Incidence, Mortality, and Predictive Factors of Hepatocellular Carcinoma in Primary Biliary Cirrhosis

Abstract

Background. The study aims to analyze in detail the incidence, mortality using the standardized incidence ratio (SIR), and standardized mortality ratio (SMR) of hepatocellular carcinoma (HCC) in primary biliary cirrhosis (PBC), because no large case studies have focused on the detailed statistical analysis of them in Asia. Methods. The study cohorts were consecutively diagnosed at Gunma University and its affiliated hospitals. Age- or sex-specific annual cancer incidence and deaths were obtained from Japanese Cancer Registry and Death Registry as a reference for the comparison of SIR or SMR of HCC. Moreover, univariate analyses and multivariate analyses were performed to clarify predictive factors for the incidence of HCC. Results. The overall 179 patients were followed up for a median of 97 months. HCC had developed in 13 cases. SIR for HCC was 11.6 (95% confidence interval (CI), 6.2–19.8) and SMR for HCC was 11.2 (95% CI, 5.4–20.6) in overall patients. The serum albumin levels were a predictive factor for the incidence of HCC in overall patients. Conclusions. The incidence and mortality of HCC in PBC patients were significantly higher than those in Japanese general population. PBC patients with low serum albumin levels were populations at high risk for HCC.

Real impact of liver cirrhosis on the development of hepatocellular carcinoma in various liver diseases—meta‐analytic assessment

“…The annual incidence (%) of HCC in the non‐cirrhotic state (Scheuer's stage Ⅰ~Ⅱ) was 0.26% and that in the pre‐cirrhotic ~cirrhotic state (Scheuer's stage Ⅲ~Ⅳ) was 1.79% (LC vs non‐LC P < 0.001) . The ratio of HCC incidence for stage Ⅲ~Ⅳ/stageⅠ~Ⅱ was 6.88‐fold.…”

Incidence and Determinants of Hepatocellular Carcinoma in Autoimmune Hepatitis: A Systematic Review and Meta-analysis

“…54 The incidence of HCC among patients with PBC has been reported to be 0–11 per 1,000 person-years and in patients with PBC cirrhosis has been reported to be 7–24 per 1,000 person-years. 55–60 The incidence of HCC among patients with PSC is not known but likely very low. 61 Based on our study findings, the risk of HCC in patients with AIH cirrhosis is lower than patients with cirrhosis related to hepatitis B, hepatitis C, or PBC.…”

Prevalence and risk factors of hepatocellular carcinoma in Japanese patients with primary biliary cirrhosis

“…Therefore, in Japan, the incidence of HCC in patients with PBC and the proportion of males have been speculated to be approximately 2% and 25%, respectively. Although the incidence of HCC is low, the incidence and mortality in patients with PBC are significantly higher than those in the general population of Japan based on detailed analyses using the standardized incidence ratio and standardized mortality ratio of HCC in patients with PBC …”

“…Although the incidence of HCC is low, the incidence and mortality in patients with PBC are significantly higher than those in the general population of Japan based on detailed analyses using the standardized incidence ratio and standardized mortality ratio of HCC in patients with PBC. 21 According to a comparative analysis of this population obtained from the National Surveys of patients with PBC in Japan (2009), male sex, old age, low serum albumin levels, low serum total cholesterol levels, advanced histological stage and symptomatic status at the time of PBC diagnosis were significant risk factors for HCC (Table 1). 1,22 The cumulative incidence of carcinogenesis was 6.5% in males and 2.0% in females during the 10 years after PBC diagnosis; the difference between males and females was statistically significant (Fig.…”

“…The incidence and mortality rate of HCC in Japanese patients with PBC are significantly higher than those in the general Japanese population. 21 However, in patients with cirrhosis, the risk is considerably higher in PBC, and cirrhosis could be a risk factor of HCC irrespective of their etiologies. In Japan, PBC as an etiology of cirrhosis is observed in 2.4% cases.…”