These authors contributed equally to this work.
Autoimmune, Cholestatic and Biliary Disease
Article first published online: 22 APR 2013
Copyright © 2012 American Association for the Study of Liver Diseases
Volume 57, Issue 5, pages 1942–1949, May 2013
How to Cite
Harada, K., Hirohara, J., Ueno, Y., Nakano, T., Kakuda, Y., Tsubouchi, H., Ichida, T. and Nakanuma, Y. (2013), Incidence of and risk factors for hepatocellular carcinoma in primary biliary cirrhosis: National data from Japan. Hepatology, 57: 1942–1949. doi: 10.1002/hep.26176
Potential conflict of interest: Nothing to report.
- Issue published online: 22 APR 2013
- Article first published online: 22 APR 2013
- Accepted manuscript online: 29 NOV 2012 01:33PM EST
- Manuscript Accepted: 8 NOV 2012
- Manuscript Received: 12 JUN 2012
Primary biliary cirrhosis (PBC) primarily affects females and is rarely complicated by hepatocellular carcinoma (HCC). Although the HCC incidence in PBC patients is low, several characteristics and risk factors associated with its development have been reported. In this study, national data concerning the current status of carcinogenesis in PBC patients in Japan are reviewed. Using data from two national questionnaire surveys, we investigated the clinicopathological findings associated with HCC in PBC patients. According to the data of all reviewed PBC patients, the HCC incidence was 2.4% (71/2946). The HCC incidence by gender was 5.1% (19/370) in males and 2.0% (52/2576) in females, and the proportion of males was 26.7%. Prognosis was significantly poorer in the PBC patients with HCC than in those without. Multivariate analysis of risk factors associated with HCC by gender revealed histological stage at the time of PBC diagnosis as an independent risk factor associated with the development of HCC in females, but not in males. Furthermore, data from another national survey of 178 PBC patients with HCC (male/female = 49/129; proportion of males 27.5%) revealed that the duration between the diagnosis of PBC and that of HCC was significantly shorter in males than in females. In addition, histological stage at the time of HCC diagnosis was an independent risk factor for HCC in females, whereas no risk factors were identified in males. Conclusion: these data indicate that males are at risk of developing HCC at any histological stage of PBC. Therefore, male PBC patients in particular should be carefully screened for HCC from the early stages of PBC. (HEPATOLOGY 2013)