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Liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis

While dysplastic liver nodules in cirrhosis are pre-malignant, little is known about the predictors of hepatocarcinogenesis of these lesions. This was a retrospective observational study of subjects with cirrhosis who had at least one hypervascular, non-malignant intrahepatic nodule on imaging while...

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Autores principales: Gazelakis, Kathryn, Majeed, Ammar, Kemp, William, Di Muzio, Bruno, Gerstenmaier, Jan, Cheung, Wa, Roberts, Stuart K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545953/
https://www.ncbi.nlm.nih.gov/pubmed/34697374
http://dx.doi.org/10.1038/s41598-021-00474-5
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author Gazelakis, Kathryn
Majeed, Ammar
Kemp, William
Di Muzio, Bruno
Gerstenmaier, Jan
Cheung, Wa
Roberts, Stuart K.
author_facet Gazelakis, Kathryn
Majeed, Ammar
Kemp, William
Di Muzio, Bruno
Gerstenmaier, Jan
Cheung, Wa
Roberts, Stuart K.
author_sort Gazelakis, Kathryn
collection PubMed
description While dysplastic liver nodules in cirrhosis are pre-malignant, little is known about the predictors of hepatocarcinogenesis of these lesions. This was a retrospective observational study of subjects with cirrhosis who had at least one hypervascular, non-malignant intrahepatic nodule on imaging while undergoing outpatient management by a tertiary hepatology referral centre between Jan 2009 and Jan 2019. Clinical and biochemical parameters were collected. The primary endpoint was transformation to hepatocellular carcinoma (HCC) as determined by Liver Imaging Reporting and Data System. During the study period, 163 non-malignant hypervascular nodules were identified in 77 patients; 147 had at least 6 months of follow up imaging and 16 received upfront radiofrequency ablation upon detection. During a median follow up of 38.5 months (IQR 16.5–74.5), 25 (17%) of the 147 hypervascular nodules being monitored transformed to HCC. On multivariate analysis, Child–Pugh grade was found to be the only independent predictor of nodule transformation into HCC (p = 0.02). Those with Child–Pugh B and C liver disease had a 10.1 (95% CI 1.22–83.8; p = 0.03) and 32.6-fold (95% CI 2.3–467; p = 0.01) increased risk respectively for HCC transformation compared to Child–Pugh A subjects. This large, single centre study demonstrates that around 20% of dysplastic nodules in cirrhotic patients undergo hepatocarcinogenesis during follow up, and that Child Pugh grade is the only independent predictor of transformation to HCC. Additional prospective studies are warranted to better understand the risk profile of these nodules, and how best they should be managed.
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spelling pubmed-85459532021-10-27 Liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis Gazelakis, Kathryn Majeed, Ammar Kemp, William Di Muzio, Bruno Gerstenmaier, Jan Cheung, Wa Roberts, Stuart K. Sci Rep Article While dysplastic liver nodules in cirrhosis are pre-malignant, little is known about the predictors of hepatocarcinogenesis of these lesions. This was a retrospective observational study of subjects with cirrhosis who had at least one hypervascular, non-malignant intrahepatic nodule on imaging while undergoing outpatient management by a tertiary hepatology referral centre between Jan 2009 and Jan 2019. Clinical and biochemical parameters were collected. The primary endpoint was transformation to hepatocellular carcinoma (HCC) as determined by Liver Imaging Reporting and Data System. During the study period, 163 non-malignant hypervascular nodules were identified in 77 patients; 147 had at least 6 months of follow up imaging and 16 received upfront radiofrequency ablation upon detection. During a median follow up of 38.5 months (IQR 16.5–74.5), 25 (17%) of the 147 hypervascular nodules being monitored transformed to HCC. On multivariate analysis, Child–Pugh grade was found to be the only independent predictor of nodule transformation into HCC (p = 0.02). Those with Child–Pugh B and C liver disease had a 10.1 (95% CI 1.22–83.8; p = 0.03) and 32.6-fold (95% CI 2.3–467; p = 0.01) increased risk respectively for HCC transformation compared to Child–Pugh A subjects. This large, single centre study demonstrates that around 20% of dysplastic nodules in cirrhotic patients undergo hepatocarcinogenesis during follow up, and that Child Pugh grade is the only independent predictor of transformation to HCC. Additional prospective studies are warranted to better understand the risk profile of these nodules, and how best they should be managed. Nature Publishing Group UK 2021-10-25 /pmc/articles/PMC8545953/ /pubmed/34697374 http://dx.doi.org/10.1038/s41598-021-00474-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Gazelakis, Kathryn
Majeed, Ammar
Kemp, William
Di Muzio, Bruno
Gerstenmaier, Jan
Cheung, Wa
Roberts, Stuart K.
Liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis
title Liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis
title_full Liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis
title_fullStr Liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis
title_full_unstemmed Liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis
title_short Liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis
title_sort liver disease severity predicts carcinogenesis of dysplastic liver nodules in cirrhosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545953/
https://www.ncbi.nlm.nih.gov/pubmed/34697374
http://dx.doi.org/10.1038/s41598-021-00474-5
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