Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
Dig Liver Dis. 2022 Sep;54(9):1215-1221. doi: 10.1016/j.dld.2022.03.002. Epub 2022 Mar 27.
Comprehensive and contemporary data pertaining large populations of patients with Primary Biliary Cholangitis (PBC) and hepatocellular carcinoma (HCC) are missing.
To describe main characteristics and outcome of PBC patients with HCC diagnosed in the new millennium.
Analysing the Italian Liver Cancer registry we identified 80 PBC patients with HCC diagnosed after the year 2000, and described their clinical characteristics, access to treatment and survival.
Median age of patients was 71 years and 50.0% were males. Cirrhosis was present in 86.3% of patients, being well-compensated in 58.0%. Median HCC diameter was smaller in patients under surveillance (2.6 vs 4.0 cm, P = 0.007). Curative treatment, feasible in 50.0% of patients, was associated with improved survival compared to palliative and supportive care (42 vs 33 vs 6 months, P<0.0001). Surveillance was associated with a non-significant improved survival (36 vs 23 months), likely due to similar rate of curative treatment in patients under (51.4%) and outside surveillance (42.6%).
PBC patients with HCC are often elderly males with well-preserved liver function. Feasibility of curative treatment is high and associated with improved prognosis. Description of these patients may help focus surveillance to identify earlier tumours, increase their curability, and improve prognosis.
目前缺乏原发性胆汁性胆管炎（PBC）和肝细胞癌（HCC）大患者人群的综合和现代数据。
描述新千年诊断的 PBC 合并 HCC 患者的主要特征和结局。
我们分析了意大利肝癌登记处的数据，确定了 80 例 2000 年后诊断为 PBC 合并 HCC 的患者，并描述了他们的临床特征、治疗途径和生存情况。
患者的中位年龄为 71 岁，50.0%为男性。86.3%的患者存在肝硬化，其中 58.0%为代偿期。接受监测的患者 HCC 直径中位数较小（2.6 对 4.0cm，P=0.007）。可行治愈性治疗的患者（50.0%）与姑息和支持性治疗相比，生存时间更长（42 对 33 对 6 个月，P<0.0001）。监测与非显著改善的生存相关（36 对 23 个月），这可能是由于监测患者（51.4%）和未监测患者（42.6%）中可行治愈性治疗的比例相似所致。
PBC 合并 HCC 的患者通常为肝功能良好的老年男性。可行治愈性治疗的可能性较高，且与预后改善相关。对这些患者的描述有助于集中监测以识别更早的肿瘤，提高其可治愈性，并改善预后。
