Relatively high risk for hepatocellular carcinoma in patients with primary biliary cirrhosis not responding to ursodeoxycholic acid

Autor: Edith M M, Kuiper, Bettina E, Hansen, Rob P R, Adang, Carin M J, van Nieuwkerk, Robin, Timmer, Joost P H, Drenth, Piet, Spoelstra, Hans T, Brouwer, Johan P H, Kuyvenhoven, Henk R, van Buuren, J, Lambert
Přispěvatelé: Gastroenterology and hepatology, CCA - Immuno-pathogenesis
Rok vydání: 2011
Předmět:
Adult
Male
medicine.medical_specialty
Cholagogues and Choleretics
Cirrhosis
Carcinoma
Hepatocellular
Time Factors
Kaplan-Meier Estimate
Gastroenterology
Risk Assessment
Primary biliary cirrhosis
Risk Factors
Internal medicine
Cause of Death
Medicine
Humans
Mass Screening
Prospective Studies
Treatment Failure
Risk factor
Molecular gastro-enterology and hepatology [IGMD 2]
Prospective cohort study
Mass screening
Aged
Netherlands
Proportional Hazards Models
Framingham Risk Score
Hepatology
business.industry
Liver Cirrhosis
Biliary
screening
Incidence
Patient Selection
Liver Neoplasms
Ursodeoxycholic Acid
hepatocellular carcinoma
Middle Aged
medicine.disease
digestive system diseases
Ursodeoxycholic acid
primary biliary cirrhosis
Survival Rate
Hepatocellular carcinoma
Female
business
medicine.drug
Zdroj: European Journal of Gastroenterology & Hepatology, 22, 12, pp. 1495-502
European Journal of Gastroenterology and Hepatology, 22(12), 1495-1502
Kuiper, E M M, Hansen, B E, Adang, R P R, van Nieuwkerk, C M J, Timmer, R, Drenth, J P, Speolstra, P, Brouwer, H T, Kuyvenhoven, J P & van Buuren, H R 2010, ' Relatively high risk for hepatocellular carcinoma in patients with primary biliary cirrhosis not responding to ursodeoxycholic acid ', European Journal of Gastroenterology and Hepatology, vol. 22, no. 12, pp. 1495-1502 . https://doi.org/10.1097/MEG.0b013e32834059e7
European Journal of Gastroenterology and Hepatology, 22(12), 1495-1502. Lippincott Williams and Wilkins
European Journal of Gastroenterology & Hepatology, 22, 1495-502
ISSN: 1473-5687
0954-691X
DOI: 10.1097/MEG.0b013e32834059e7
Popis: Background: The reported incidence of hepatocellular carcinoma (HCC) among patients with primary biliary cirrhosis (PBC) varies from 0.7-3.8%, whereas in cirrhotic patients the risk is considerably higher. Age, male sex, cirrhosis, and portal hypertension are reported risk factors. It has been suggested that ursodeoxycholic acid (UDCA) may protect against HCC. We aimed to define risk factors for the development of HCC at the time of PBC diagnosis and to identify, among patients treated with UDCA for a long term, a subgroup that could benefit from screening. Methods: Prospective multicenter cohort study of patients with established PBC treated with 13-15 mg/kg/day UDCA. Age, sex, antimitochondrial antibodies, bilirubin, albumin, alkaline phosphatase, alanine aminotransferase, aspartate amino transferase, cirrhosis, portal hypertension, Mayo Risk Score, prognostic class (based on bilirubin and albumin levels), and response to UDCA (normalization of bilirubin and/or albumin levels) were analyzed as potential risk factors in Cox regression analysis. Results: Three hundred and seventy-five patients were included, median follow-up was 9.7 years. HCC occurred in nine patients, corresponding with an annual incidence of 0.2%. The factor significantly associated with the development of HCC was the response to UDCA (P
Databáze: OpenAIRE
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