INCREASED LIVER IRON STORES IN PATIENTS WITH HEPATOCELLULAR-CARCINOMADEVELOPED ON A NONCIRRHOTIC LIVER

Iron was systematically studied in the nontumorous liver of 24 patient s with hepatocellular carcinoma (HCC) developed on a noncirrhotic live r compared with 4 control groups (cirrhosis with and without HCC, live r metastasis, and normal liver) matched according to age, sex, and pre sence of chronic alcoholism, Assessment of Liver iron was made by (1) histology according to iron distribution and quantification (total iro n score: 0 to 60), and (2) biochemistry (liver iron concentration-N < 36 pmol/g) with calculation of the hepatic iron index (liver iron conc entration/age). Patients with hepatocellular carcinoma developed on a noncirrhotic liver presented with (1) histological iron in 83%; (2) pa renchymal iron excess significantly more frequent (90%) than in contro ls; (3) total iron score (15 +/- 12) and liver iron concentration (81 +/- 96) significantly greater than in controls; and (4) hepatic iron i ndex significantly increased (1.4 +/- 1.5) when compared with control groups, except for the hepatocellular carcinoma complicating cirrhosis group (0.9 +/- 1.1). This study (1) shows a mild but unquestionable p arenchymal iron excess in the nontumorous liver of most patients prese nting with hepatocellular carcinoma developed on a noncirrhotic liver and, at a lesser extent, on cirrhosis, (2) should incite others to stu dy the putative role of iron in the development of liver cancer both i n patients with cirrhosis and those without it, whatever the cause of the underlying liver disease, and (3) add argument to take into accoun t and to treat any liver iron excess, even when mild.