To the Editor: In the report by Tsukuma et al. (June 24 issue)1on the risk factors for hepatocellular carcinoma in patientswith chronic liver disease, the study group was composed ofpatients with cirrhosis of the liver or chronic hepatitis. Itis not stated whether the patients had had liver biopsies, althoughthe criteria for enrollment, "a clinical diagnosis of chronichepatitis or compensated cirrhosis," suggest that biopsies werenot performed in all patients.
I believe that histologic study, particularly in the patientswith chronic hepatitis, could have contributed to a more accurateclassification of the liver disease. It . . . [Full Text of this Article]
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