Characterization and clinical course of hepatobiliary carcinoma in patients with primary sclerosing cholangitis.

Abstract:

OBJECTIVE:Primary sclerosing cholangitis (PSC) confers a high risk of development of hepatobiliary carcinoma (HBC). The aim of the study was to identify indicators and risk factors for developing HBC in PSC patients. MATERIAL AND METHODS:Thirty-nine PSC patients with HBC at time of HBC diagnosis were compared with 101 PSC patients without HBC at time of acceptance for liver transplantation. RESULTS:Eighteen of these patients (46.2%) developed HBC within one year after diagnosis of PSC. In PSC patients with HBC male gender, nicotine abuse, long duration of inflammatory bowl disease (IBD), clinical symptoms, elevation of CA 19-9, as well as dominant bile duct stenosis were significantly more frequent (p<0.05) compared with the PSC control group. A cross-validated sensitivity and specificity of 85% and 97%, respectively, for the detection of HBC was obtained using the following parameters: weight loss, elevation of CA 19-9 >or= 200 kU/l, and dominant bile duct stenosis. CONCLUSIONS:HBC is not necessarily a late complication of end-stage PSC. A long history of IBD, male gender, and nicotine abuse are risk factors for the development of HBC. In particular, CA 19-9, body-weight and dominant bile duct stenosis are valuable indicators in detecting HBC in PSC patients.

journal_name

Scand J Gastroenterol

authors

Tischendorf JJ,Meier PN,Strassburg CP,Klempnauer J,Hecker H,Manns MP,Krüger M

doi

10.1080/00365520600633495

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

1227-34

issue

10

eissn

0036-5521

issn

1502-7708

pii

U2U2X5407732L774

journal_volume

41

pub_type

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