Incidence of Hepatocellular Carcinoma in Primary Biliary Cholangitis: A Systematic Review and Meta-Analysis
- PDF / 4,512,346 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 13 Downloads / 230 Views
ORIGINAL ARTICLE
Incidence of Hepatocellular Carcinoma in Primary Biliary Cholangitis: A Systematic Review and Meta‑Analysis Yamini Natarajan1 · Aylin Tansel1 · Parth Patel1 · Kingsley Emologu1 · Richa Shukla1 · Zeeshan Qureshi1 · Hashem B. El‑Serag1,2,3,4 · Aaron P. Thrift1,4 · Fasiha Kanwal1,2,3,4 Received: 3 May 2019 / Accepted: 18 July 2020 © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
Abstract Background The risk and determinants of HCC in patients with primary biliary cholangitis (PBC) are unclear. We conducted a systematic review and meta-analysis of the incidence of HCC and risk factors associated with HCC risk among patients with PBC. Methods We searched PubMed, EMBASE, MEDLINE, Cochrane databases and reference lists from relevant articles to identify cohort studies that examined incidence of HCC in patients with PBC from inception through November 2019. Results A total of 29 studies including 22,615 patients met the eligibility criteria. The median cohort size was 292 patients followed for an average of 76 months. The pooled incidence rate for patients with PBC was 4.17 per 1000 patient-years (95% CI 3.17–5.47). On subgroup analysis, the incidence of HCC in patients with PBC cirrhosis was 15.7 per 1000 patient-years (95% CI 8.73–28.24). The HCC incidence rate was 9.82 per 1000 person-years (95% CI 5.92–16.28) in men and 3.82 per 1000 person-years (95% CI 2.85–5.11) in women. Conclusions Cirrhosis is the strongest risk factor for HCC in patients with PBC. Male gender was also a risk factor. Our meta-analysis supports current recommendations of HCC surveillance in patients with PBC cirrhosis. Further studies are needed to evaluate risk factors in this population. Keywords Epidemiology · Hepatology · Hepatocellular carcinoma · Primary biliary cirrhosis · Risk factor · Natural history · Mortality · Systematic review
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-020-06498-7) contains supplementary material, which is available to authorized users. * Yamini Natarajan [email protected] 1
Section of Gastroenterology and Hepatology and Clinical Epidemiology and Comparative Effectiveness Program in the Health Services Research, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, 2002 Holcombe Blvd (MS152), Houston, TX 77030, USA
2
Clinical Epidemiology and Comparative Effectiveness Program, Section of Health Services Research (IQuESt), Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA
3
Texas Medical Center Digestive Disease Center, Houston, TX, USA
4
Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine, Houston, TX, USA
Abbreviations PBC Primary biliary cirrhosis HCC Hepatocellular carcinoma CI Confidence interval OR ODDS ratio HR Hazard ratio PH Proportional hazards
Introduction Primary biliary cholangitis (PBC) is a chronic autoimmune disease that can result in cirrhosis and portal h
Data Loading...
