Abstract
Background A potential correlation between sex hormones, such as androgens and estrogens, and the development and progression of hepatocellular carcinoma (HCC) has been proposed. However, its details, in particular, aromatase status in diseased human liver has remained largely unknown. Materials and methods We immunolocalized aromatase, 17β-hydroxysteroid dehydrogenase (17β-HSD) type 1 and 17β-HSD type 2 in a total of 155 cases, consisting of normal liver (n = 10), nonalcoholic steatohepatitis (NASH) (n = 18), primary sclerosing cholangitis (PSC) (n = 6), primary biliary cholangitis (PBC) (n = 13), biliary atresia (n = 18), alcoholic hepatitis (n = 11), hepatitis C virus (HCV) (n = 31), HCV sustained virologic response (HCV-SVR) (n = 10), hepatitis B virus (HBV) (n = 20), HBV sustained virologic response (HBV-SVR) (n = 8) and infants (n = 10). Results Immunoreactivity scores of aromatase in HBV (59.5 ± 30.9), HBV-SVR (68.1 ± 33.5) and infants (100.5 ± 36.6) were significantly higher than those in normal liver (26.0 ± 17.1). Scores of 17β-HSD type 1 in any etiology other than HBV (116.3 ± 23.7) and infants (120.0 ± 28.5) were significantly lower than those in normal liver (122.5 ± 8.6). Scores of 17β-HSD type 2 in NASH (74.4 ± 36.6) were significantly lower than those in normal liver (128.0 ± 29.7). Conclusion High immunoreactivity scores of aromatase and 17β-HSD type 1 in the patients with HBV suggest a correlation between HBV infection and in situ estrogen synthesis in hepatocytes.