scholarly journals Current Trends and Characteristics of Hepatocellular Carcinoma in Patients with Autoimmune Liver Diseases

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1023
Author(s):  
Eirini I. Rigopoulou ◽  
George N. Dalekos
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Diseases ◽  
Treatment Modalities ◽  
Primary Biliary Cholangitis ◽  
Autoimmune Liver Diseases ◽  
Increased Risk ◽  
Liver Cancers ◽  
Medium Risk ◽  
Causes Of Mortality

Hepatocellular carcinoma (HCC), the commonest among liver cancers, is one of the leading causes of mortality among malignancies worldwide. Several reports demonstrate autoimmune liver diseases (AILDs), including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) to confer increased risk of hepatobiliary malignancies, albeit at lower frequencies compared to other liver diseases. Several parameters have been recognized as risk factors for HCC development in AIH and PBC, including demographics such as older age and male sex, clinical features, the most decisive being cirrhosis and other co-existing factors, such as alcohol consumption. Moreover, biochemical activity and treatment response have been increasingly recognized as prognostic factors for HCC development in AIH and PBC. As available treatment modalities are effective only when HCC diagnosis is established early, surveillance has been proven essential for HCC prognosis. Considering that the risk for HCC is not uniform between and within disease groups, refinement of screening strategies according to prevailing demographic, clinical, and molecular risk factors is mandated in AILDs patients, as personalized HCC risk prediction will offer significant advantage in patients at high and/or medium risk. Furthermore, future investigations should draw attention to whether modification of immunosuppression could benefit AIH patients after HCC diagnosis.

The Association of Two Rare Diseases is Not Rare: Primary Immunodeficiencies and Autoimmune Liver Diseases

2021 ◽  
Author(s):  
Şefika Nur Ayar ◽  
Elif Soyak ◽  
Cem Şimşek ◽  
Deniz Çağdaş ◽  
Yasemin Balaban
Keyword(s):  
Rare Diseases ◽  
Liver Diseases ◽  
Strong Association ◽  
Laboratory Data ◽  
Tertiary Hospital ◽  
Iga Deficiency ◽  
Primary Biliary Cholangitis ◽  
Cross Sectional ◽  
Autoimmune Liver Diseases ◽  
Igm Deficiency

Abstract Purpose: PIDs associates with autoimmune diseases include autoimmune liver diseases (AILD); however, the frequency of PIDs among patients with AILD is unknown. This study aimed to evaluate the strength of the association between AILD and PIDs. Methods: We conducted this single-center, cross-sectional, and descriptive study in a tertiary hospital. We evaluated eighty-two patients with AILD (39 autoimmune hepatitis (AIH), 32 with primary biliary cholangitis (PBC), seven with variant syndromes (VS), and four with primary sclerosing cholangitis (PSC) for the presence of PIDs. We obtained a detailed history of infections, comorbidities, family history, and laboratory data from the files. All patients were evaluated in the immunology department for further examination, and PID diagnoses were made according to ESID (The European Society for Immunodeficiencies) criteria. Results: Out of 82 patients with AILD, PIDs were diagnosed in 18% (15 patients); there were four patients with common variable immunodeficiency (CVID), four with partial IgA deficiency (PIgAD), four with selective IgM deficiency (SIgMD), and three with combined immunodeficiency (CID). PIDs were present in 29% of patients with VS, 25 % of patients with PSC, 23% of patients with AIH, and 9% of patients with PBC. Conclusion: Although PIDs are rare diseases in the general population, they have a strong association with AILD and were detected in one-fifth of the patients. Further research with larger patient groups is needed to evaluate the diagnostic and prognostic impacts of PIDs on AILD.

scholarly journals Epidemiology of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Related Hepatocellular Carcinoma

2018 ◽  
Vol 12 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Arnolfo Petruzziello
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hbv Infection ◽  
Sub Saharan Africa ◽  
Liver Cancers ◽  
B Virus

Introduction:Hepatocellular carcinoma (HCC) is one of the most prevalent primary malignant tumors and accounts for about 90% of all primary liver cancers. Its distribution varies greatly according to geographic location and it is more common in middle and low- income countries than in developed ones especially in Eastern Asia and Sub Saharan Africa (70% of all new HCCs worldwide), with incidence rates of over 20 per 100,000 individuals.Explanation:The most important risk factors for HCC are Hepatitis B Virus (HBV) infection, Hepatitis C Virus (HCV) infection, excessive consumption of alcohol and exposition to aflatoxin B1. Its geographic variability and heterogeneity have been widely associated with the different distribution of HBV and HCV infections worldwide.Chronic HBV infection is one of the leading risk factors for HCC globally accounting for at least 50% cases of primary liver tumors worldwide. Generally, while HBV is the main causative agent in the high incidence HCC areas, HCV is the major etiological factor in low incidence HCC areas, like Western Europe and North America.Conclusion:HBV-induced HCC is a complex, stepwise process that includes integration of HBV DNA into host DNA at multiple or single sites. On the contrary, the cancerogenesis mechanism of HCV is not completely known and it still remains controversial as to whether HCV itself plays a direct role in the development of tumorigenic progression.

scholarly journals Hepatocellular carcinoma in patients with autoimmune liver diseases: Two case reports and literature review

2007 ◽  
Vol 6 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Judith Meza-Junco; ◽  
Aldo J. Montaño-Loza; ◽  
Braulio Martínez-Benitez; ◽  
Eric Kimura-Hayama
Keyword(s):  
Hepatocellular Carcinoma ◽  
Literature Review ◽  
Liver Diseases ◽  
Case Reports ◽  
Autoimmune Liver Diseases

Worldwide Incidence of Autoimmune Liver Disease

2015 ◽  
Vol 33 (Suppl. 2) ◽  
pp. 2-12 ◽  
Author(s):  
Peter Jepsen ◽  
Lisbet Grønbæk ◽  
Hendrik Vilstrup
Keyword(s):  
Risk Factors ◽  
Liver Diseases ◽  
Incidence Rates ◽  
Case Finding ◽  
Biliary Cirrhosis ◽  
Immunoglobulin G4 ◽  
Autoimmune Liver Diseases ◽  
North East ◽  
Standard Population ◽  
Incident Cases

Background: The variation that occurs in the incidence patterns of autoimmune liver diseases may provide insight into the risk factors causing the diseases. We systematically reviewed studies on the incidence of autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), and immunoglobulin G4-associated cholangitis (IAC) in general populations. Key Messages: We found relevant studies through Medline and Scopus, and we examined whether they were population-based; the way they found cases for inclusion and which diagnostic criteria they used; and whether they used standardization to facilitate comparison with other studies. The 55 identified studies varied greatly in their case-finding methods, and only 14 (25%) of them used a standard population. Reported incidence rates of AIH were around 1 per 100,000 population per year, possibly higher in Scandinavia than in other countries, and a Danish study of the 1994-2012 period found an increasing incidence. A majority of PBC studies found incidence rates of 1-2 per 100,000 population per year and an increasing time trend, but incidence was lower in the Netherlands and New Zealand and higher in North East England. Most studies of PSC found incidence rates around 1 per 100,000 population per year, but there were no incident cases among 100,000 Alaska natives during the period 1984-2000. The incidence of IAC remains unknown. Conclusions: The incidence of the autoimmune liver diseases is around 1-2 per 100,000 population per year for each disease. The variation in incidence over time and place suggests that there are differences in the prevalence of risk factors for the diseases, but the studies used different methods and so it is difficult to draw firm conclusions. We recommend that groups of investigators conduct multisite studies with identical case-finding methods, and that they use a standard population to account for differences in demographics.

scholarly journals Variety of lung involvement in autoimmune liver diseases

2018 ◽  
Vol 90 (8) ◽  
pp. 107-112
Author(s):  
L A Akulkina ◽  
M Yu Brovko ◽  
V I Sholomova ◽  
T P Rozina ◽  
A S Yanakayeva ◽  
...  
Keyword(s):  
Liver Diseases ◽  
Primary Biliary Cholangitis ◽  
Extrahepatic Manifestations ◽  
Specific Procedure ◽  
High Resolution Computed Tomography ◽  
Lung Lesions ◽  
Autoimmune Liver Diseases ◽  
Pulmonary Parenchyma ◽  
Lung Vessels

The primary autoimmune liver diseases conventionally include primary biliary cholangitis, primary sclerosing cholangitis and autoimmune hepatitis. Despite of primary autoimmune affection of different parts of the hepatobiliary system, in the recent decades, a lot of data has emerged indicating the presence of extrahepatic manifestations of these diseases, in particular, lung lesions, such as nodular and interstitial changes with possible progression and development of fibrosis and respiratory failure. In case of lungs disease, both pulmonary parenchyma and lung vessels, pleura, and intrathoracic lymph nodes can be involved. The most sensitive and specific procedure to assess the extent of the lung lesions and their evolution is high-resolution computed tomography. Due to the possibility of long-term asymptomatic course of the pulmonary disease with development of irreversible changes in patients with autoimmune liver diseases, it seems reasonable to conduct screening studies aimed at early detection and treatment of lung lesions in this population.

scholarly journals Factors predicting long-term outcome of early stage hepatocellular carcinoma after primary curative treatment - the role of surgical or nonsurgical methods

2020 ◽  
Author(s):  
Ming-Jeng Kuo ◽  
Chi-Ling Chen ◽  
Lein-ray Mo
Keyword(s):  
Hepatocellular Carcinoma ◽  
Late Recurrence ◽  
Early Recurrence ◽  
Curative Treatment ◽  
Treatment Modalities ◽  
Long Term Outcome ◽  
Increased Risk ◽  
Significant Difference ◽  
Early Hcc ◽  
Time Varying Covariates

Abstract Background The effect of putative factors on the clinical course of early hepatocellular carcinoma (HCC) after primary surgical or nonsurgical curative treatment, which remains elusive, was quantified. Methods Patients with newly diagnosed early HCC who received surgical resection (SR) or percutaneous radiofrequency ablation (RFA) with or without transcatheter arterial chemoembolization (TACE) from January 2003 to December 2016 were enrolled. The cumulative overall survival (OS) and disease-free survival (DFS) were compared. A polytomous logistic regression was used to estimate factors regarding early and late recurrence. Independent predictors of OS were identified using Cox proportional hazard regression. Results One hundred twenty-five patients underwent SR, and 176 patients underwent RFA, of whom 72 were treated with TACE followed by RFA. Either match analysis based on propensity score or multiple adjustment regression showed no significant difference in DFS and OS between the two groups. Multivariate analysis showed high AFP (>= 20 ng/mL), and multinodularity significantly increased risk of early recurrence (<=1year). In contrast, hepatitis B virus, hepatitis C virus and multinodularity were significantly associated with late recurrence (>1year). Multivariate Cox regression with recurrent events as time-varying covariates identified older age (HR=1.55, 95% CI:1.01-2.36), clinically significant portal hypertension (CSPH) (HR=1.97, 95% CI:1.26-3.08), early recurrence (HR=6.62, 95% CI:3.79-11.6) and late recurrence (HR=3.75, 95% CI:1.99-7.08) as independent risk factors of mortality. A simple risk score showed fair calibration and discrimination in early HCC patients after primary curative treatment. In the Barcelona Clinic Liver Cancer (BCLC) stage A subgroup, SR significantly improved DFS comparing to those received RFA with or without TACE. Conclusion Host and tumor factors rather than the initial treatment modalities determine the outcomes of early HCC after primary curative treatment. Statistical models based on recurrence types can predict early HCC prognosis but further external validation is necessary.

scholarly journals The risk of liver cancer in autoimmune liver diseases

2019 ◽  
Vol 11 ◽  
pp. 175883591986191 ◽  
Author(s):  
Ana Lleo ◽  
Ynto S. de Boer ◽  
Rodrigo Liberal ◽  
Massimo Colombo
Keyword(s):  
Early Diagnosis ◽  
Liver Diseases ◽  
Close Association ◽  
Fatal Outcome ◽  
Primary Biliary Cholangitis ◽  
Primary Malignancy ◽  
Abdominal Ultrasonography ◽  
Systematic Analysis ◽  
Acid Therapy ◽  
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 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.

scholarly journals The Microbiome in Autoimmune Liver Diseases: Metagenomic and Metabolomic Changes

2021 ◽  
Vol 12 ◽  
Author(s):  
Yanping Zheng ◽  
Ying Ran ◽  
Hongxia Zhang ◽  
Bangmao Wang ◽  
Lu Zhou
Keyword(s):  
Gut Microbiome ◽  
Metabolic Pathways ◽  
Liver Diseases ◽  
Critical Role ◽  
Short Chain Fatty Acids ◽  
Primary Biliary Cholangitis ◽  
Mechanistic Studies ◽  
Autoimmune Liver Diseases ◽  
Acid Metabolites

Recent studies have identified the critical role of microbiota in the pathophysiology of autoimmune liver diseases (AILDs), including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). Metagenomic studies reveal significant decrease of gut bacterial diversity in AILDs. Although profiles of metagenomic vary widely, Veillonella is commonly enriched in AIH, PBC, and PSC. Apart from gut microbiome, the oral and bile microbiome seem to be associated with these diseases as well. The functional analysis of metagenomics suggests that metabolic pathways changed in the gut microbiome of the patients. Microbial metabolites, including short-chain fatty acids (SCFAs) and microbial bile acid metabolites, have been shown to modulate innate immunity, adaptive immunity, and inflammation. Taken together, the evidence of host–microbiome interactions and in-depth mechanistic studies needs further accumulation, which will offer more possibilities to clarify the mechanisms of AILDs and provide potential molecular targets for the prevention and treatment in the future.

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