TY - JOUR
T1 - Hepatic and extrahepatic malignancies in autoimmune hepatitis. A long-term follow-up in 473 Swedish patients
AU - Werner, Marten
AU - Almer, Sven
AU - Prytz, Hanne
AU - Lindgren, Stefan
AU - Wallerstedt, Sven
AU - Bjoersson, Einar
AU - Bergquist, Annika
AU - Sandberg-Gertzen, Hanna
AU - Hultcrantz, Rolf
AU - Sangfelt, Per
AU - Weiland, Ola
AU - Danielsson, Ake
PY - 2009
Y1 - 2009
N2 - Background/Aims: Autoimmune Hepatitis (AIH) is a liver disease which may lead to liver cirrhosis. Cirrhosis is a well-known risk factor for hepatocellular cancer. Lymphoma is a disease, where immune modulating drugs as well as the autoimmune disease itself may contribute to the elevated risk. The aim was to investigate the risks of malignancies in a large cohort of AIH patients. Methods: Four hundred and seventy-three patients with AIH were matched to the Swedish national cancer register as well as to the death cause register. Results: We found an overall higher risk of malignancies in the cohort of A I H patients from the date of diagnosis with a SIR of 1.51 (95% CI 1.10-2.03). SIR in the subpopulation of well defined catchment areas and complete case finding was 23.28 (95% CI 7.5-54.34) for HCC. Lymphomas were found a SIR of 13.09 (95% CI 4.22-30.56). Conclusions: There was an overall increased risk of malignancies in a cohort of AIH patients, which manly was caused by hepatobiliary cancers. However, the true risk of HCC in an AIH cirrhotic cohort has yet to be investigated. A significantly higher risk of lymphomas was also found, but no clear cut association to the use of immune modulators. (C) 2008 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
AB - Background/Aims: Autoimmune Hepatitis (AIH) is a liver disease which may lead to liver cirrhosis. Cirrhosis is a well-known risk factor for hepatocellular cancer. Lymphoma is a disease, where immune modulating drugs as well as the autoimmune disease itself may contribute to the elevated risk. The aim was to investigate the risks of malignancies in a large cohort of AIH patients. Methods: Four hundred and seventy-three patients with AIH were matched to the Swedish national cancer register as well as to the death cause register. Results: We found an overall higher risk of malignancies in the cohort of A I H patients from the date of diagnosis with a SIR of 1.51 (95% CI 1.10-2.03). SIR in the subpopulation of well defined catchment areas and complete case finding was 23.28 (95% CI 7.5-54.34) for HCC. Lymphomas were found a SIR of 13.09 (95% CI 4.22-30.56). Conclusions: There was an overall increased risk of malignancies in a cohort of AIH patients, which manly was caused by hepatobiliary cancers. However, the true risk of HCC in an AIH cirrhotic cohort has yet to be investigated. A significantly higher risk of lymphomas was also found, but no clear cut association to the use of immune modulators. (C) 2008 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
KW - Malignancies
KW - Lymphoma
KW - Autoimmune hepatitis
KW - Hepatocellular carcinoma
U2 - 10.1016/j.jhep.2008.08.022
DO - 10.1016/j.jhep.2008.08.022
M3 - Article
SN - 0168-8278
VL - 50
SP - 388
EP - 393
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 2
ER -
