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Differences in hepatocellular carcinoma risk, predictors and trends over time according to etiology of cirrhosis

Ioannou, George N ; Green, Pamela ; Lowy, Elliott ; Mun, Elijah J ; Berry, Kristin Mehta, Anand S.

PloS one, 2018-09, Vol.13 (9), p.e0204412-e0204412 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Differences in hepatocellular carcinoma risk, predictors and trends over time according to etiology of cirrhosis
Autor: Ioannou, George N ; Green, Pamela ; Lowy, Elliott ; Mun, Elijah J ; Berry, Kristin
Mehta, Anand S.
Assuntos: Adult ; Aged ; Alkaline phosphatase ; Biology and life sciences ; Biomarkers - metabolism ; Body mass ; Carcinoma, Hepatocellular - epidemiology ; Care and treatment ; Cirrhosis ; Codes ; Complications and side effects ; Diabetes ; Diabetes mellitus ; Etiology ; Fatty liver ; Female ; Follow-Up Studies ; Gastroenterology ; Health care ; Health services ; Hepatitis ; Hepatitis C ; Hepatocellular carcinoma ; Hepatology ; Hepatoma ; HIV ; Human immunodeficiency virus ; Humans ; Incidence ; Infections ; Liver ; Liver cancer ; Liver cirrhosis ; Liver Cirrhosis - epidemiology ; Liver Cirrhosis - etiology ; Liver Cirrhosis - metabolism ; Liver diseases ; Male ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Minority & ethnic groups ; Patients ; People and Places ; Physical Sciences ; R&D ; Research & development ; Risk analysis ; Risk Factors ; Serum albumin ; Time Factors ; Trends ; Veterans ; Viruses ; Young Adult
É parte de: PloS one, 2018-09, Vol.13 (9), p.e0204412-e0204412
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Current address: Department of Medicine, University of Washington, Seattle, Washington, United States of America
Competing Interests: The authors have declared that no competing interests exist.
Current address: Department of Medicine, Veterans Affairs Puget Sound Healthcare System, Seattle, Washington, United States of America
Descrição: Hepatocellular carcinoma (HCC) risk is high in cirrhosis. We sought to describe differences in HCC risk, predictors and trends over time according to etiology of cirrhosis. We identified 116,404 patients with cirrhosis diagnosed between 2001-2014 in the VA healthcare system and determined incident HCC cases occurring from the date of cirrhosis diagnosis until 01/31/2017. Patients were divided by cirrhosis etiology into hepatitis C virus (HCV, n = 52,671), alcoholic liver disease (ALD, n = 35,730), nonalcoholic fatty liver disease (NAFLD, n = 17,354), or OTHER (n = 10,649). During a mean follow-up of 4.3 years, 10,042 new HCC cases were diagnosed. Patients with HCV had >3 times higher incidence of HCC (3.3 per 100 patient-years) than patients with ALD (0.86/100 patient-years), NAFLD (0.90/100 patient-years) or OTHER (1.0/100 patient-years), an association that persisted after adjusting for baseline characteristics. HCC incidence was 1.6 times higher in patients with cirrhosis diagnosed in 2008-2014 (2.47/100 patient-years) than in 2001-2007 (1.55/100 patient-years). Independent predictors of HCC among all cirrhosis etiologies included: age, male sex, Hispanic ethnicity, high serum alpha fetoprotein, alkaline phosphatase and AST/√ALT ratio and low serum albumin and platelet count. Diabetes was associated with HCC in ALD-cirrhosis and NAFLD-cirrhosis, and BMI in ALD-cirrhosis. HCC risk is 3 times greater in cirrhotic patients with HCV than ALD or NAFLD. HCC risk continues to increase over time in analyses extending to 2017 in cirrhosis of all etiologies. Multiple readily available risk factors for HCC were identified that were influenced by cirrhosis etiology and could be used to develop HCC risk estimation models.
Editor: United States: Public Library of Science
Idioma: Inglês

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Differences in hepatocellular carcinoma risk, predictors and trends over time according to etiology of cirrhosis

Ioannou, George N ; Green, Pamela ; Lowy, Elliott ; Mun, Elijah J ; Berry, Kristin Mehta, Anand S.

United States: Public Library of Science

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