Are patients with cirrhotic stage primary sclerosing cholangitis at risk for the development of hepatocellular cancer?

被引:67
作者
Harnois, DM
Gores, GJ
Ludwig, J
Steers, JL
LaRusso, NF
Wiesner, RH
机构
[1] MAYO CLIN & MAYO FDN,DIV GASTROENTEROL,ROCHESTER,MN 55905
[2] MAYO CLIN & MAYO FDN,SECT LIVER TRANSPLANTAT,ROCHESTER,MN 55905
[3] MAYO CLIN & MAYO FDN,DEPT PATHOL,ROCHESTER,MN 55905
关键词
fibrolamellar hepatocellular carcinoma; inflammatory bowel disease; screening;
D O I
10.1016/S0168-8278(97)80356-X
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: The risk of cholangiocarcinoma in primary sclerosing cholangitis is widely recognized to be 8-30%, whereas the risk of acquiring hepatocellular carcinoma in primary sclerosing cholangitis is unknown. As in other chronic river diseases, the presence of hepatocellular carcinoma in a patient with primary sclerosing cholangitis undergoing evaluation for orthotopic liver transplantation would clearly impact on the candidacy, diagnostic evaluation, and alternative treatment options, Thus, the aim of our study was to determine the prevalence Of hepatocellular carcinoma in patients undergoing liver transplantation for primary sclerosing cholangitis. Methods: The records of the 520 patients undergoing orthotopic liver transplantation at our institution between 1985 and May 1995 were reviewed. Of the 134 patients with primary sclerosing cholangitis, three (2%) had hepatocellular carcinoma. In the 386 patients without primary sclerosing cholangitis undergoing orthotopic liver transplantation, 22 (6%) had hepatocellular carcinoma. Results: Neither the duration of primary sclerosing cholangitis (range 7-23 years) nor the presence of ulcerative colitis (two Of three patients) distinguished those patients with primary sclerosing cholangitis plus hepatocellular carcinoma from those with primary sclerosing cholangitis alone, None of the three patients with primary sclerosing cholangitis plus hepatocellular carcinoma Bead evidence for hepatitis B or C, alpha-1-antitrypsin deficiency, or hemochromatosis. None of the tumors was of the fibrolamellar variety of hepatocellular carcinoma. Conclusions: The prevalence of hepatocellular carcinoma in patients with primary sclerosing cholangitis undergoing orthotopic liver transplantation is 2%. These data suggest-that patients with advanced cirrhotic-stage primary sclerosing cholangitis are at increased risk for developing hepatocellular carcinoma and should be screened for hepatocellular carcinoma as well as for cholangiocarcinoma prior to orthotopic liver transplantation.
引用
收藏
页码:512 / 516
页数:5
相关论文
共 10 条
[1]
Natural history and prognostic factors in 305 Swedish patients with primary sclerosing cholangitis [J].
Broome, U ;
Olsson, R ;
Loof, L ;
Bodemar, G ;
Hultcrantz, R ;
Danielsson, A ;
Prytz, H ;
SandbergGertzen, H ;
Wallerstedt, S ;
Lindberg, G .
GUT, 1996, 38 (04) :610-615
[2]
FARGES O, 1995, SURGERY, V117, P145
[3]
HEPATOCELLULAR-CARCINOMA IN PRIMARY BILIARY-CIRRHOSIS [J].
FARINATI, F ;
FLOREANI, A ;
DEMARIA, N ;
FAGIUOLI, S ;
NACCARATO, R ;
CHIARAMONTE, M .
JOURNAL OF HEPATOLOGY, 1994, 21 (03) :315-316
[4]
HEPATOCELLULAR-CARCINOMA COMPLICATING PRIMARY SCLEROSING CHOLANGITIS [J].
ISMAIL, T ;
ANGRISANI, L ;
HUBSCHER, S ;
MCMASTER, P .
BRITISH JOURNAL OF SURGERY, 1991, 78 (03) :360-361
[5]
RECURRENCE OF HEPATOCELLULAR-CARCINOMA AFTER LIVER RETRANSPLANTATION [J].
KLOMPMAKER, IJ ;
DEBRUIN, KM ;
GOUW, AS ;
BAMS, JL ;
SLOOFF, MJ .
BRITISH MEDICAL JOURNAL, 1988, 296 (6634) :1445-1445
[6]
CANCER RISK IN PRIMARY BILIARY-CIRRHOSIS - A POPULATION-BASED STUDY FROM SWEDEN [J].
LOOF, L ;
ADAMI, HO ;
SPAREN, P ;
DANIELSSON, A ;
ERIKSSON, LS ;
HULTCRANTZ, R ;
LINDGREN, S ;
OLSSON, R ;
PRYTZ, H ;
RYDEN, BO ;
SANDBERGGERTZEN, H ;
WALLERSTEDT, S .
HEPATOLOGY, 1994, 20 (01) :101-104
[7]
LUDWIG J, 1994, MODERN PATHOL, V7, P790
[8]
Riegler J L, 1996, Semin Gastrointest Dis, V7, P74
[9]
CHOLANGIOCARCINOMA COMPLICATING PRIMARY SCLEROSING CHOLANGITIS [J].
ROSEN, CB ;
NAGORNEY, DM ;
WIESNER, RH ;
COFFEY, RJ ;
LARUSSO, NF .
ANNALS OF SURGERY, 1991, 213 (01) :21-25
[10]
FIBROLAMELLAR HEPATOCELLULAR-CARCINOMA COMPLICATING ULCERATIVE-COLITIS WITH PRIMARY SCLEROSING CHOLANGITIS [J].
SNOOK, JA ;
KELLY, P ;
CHAPMAN, RW ;
JEWELL, DP .
GUT, 1989, 30 (02) :243-245