatitis B Virus- and Hepatitis C Virus-Related Hepatocellular Carcinoma: Analysis of a Nationwide Cohort Dong Hyun Sinn, Geum-Youn Gwak, Juhee Cho, Seung Woon Paik, Byung Chul Yoo, Pierre Roques PLoS ONE.2014; 9(11): e112184. CrossRef
Burden of cancer in Korea during 2000–2020 Jae-Hyun Park, Kwang-Sig Lee, Kyu-Sik Choi Cancer Epidemiology.2013; 37(4): 353. CrossRef
Factors influencing hepatocellular carcinoma prognosis after hepatectomy: a single-center experience Sung Keun Park, Young Kul Jung, Dong Hae Chung, Keon Kuk Kim, Yeon Ho Park, Jung Nam Lee, Oh Sang Kwon, Yun Soo Kim, Duck Joo Choi, Ju Hyun Kim The Korean Journal of Internal Medicine.2013; 28(4): 428. CrossRef
The Korean National Liver Cancer Surveillance Program: Experience of a Single Healthcare Center in 2011 Jae-Jun Shim, Hyun Jin Park, Jung-Wook Kim, Eun Jung Hwang, Chang Kyun Lee, Jae Young Jang, Seong Jin Park, Hyun Rim Choi, Byung-Ho Kim Korean Journal of Medicine.2013; 84(5): 672. CrossRef
Hepatoprotective Effects of Hovenia dulcis Extract on Acute and Chronic Liver Injuries induced by Alcohol and Carbon Tetrachloride Young-Sik Kim, Juyeon Park, Yongbeom Kwon, Dong Wook Lim, MiKyung Song, Ho-Young Choi, Hocheol Kim The Korea Journal of Herbology.2013; 28(4): 25. CrossRef
Clinical features and outcome of cryptogenic hepatocellular carcinoma compared to those of viral and alcoholic hepatocellular carcinoma Sang Soo Lee, Sook-Hyang Jeong, Young-Sang Byoun, Seong Min Chung, Mun Hyuk Seong, Hyung Rae Sohn, Bo-young Min, Eun Sun Jang, Jin-Wook Kim, Guan Jung Park, Yoon Jin Lee, Kyoung Ho Lee, Soyeon Ahn BMC Cancer.2013;[Epub] CrossRef
Status of Primary Liver Cancer Found through Routine Health Check-up Changhyun Lee, Jong In Yang, Hee Jin Byun, Jung Mook Kang, Seoungho Choi, Jeong Yoon Yim Journal of Korean Medical Science.2013; 28(10): 1449. CrossRef
Comparison of Steroid-Free Immunosuppression and Standard Immunosuppression for Liver Transplant Patients with Hepatocellular Carcinoma Tonghai Xing, Li Huang, Zhenhai Yu, Lin Zhong, Shuyun Wang, Zhihai Peng, Peter Starkel PLoS ONE.2013; 8(8): e71251. CrossRef
C-reactive protein may be a prognostic factor in hepatocellular carcinoma with malignant portal vein invasion Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Justin Sangwook Ko, Jae Berm Park, Joon Hyeok Lee, Sung Joo Kim, Seung Woon Paik, Cheol-Keun Park World Journal of Surgical Oncology.2013;[Epub] CrossRef
Analysis of prognostic factors and 5-year survival rate in patients with hepatocellular carcinoma: a single-center experience Sang Seok Lee, Hyun Sung Shin, Hyung Joon Kim, Su Jin Lee, Hyun Suk Lee, Kyung Hee Hyun, Yong Hyun Kim, Byoung Woon Kwon, Jin Hyung Han, Hoon Choi, Bae Hwan Kim, Joon Hyuk Lee, Ha Yan Kang, Hyun Deok Shin, Il Han Song The Korean Journal of Hepatology.2012; 18(1): 48. CrossRef
Serum Selenium Levels in Korean Hepatoma Patients In-Wook Kim, Su-Mi Bae, Yong-Wan Kim, Hai-Bo Liu, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Pankaj Kumar Chaturvedi, Gantumur Battogtokh, Woong Shick Ahn Biological Trace Element Research.2012; 148(1): 25. CrossRef
Risk Factors of Peritoneal Recurrence and Outcome of Resected Peritoneal Recurrence After Liver Resection in Hepatocellular Carcinoma: Review of 1222 Cases of Hepatectomy in a Tertiary Institution Alfred Wei Chieh Kow, Choon Hyuck David Kwon, Sanghyun Song, Milljae Shin, Jong Man Kim, Jae-Won Joh Annals of Surgical Oncology.2012; 19(7): 2246. CrossRef
NS-398 induces caspase-dependent, mitochondria-mediated intrinsic apoptosis of hepatoma cells Il Han Song, Suk Bae Kim, Hyun Duk Shin, Ha Yan Kang, Eun Young Kim Advances in Bioscience and Biotechnology.2012; 03(06): 649. CrossRef
Noninvasive diagnosis of hepatocellular carcinoma Byung Seok Kim Clinical and Molecular Hepatology.2012; 18(2): 245. CrossRef
Comparison of usefulness of clinical diagnostic criteria for hepatocellular carcinoma in a hepatitis B endemic area So Young Bae, Moon Seok Choi, Geum-Youn Gwak, Yong Han Paik, Joon Hyoek Lee, Kwang Cheol Koh, Seung Woon Paik, Byung Chul Yoo Clinical and Molecular Hepatology.2012; 18(2): 185. CrossRef
A Genetic Variant in Long Non-Coding RNA HULC Contributes to Risk of HBV-Related Hepatocellular Carcinoma in a Chinese Population Yao Liu, Shandong Pan, Li Liu, Xiangjun Zhai, Jibin Liu, Juan Wen, Yixin Zhang, Jianguo Chen, Hongbing Shen, Zhibin Hu, Rui Medeiros PLoS ONE.2012; 7(4): e35145. CrossRef
The Role of Preoperative [18F]Fluorodeoxyglucose Positron Emission Tomography in Predicting Early Recurrence After Curative Resection of Hepatocellular Carcinomas Sung Gwe Ahn, Sung Hoon Kim, Tae Joo Jeon, Ho Jin Cho, Sae Byeol Choi, Mi Jin Yun, Jong Doo Lee, Kyung Sik Kim Journal of Gastrointestinal Surgery.2011; 15(11): 2044. CrossRef
Dae Won Jun , Ji Yong Moon , Sang Hyeon Baeg , Ho Soon Choi , Joo Hyun Sohn , Oh Young Lee , Byung Chul Yoon , Min Ho Lee , Dong Hoo Lee , Choon Suhk Kee
Background/Aims Despite the improvement of personal and social hygiene, pyogenic liver abscess is still a common disease. We compared the incidence, infection route, underlying disease and major complications between two different local hospitals. Methods: We reviewed the clinical data of 100 patients with pyogenic liver abscess who were treated at Seoul and Guri Hanyang University Hospital from 1999 to 2003. Results: There were 64 males and 36 females in the study group; they were aged from 19 to 94 years with a mean of 56.5 years. Every year 19 to 23 pyogenic liver abscess patients were admitted to both hospitals. The most common organism isolated was Klebsiella pneumoniae in both local hospitals. In the Seoul hospital, diabetes (40.9%) was most common associated condition. In the Guri hospital, biliary tract disease or a history of hepatobiliary surgery (54.2%) was the most common associated condition. Catheter drainage and/or percutaneous needle aspiration were established as the standard treatment modality. Conclusions: In both regional hospitals, the incidence of pyogenic liver abscess did not decrease and Klebsiella pneumoniae was the most common organism. Diabetes and biliary tract disease, including, previous hepatobiliary surgery, were the most identifiable underlying disease. (Korean J Hepatol 2005;11:250-260)
Uh Young Huh, M.D., Jin Hyuk Kim, M.D., Byung-Ho Kim, M.D., Ki Deuk Nam, M.D.,
Jae Young Jang, M.D., Nam Hoon Kim, M.D., Sang Kil Lee, M.D., Kwang Ro Joo, M.D.,
Seok Ho Dong, M.D., Hyo Jong Kim, M.D., Young Woon Chang, M.D., Joung Il Lee, M.D.,
and Rin Chang, M.D.
Background/Aims Patients with hepatocellular carcinoma (HCC) may manifest paraneoplastic syndromes such as hypercholesterolemia, hypoglycemia, hypercalcemia and erythrocytosis. This study was aimed at evaluating the incidence and clinical significance of paraneoplastic syndromes in Korean HCC patients. Methods: The medical records of 165 HCC patients who were diagnosed and died in the Kyung Hee University Hospital, were reviewed retrospectively. The following variables were analyzed: age, gender, hepatitis markers, platelet, liver function test, α-fetoprotein (AFP), Child-Pugh score, tumor features, and the duration of their survival. Results: In total, paraneoplastic syndromes were presented in 43.6% of the HCC patients during the course of their disease. Hypercholesterolemia was solely presented in 14.5%, hypoglycemia in 12.7% and hypercalcemia in 7.8%. The patients who presented with more than 2 syndromes were 8.5%. While 80% of erythrocytosis (4/5) and 51.6% of hypercholesterolemia (16/31) was presented at the time of HCC diagnosis, hypoglycemia and hypercalcemia mainly occurred as terminal events. The patients with paraneoplastic syndromes were younger and had higher rates of portal vein thrombosis, bi-lobar tumor involvement and tumor more of more than 10cm in diameter, compared to those patients without them. The proportion of patients with a serum AFP more than 400ng/mL tended to be higher in the patients with paraneoplastic syndromes. The HCC patients with paraneoplastic syndromes, except for erythrocytosis, had a shorter survival than those patients without them. Conclusions: Paraneoplastic syndromes are not infrequently presented in HCC patients, especially at an advanced stage, and the survival of these patients is relatively shorter. (Korean J Hepatol 2005;11:275-283)
Background/Aims Sclerosing hepatocellular carcinoma (HCC) is an unusual subtype of HCC that is
characterized by an embedded dense fibrous stroma in the tubular neoplastic structures. We aimed to
assess the surgical approaches and outcomes of sclerosing HCC. Methods: We retrospectively analyzed
the clinicopathologic features of 6 patients with sclerosing HCC who underwent surgical treatment at Asan
Medical Center between July 1989 and December 2005. Results: Six HCC patients with sclerosing HCC were
diagnosed out of the total 1390 HCC patients (0.43%) during the study period. The mean age was 58 years and
4 patients were male. Weight loss and abdominal pain were the most common symptoms. The serum calcium
and phosphorus levels were normal in all the patients. All of them were hepatitis B surface antigen-positive,
but none was positive for hepatitis C. All the lesions were solitary. The tumor size ranged from 45 to 150 mm
in diameter (median size: 81 mm). We performed right trisegmentectomy (n=1), central bisegmentectomy (n=1),
right anterior segmentectomy (n=1), ex-vivo resection and autotransplantation (n=1) and right posterior
segmentectomy (n=2). The median overall survival and disease free-survival periods were 24 months and 9.5
months, respectively. Conclusions: The incidence of sclerosing HCC was very low. Sclerosing HCC was often
not correctly diagnosed before an operation, but performing resection prolonged the patients’ survival and their
prognosis was not worse than that for ordinary HCC. Our experience implicates that aggressive surgical
treatment for sclerosing HCC is beneficial for patient survival. (Korean J Hepatol 2006;12:412-419)
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