Hepatocellular carcinoma in primary biliary cirrhosis: Similar incidence to that in hepatitis C virus-related cirrhosis

OBJECTIVES: The prevalence of hepatocellular carcinoma (HCC) in primary bil iary cirrhosis (PBC) is not well established, as some reports suggest a low risk, whereas others indicate that HCC may be no less frequent than in oth er types of cirrhosis. METHODS: We compared the incidence of HCC in a series of 140 patients with PBC (five men, 135 women, mean age 54 +/- 1.6 yr) followed-up for a mean of period of 5.6 +/- 0.4 yr with a group of patients with cirrhosis related t o hepatitis C virus (HCV) who were matched for age, sex, and follow-up peri od. In all patients, HCC was prospectively screened by clinical, laboratory , and ultrasound procedures. RESULTS: Five patients with PBC (3.6%) developed HCC. All were in stage IV of the disease. The incidence of HCC in the 45 patients with late stages of the disease (III or IV) was 11.1%, similar to that found in patients with HCV related cirrhosis. which was 15.0%. The relative risk for HCC in late s tages of PBC was of 0.812 (95% CI, 0.229-2.883) with respect to HCV-related cirrhosis. The probability for developing HCC was significantly higher in patients with HCV-related cirrhosis than in PBC patients overall (p = 0.001 ), hut was similar in patients with HCV-related cirrhosis and in patients w ith PBC in stages III and IV (p = ns). CONCLUSION: The risk for HCC in patients with late stages of PBC is similar to that in patients with HCV-related cirrhosis. (Am J Gastroenterol 2001:9 6: 1160-1163. (C) 2001 by Am. Coll. of Gastroenterology).