Development of Hepatocellular Carcinoma in Autoimmune Hepatitis Patients: A Case Series
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Robert J. Wong Robert Gish Todd Frederick Natalie Bzowej Catherine Frenette
- چاپ و سال / کشور: 2010
Description
Background The risk of hepatocellular carcinoma (HCC) among patients with autoimmune hepatitis (AIH) is believed to be low compared with other chronic liver diseases, and uncertainty exists over the need to perform HCC surveillance. If surveillance is initiated, the optimal timing is also not yet defined. Aims The aim of the study was to investigate the prevalence of HCC among AIH patients. Methods This was a retrospective study analyzing patient data from 1999 to 2009 in a large tertiary-care community hospital to assess the prevalence ofHCCamong AIHpatients. Results Among 322 AIH cases, cancer screening identified six patients that developed HCC (prevalence: 459 per 100,000 patient-years). All six patients were extracted from the subset of AIH patients with cirrhosis (n = 50), resulting in a prevalence of 1,920 per 100,000 patient-years. In the AIH with HCC cohort, mean age of AIH diagnosis was 51.8 years (range, 24–70) and mean age of HCC diagnosis was 60.0 years (range, 37–71). The mean interval between diagnosis of AIH and HCC was 10.0 years. Three patients had AJCC stage C2 cancer at diagnosis, and two had BCLC stage B or C. Conclusions The risk of HCC among AIH patients with cirrhosis is 1.9% per year. This is comparable to HCC risk among patients with cirrhosis secondary to HBV, HCV, hemochromatosis, or alcohol-related liver disease. Although this data needs to be confirmed in prospective studies, routine cancer screening and surveillance among this cohort for early detection and treatment should be conducted.
Dig Dis Sci (2011) 56:578–585 DOI 10.1007/s10620-010-1444-6 Received: 9 June 2010 / Accepted: 19 September 2010 / Published online: 3 November 2010 Springer Science+Business Media, LLC 2010 Abstract Background The risk of hepatocellular carcinoma (HCC) among patients with autoimmune hepatitis (AIH) is believed to be low compared with other chronic liver diseases, and uncertainty exists over the need to perform HCC surveillance. If surveillance is initiated, the optimal timing is also not yet defined. Aims The aim of the study was to investigate the prevalence of HCC among AIH patients. Methods This was a retrospective study analyzing patient data from 1999 to 2009 in a large tertiary-care community hospital to assess the prevalence ofHCCamong AIHpatients. Results Among 322 AIH cases, cancer screening identified six patients that developed HCC (prevalence: 459 per 100,000 patient-years). All six patients were extracted from the subset of AIH patients with cirrhosis (n = 50), resulting in a prevalence of 1,920 per 100,000 patient-years. In the AIH with HCC cohort, mean age of AIH diagnosis was 51.8 years (range, 24–70) and mean age of HCC diagnosis was 60.0 years (range, 37–71). The mean interval between diagnosis of AIH and HCC was 10.0 years. Three patients
