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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Evaluation of risk factors in the development of hepatocellular carcinoma in autoimmune hepatitis: Implications for follow-up and screening.
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Evaluation of risk factors in the development of hepatocellular carcinoma in autoimmune hepatitis: Implications for follow-up and screening.

机译：自身免疫性肝炎肝细胞癌发展中的危险因素评估：对随访和筛查的意义。

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Hepatocellular carcinoma (HCC) has traditionally been considered a rare complication of cirrhosis secondary to autoimmune hepatitis (AIH), yet the true incidence remains unknown due to a lack of published data. Consequently, some professional guidelines do not mandate routine surveillance for HCC in this condition. Our aims were to evaluate the rate at which HCC develops among a large, prospectively obtained cohort of patients with AIH at a single center. Demographic, clinical, and laboratory indices associated with the development of HCC were also identified. HCC was discovered in 15 of 243 patients with AIH, all of whom had type 1 AIH equating to 1090 cases per 100,000 patient follow-up years. HCC occurred in the same proportion of females as males, 6.1% versus 6.4%, P = 0.95. HCC occurred more frequently in patients who had cirrhosis at presentation, 9.3% versus 3.4%, P = 0.048, or who had a variceal bleed as the index presentation of AIH, 20% versus 5.3%, P = 0.003. The median duration from time ofconfirmed cirrhosis to a diagnosis of HCC was 102.5 months, range 12-195 months. Median survival in patients whose HCC was diagnosed on surveillance was 19 months (range 6-36 months) compared with 2 months (range 0-14 months) for patients presenting symptomatically (P = 0.042). CONCLUSION: Cirrhosis in AIH is the sine qua non for HCC development, which subsequently occurs at a rate of 1.1% per year and affects men and women in equal proportions.
机译：传统上，肝细胞癌（HCC）被认为是自身免疫性肝炎（AIH）继发的肝硬化的罕见并发症，但是由于缺乏公开的数据，真正的发病率仍然未知。因此，在这种情况下，某些专业准则不要求对HCC进行例行监视。我们的目的是评估在单个中心的大量预期获得的AIH患者队列中HCC的发生率。还确定了与HCC发生有关的人口统计学，临床和实验室指标。在243例AIH患者中，有15例发现了HCC，所有这些患者均患有1型AIH，相当于每100,000名患者随访1090例。肝癌的女性比例与男性相同，分别为6.1％和6.4％，P = 0.95。表现为肝硬化的患者中，肝癌的发生频率更高，分别为9.3％和3.4％，P = 0.048，或者AIH的指标表现为静脉曲张出血，分别为20％和5.3％，P = 0.003。从确诊肝硬化到诊断出肝癌的中位持续时间为102.5个月，范围为12-195个月。经监测诊断为HCC的患者的中位生存期为19个月（6-36个月），而有症状的患者为2个月（0-14个月）（P = 0.042）。结论：AIH的肝硬化是肝癌发展的必要条件，随后每年以1.1％的速度发生，并以相同的比例影响男女。

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