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The risk of liver cancer in autoimmune liver diseases
Hepatocellular carcinoma (HCC), the dominant primary malignancy of the liver, has almost invariably a fatal outcome that can be averted only by early diagnosis and treatment. While the close association of HCC with chronic viral hepatitis and alcohol abuse has impacted favourably on screening and tr...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628541/ https://www.ncbi.nlm.nih.gov/pubmed/31320937 http://dx.doi.org/10.1177/1758835919861914 |
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author | Lleo, Ana de Boer, Ynto S. Liberal, Rodrigo Colombo, Massimo |
author_facet | Lleo, Ana de Boer, Ynto S. Liberal, Rodrigo Colombo, Massimo |
author_sort | Lleo, Ana |
collection | PubMed |
description | Hepatocellular carcinoma (HCC), the dominant primary malignancy of the liver, has almost invariably a fatal outcome that can be averted only by early diagnosis and treatment. While the close association of HCC with chronic viral hepatitis and alcohol abuse has impacted favourably on screening and treatment of this deadly tumour, at the same time it has long obscured the etiologic role of autoimmune liver diseases. Recently, a systematic analysis of 25 published cohorts disclosed a 3.1 × 1000 patients/year incidence of HCC in autoimmune hepatitis patients that tripled in those with cirrhosis. HCC is also a sequela of primary biliary cholangitis, where the incidence is more relevant in males, those with advanced liver disease and nonresponders to ursodeoxycholic acid therapy. Cholangiocarcinoma (CCA), the second ranking primary cancer of the liver, is also on the rise with its intrahepatic pattern, in part reflecting an association with chronic liver diseases of diverse aetiology. In the USA and northern Europe, perihilar CCA is a frequent complication of primary sclerosing cholangitis, a cholestatic disorder thought to be immune mediated. International Guidelines clearly recommend HCC screening with abdominal ultrasonography every 6 months in autoimmune cirrhotic patients. While surveillance of patients with autoimmune liver disorders who are at risk of HCC affects both early diagnosis and radical therapy of this tumour, this is not the case for CCA, where early diagnosis is challenged by the lack of sensitive and accurate tests for screening. |
format | Online Article Text |
id | pubmed-6628541 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-66285412019-07-18 The risk of liver cancer in autoimmune liver diseases Lleo, Ana de Boer, Ynto S. Liberal, Rodrigo Colombo, Massimo Ther Adv Med Oncol Early Diagnosis and Therapeutic Advances for Liver Cancer: From Bench to Bedside Hepatocellular carcinoma (HCC), the dominant primary malignancy of the liver, has almost invariably a fatal outcome that can be averted only by early diagnosis and treatment. While the close association of HCC with chronic viral hepatitis and alcohol abuse has impacted favourably on screening and treatment of this deadly tumour, at the same time it has long obscured the etiologic role of autoimmune liver diseases. Recently, a systematic analysis of 25 published cohorts disclosed a 3.1 × 1000 patients/year incidence of HCC in autoimmune hepatitis patients that tripled in those with cirrhosis. HCC is also a sequela of primary biliary cholangitis, where the incidence is more relevant in males, those with advanced liver disease and nonresponders to ursodeoxycholic acid therapy. Cholangiocarcinoma (CCA), the second ranking primary cancer of the liver, is also on the rise with its intrahepatic pattern, in part reflecting an association with chronic liver diseases of diverse aetiology. In the USA and northern Europe, perihilar CCA is a frequent complication of primary sclerosing cholangitis, a cholestatic disorder thought to be immune mediated. International Guidelines clearly recommend HCC screening with abdominal ultrasonography every 6 months in autoimmune cirrhotic patients. While surveillance of patients with autoimmune liver disorders who are at risk of HCC affects both early diagnosis and radical therapy of this tumour, this is not the case for CCA, where early diagnosis is challenged by the lack of sensitive and accurate tests for screening. SAGE Publications 2019-07-12 /pmc/articles/PMC6628541/ /pubmed/31320937 http://dx.doi.org/10.1177/1758835919861914 Text en © The Author(s), 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Early Diagnosis and Therapeutic Advances for Liver Cancer: From Bench to Bedside Lleo, Ana de Boer, Ynto S. Liberal, Rodrigo Colombo, Massimo The risk of liver cancer in autoimmune liver diseases |
title | The risk of liver cancer in autoimmune liver diseases |
title_full | The risk of liver cancer in autoimmune liver diseases |
title_fullStr | The risk of liver cancer in autoimmune liver diseases |
title_full_unstemmed | The risk of liver cancer in autoimmune liver diseases |
title_short | The risk of liver cancer in autoimmune liver diseases |
title_sort | risk of liver cancer in autoimmune liver diseases |
topic | Early Diagnosis and Therapeutic Advances for Liver Cancer: From Bench to Bedside |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628541/ https://www.ncbi.nlm.nih.gov/pubmed/31320937 http://dx.doi.org/10.1177/1758835919861914 |
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