Murata Yosuke, Abe Masanori, Furukawa Shinya, Kumagi Teru, Matsui Hidetaka, Matsuura Kana, Matsuura Bunzo, Hiasa Yoichi, Onji Morikazu
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, To-on, Ehime 791-0295, Japan.
J Gastroenterol. 2006 Dec;41(12):1220-6. doi: 10.1007/s00535-006-1914-y. Epub 2007 Feb 6.
Esophageal varices (EV), one feature of portal hypertension, have been regarded as a late complication of liver diseases. However, accumulating evidence indicates that EV sometimes develop early during the course of primary biliary cirrhosis (PBC). The prognosis is usually poorer for patients with symptomatic PBC than for those with asymptomatic PBC. Nevertheless, the clinical features and prognosis of patients with PBC whose initial symptoms are EV have not been clarified.
The clinical features and the prognosis of patients who initially developed EV without other symptoms (v-PBC) were retrospectively investigated in 54 patients with symptomatic PBC.
The leukocyte and platelet counts were lower in patients with v-PBC than in those with PBC accompanied by other symptoms (s-PBC). Liver function tests, autoantibodies, and histological stage did not differ between patients with v-PBC and those with s-PBC. Although the prognosis did not differ, the incidence of hepatocellular carcinoma was significantly higher in v-PBC than in s-PBC (P = 0.0037).
These data indicate that v-PBC is a hypercarcinogenic state and constitutes a new subgroup of PBC.
食管静脉曲张（EV）是门静脉高压的一个特征，一直被视为肝脏疾病的晚期并发症。然而，越来越多的证据表明，EV有时会在原发性胆汁性肝硬化（PBC）病程的早期出现。有症状的PBC患者的预后通常比无症状的PBC患者差。然而，以EV为初始症状的PBC患者的临床特征和预后尚未明确。
对54例有症状的PBC患者进行回顾性研究，这些患者最初出现EV且无其他症状（v-PBC）。
v-PBC患者的白细胞和血小板计数低于伴有其他症状的PBC患者（s-PBC）。v-PBC患者和s-PBC患者的肝功能检查、自身抗体和组织学分期无差异。虽然预后无差异，但v-PBC患者肝细胞癌的发生率显著高于s-PBC患者（P = 0.0037）。
这些数据表明，v-PBC是一种高致癌状态，构成了PBC的一个新亚组。
