Brief Articles
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World J Gastroenterol. Jan 14, 2009; 15(2): 231-239
Published online Jan 14, 2009. doi: 10.3748/wjg.15.231
Features of hepatocellular carcinoma in cases with autoimmune hepatitis and primary biliary cirrhosis
Takuya Watanabe, Kenji Soga, Haruka Hirono, Katsuhiko Hasegawa, Koichi Shibasaki, Hirokazu Kawai, Yutaka Aoyagi
Takuya Watanabe, Kenji Soga, Haruka Hirono, Katsuhiko Hasegawa, Koichi Shibasaki, Department of Internal Medicine and Gastroenterology, Medical Hospital, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chu-o-ku, Niigata 951-8580, Japan
Hirokazu Kawai, Yutaka Aoyagi, Department of Gastroen-terology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi, Chu-o-ku, Niigata 951-8510, Japan
Author contributions: Watanabe T, Soga K, Hirono H, Hasegawa K, Shibasaki K, Kawai H, Aoyagi Y designed the research; Watanabe T, performed the research and analyzed the data; Watanabe T wrote the paper.
Correspondence to: Takuya Watanabe, MD, PhD, Department of Internal Medicine and Gastroenterology, Medical Hospital, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chu-o-ku, Niigata 951-8580, Japan. nabetaku@dia-net.ne.jp
Telephone: +81-25-2671500
Fax: +81-25-2671582
Received: September 23, 2008
Revised: November 19, 2008
Accepted: November 26, 2008
Published online: January 14, 2009
Abstract

AIM: To characterize the clinical features of hepatocellular carcinoma (HCC) associated with autoimmune liver disease, we critically evaluated the literature on HCC associated with autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC).

METHODS: A systematic review of the literature was conducted using the Japana Centra Revuo Medicina database which produced 38 cases of HCC with AIH (AIH-series) and 50 cases of HCC with PBC (PBC-series). We compared the clinical features of these two sets of patients with the general Japanese HCC population.

RESULTS: On average, HCC was more common in men than in women with AIH or PBC. While many patients underwent chemolipiodolization (CL) or transcatheter arterial embolization (TAE) (AIH-series: P = 0.048 (vs operation), P = 0.018 (vs RFA, PEIT); PBC-series: P = 0.027 (vs RFA, PEIT), others refused therapeutic interventions [AIH-series: P = 0.038 (vs RFA, PEIT); PBC-series: P = 0.003 (vs RFA, PEIT)]. Liver failure was the primary cause of death among patients in this study, followed by tumor rupture. The survival interval between diagnosis and death was fairly short, averaging 14 ± 12 mo in AIH patients and 8.4 ± 14 mo in PBC patients.

CONCLUSION: We demonstrated common clinical features among Japanese cases of HCC arising from AIH and PBC.

Keywords: Autoimmune hepatitis, Autoimmune liver disease, Hepatocellular carcinoma, Literature review, Primary biliary cirrhosis