Cancer Med. 2019 Feb 21. doi: 10.1002/cam4.1998. [Epub ahead of print]
Real impact of liver cirrhosis on the development of hepatocellular carcinoma in various liver diseases-meta-analytic assessment.
Tarao K1, Nozaki A2, Ikeda T3, Sato A4, Komatsu H5, Komatsu T6, Taguri M7, Tanaka K8.
Author information
1
Tarao's Gastroenterological Clinic, Yokohama, Japan.
2
Gastroenterological Center, Medical Center, Yokohama City University, Yokohama, Japan.
3
Gastroenterology Department, Yokosuka General Hospital Uwamachi, Yokosuka, Japan.
4
Division of Gastroenterology, Department of Internal Medicine, St. Marianna University, Yokohama City Seibu Hospital, Yokohama, Japan.
5
Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
6
Department Clinical Research, National Hospital Organization, Yokohama Medical Center, Yokohama, Japan.
7
Department of Data Science, Yokohama City University, Yokohama, Japan.
8
Hatano Red Cross Hospital, Kanagawa, Japan.
Abstract
BACKGROUND:
It is well known that the incidence of developing hepatocelluler carcinoma (HCC) is increased in liver cirrhosis of different etiologies. However, comparison of HCC incidence in various liver diseases has not yet been estimated. We surveyed this comparison.
METHODS:
The PubMed database was examined (1989-2017) for studies published in English language regarding the prospective follow-up results for the development of HCC in various liver diseases. A meta-analysis was performed for each liver disease.
RESULTS:
The annual incidence (%) of HCC in the non-cirrhotic stage and cirrhotic stage, and the ratio of HCC incidence in the cirrhotic stage/non-cirrhotic stage were as follows. (a) hepatitis B virus liver disease: 0.37%→3.23% (8.73-fold), (b) hepatitis C virus liver diseases: 0.68%→4.81% (7.07-fold), (c) primary biliary cholangitis (0.26%→1.79%, 6.88-fold), (d) autoimmune hepatitis (0.19%→0.53%, 2.79-fold), and (e) NASH (0.03%→1.35%, 45.00-fold). Regarding primary hemochromatosis and alcoholic liver diseases, only follow-up studies in the cirrhotic stage were presented, 1.20% and 2.06%, respectively.
CONCLUSIONS:
When the liver diseases advance to cirrhosis, the incidence of HCC is markedly increased. The development of HCC must be closely monitored by ultrasonography, magnetic resonance imaging, and computed tomography, irrespective of the different kinds of liver diseases.