Hepatocellular carcinoma in primary sclerosing cholangitis and primary biliary cholangitis: a clinical and pathological study in an uncommon but emerging setting

被引:0
作者
Dustin E. Bosch
Yoh Zen
Sarag A. Boukhar
Yongjun Liu
Lin Cheng
Matthew M. Yeh
机构
[1] University of Washington School of Medicine,Department of Laboratory Medicine and Pathology
[2] University of Iowa,Department of Pathology, Roy J. and Lucille A. Carver College of Medicine
[3] King’s College Hospital & King’s College London,Institute of Liver Studies
[4] University of Wisconsin,Department of Pathology, School of Medicine and Public Health
[5] Rush University,Department of Pathology
[6] University of Washington School of Medicine,Department of Medicine
来源
Virchows Archiv | 2021年 / 479卷
关键词
Liver; Primary biliary cholangitis; Primary sclerosing cholangitis; Metabolic syndrome; Diabetes; Hepatocellular carcinoma;
D O I
暂无
中图分类号
学科分类号
摘要
Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are biliary tract pathologies with increased risk of HCC, although HCC is more commonly associated with viral hepatitis and steatohepatitis. HCC risk stratification in PBC/PSC populations may help select patients for surveillance. We hypothesized that metabolic syndrome associated diagnoses and co-morbid nonalcoholic fatty liver disease (NAFLD) may be risk factors for HCC in patients with PBC and PSC. We undertook a multi-institutional case control study of PSC (19 cases, 38 controls) and PBC (39 cases and controls) patients with advanced fibrosis, matched for known HCC risk factors of age and sex, who had native liver explant or resection specimens. In the PSC population, HCC risk was significantly associated with multiple metabolic syndrome associated diagnoses (OR 13, p = 0.02), hyperlipidemia (OR 29, p = 0.03), and obesity (OR 6.8, p = 0.01). In the PBC cohort, only type 2 diabetes was a risk factor for HCC (OR 4.7, p = 0.03). In the PSC cohort, thick fibrous septae were associated with HCC risk (OR 3.4, p = 0.04). No other pathologic features of the nonneoplastic liver were significantly associated with HCC, including features of NAFLD such as macrovesicular steatosis, pericellular fibrosis, and steatohepatitis. Metabolic syndrome associated diagnoses, specifically type 2 diabetes among PBC patients, is associated with HCC risk in patients with biliary type cirrhosis. However, we found no evidence that HCC risk is related to co-morbid NAFLD, indicating a likely distinct mechanism of metabolic syndrome-associated carcinogenesis in these populations.
引用
收藏
页码:1131 / 1143
页数:12
相关论文
共 50 条
[41]   The primary sclerosing cholangitis [J].
Yamoul, R. ;
Attoulou, G. ;
Njoumi, N. ;
Najih, M. ;
Tajddine, T. ;
Mikou, I. ;
Alkandry, S. .
JOURNAL AFRICAIN D HEPATO-GASTROENTEROLOGIE, 2013, 7 (03) :145-146
[42]   Primary biliary cholangitis metachronously complicated with combined hepatocellular carcinoma-cholangiocellular carcinoma and hepatocellular carcinoma [J].
Ryuta Ide ;
Akihiko Oshita ;
Takashi Nishisaka ;
Hideki Nakahara ;
Shiomi Aimitsu ;
Toshiyuki Itamoto .
World Journal of Hepatology, 2017, (36) :1378-1384
[43]   GRANULOMAS IN PRIMARY SCLEROSING CHOLANGITIS [J].
LUDWIG, J ;
COLINA, F ;
POTERUCHA, JJ .
LIVER, 1995, 15 (06) :307-312
[44]   Primary sclerosing cholangitis [J].
C. B. L. M. Majoie ;
K. Huibregtse ;
J. W. A. J. Reeders .
Abdominal Imaging, 1997, 22 :194-198
[45]   Primary sclerosing cholangitis [J].
Karlsen, Tom H. ;
Schrumpf, Erik ;
Boberg, Kirsten Muri .
BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY, 2010, 24 (05) :655-666
[46]   Primary sclerosing cholangitis [J].
Majoie, CBLM ;
Huibregtse, K ;
Reeders, JWAJ .
ABDOMINAL IMAGING, 1997, 22 (02) :194-198
[47]   Primary sclerosing cholangitis [J].
Stiehl, A ;
Benz, C ;
Sauer, P .
CANADIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2000, 14 (04) :311-315
[48]   Primary sclerosing cholangitis [J].
Young-Mee Lee ;
David J. Kim .
Current Treatment Options in Gastroenterology, 2001, 4 (6) :469-477
[49]   Primary Sclerosing Cholangitis [J].
Williamson, Kate D. ;
Chapman, Roger W. .
DIGESTIVE DISEASES, 2014, 32 (04) :438-445
[50]   Biliary dysplasia as a marker of cholangiocarcinoma in primary sclerosing cholangitis [J].
Fleming, KA ;
Boberg, KM ;
Glaumann, H ;
Bergquist, A ;
Smith, D ;
Clausen, OPF .
JOURNAL OF HEPATOLOGY, 2001, 34 (03) :360-365