Risk factors for cancer in patients with primary biliary cholangitis and autoimmune hepatitis and primary biliary cholangitis overlap syndrome

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dc.creatorMichelle Harriz Braga
dc.creatorGuilherme Grossi Lopes Cançado
dc.creatorPaulo Lisboa Bittencourt
dc.creatorClaudia Alves Couto
dc.creatorLaura Vilar Guedes
dc.creatorAndré Mourão Costa Lima
dc.creatorMaria Lucia Gomes Ferraz
dc.creatorCristiane Alves Villela-Nogueira
dc.creatorMateus Jorge Nardelli
dc.creatorLuciana Costa Faria
dc.creatorNathalia Mota de Faria Gomes
dc.creatorElze Maria Gomes Oliveira
dc.creatorVivian Rotman
dc.creatorMaria Beatriz Oliveira
dc.creatorSimone Muniz Carvalho Fernandes da Cunha
dc.creatorMarlone Cunha-Silva
dc.creatorLiliana Sampaio Costa Mendes
dc.creatorClaudia Alexandra Pontes Ivantes
dc.creatorLiana Codes
dc.creatorValeria Ferreira de Almeida e Borges
dc.creatorFabio Heleno de Lima Pace
dc.creatorMario Guimaraes Pessoa
dc.creatorIzabelle Venturini Signorelli
dc.creatorGabriela Perdomo Coral
dc.creatorJoão Galizzi-Filho
dc.creatorAline Lopes Chagas
dc.creatorDebora Raquel Benedita Terrabuio
dc.creatorEduardo Luiz Rachid Cancado
dc.date.accessioned2025-02-10T18:11:09Z
dc.date.accessioned2025-09-08T23:54:25Z
dc.date.available2025-02-10T18:11:09Z
dc.date.issued2023-04-23
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.1016/j.aohep.2023.101105
dc.identifier.issn1665-2681
dc.identifier.urihttps://hdl.handle.net/1843/79825
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofAnnals of Hepatology
dc.rightsAcesso Aberto
dc.subjectCarcinoma Hepatocelular
dc.subjectFatores de Risco
dc.subjectCâncer
dc.subjectHepatite
dc.subject.otherExtra-hepatic malignancy
dc.subject.otherHepatocellular carcinoma
dc.subject.otherRisk factor
dc.titleRisk factors for cancer in patients with primary biliary cholangitis and autoimmune hepatitis and primary biliary cholangitis overlap syndrome
dc.typeArtigo de periódico
local.citation.epage06
local.citation.issue4
local.citation.spage01
local.citation.volume28
local.description.resumoIntroduction and objectives: primary biliary cholangitis (PBC) and autoimmune hepatitis (AIH) and PBC overlap syndrome (AIH/PBC) have been associated with a higher risk of hepatocellular carcinoma (HCC) and extra-hepatic malignancy (EHM). This study aims to assess potential risk factors associated with cancer development in PBC and AIH/PBC. Materials and methods: the Brazilian Cholestasis Study Group database was reviewed to compare clinical and laboratory features of PBC patients with HCC and EHM with those without cancer. Results: among the 752 PBC patients enrolled, 64 of them with AIH/PBC, 87 cancers were identified in 72 patients, including 20 cases of HCC and 67 of EHM. Patients with HCC had a higher prevalence of cirrhosis (95% vs. 32.5% of those subjects without cancer, p≤0.001), smoking (55% vs. 12.3%, p≤0.001), CREST syndrome (30% vs 7.6%, p=0.003) and prior azathioprine (30% vs 8%, p= 0.005) and prednisone (35% vs 14%, p= 0.018) use, whereas patients with EHM had a higher prevalence of smoking (42.3% vs 12.4% of those subjects without cancer, p= <0.001), AMA positivity (96.6% vs 80.1%, p≤0.001), azathioprine therapy (21% vs 7.9%, p= 0.01) and concurrent other autoimmune diseases. In multivariate analysis, cirrhosis, obesity and prior azathioprine therapy were independent risk factors for HCC, while Sjogren syndrome and psoriasis were associated with EHM. Fibrates reduced EHM risk.
local.identifier.orcidhttps://orcid.org/0000-0002-5196-1480
local.identifier.orcidhttps://orcid.org/0000-0002-7824-2152
local.identifier.orcidhttps://orcid.org/0000-0002-9776-4757
local.identifier.orcidhttps://orcid.org/0000-0003-3578-9286
local.identifier.orcidhttps://orcid.org/0000-0001-8992-8494
local.identifier.orcidhttps://orcid.org/0000-0003-1355-2368
local.identifier.orcidhttps://orcid.org/0000-0001-7199-9980
local.identifier.orcidhttps://orcid.org/0009-0001-9019-7382
local.identifier.orcidhttps://orcid.org/0000-0002-5232-4600
local.identifier.orcidhttps://orcid.org/0000-0003-0522-396X
local.identifier.orcidhttps://orcid.org/0000-0002-4424-6606
local.identifier.orcidhttps://orcid.org/0000-0003-2447-8845
local.identifier.orcidhttps://orcid.org/0000-0001-5422-557X
local.identifier.orcidhttps://orcid.org/0000-0001-5178-8705
local.identifier.orcidhttps://orcid.org/0000-0001-8663-2700
local.identifier.orcidhttps://orcid.org/0000-0002-0942-7348
local.identifier.orcidhttps://orcid.org/0000-0001-7643-9050
local.identifier.orcidhttps://orcid.org/0000-0003-4072-1761
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE CLÍNICA MÉDICA
local.publisher.initialsUFMG
local.url.externahttps://pdf.sciencedirectassets.com/321204/1-s2.0-S1665268123X00040/1-s2.0-S1665268123002090/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjELn%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJHMEUCIBcAkP5cVXyAgiDNUnbp8D8BZDn00GJIO0j3hkPgVnyhAiEAgzXQ4x8XsMgGxDPrBzeY5wbmkHrftCAyrRonSR%2F27rQquwUIwf%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FARAFGgwwNTkwMDM1NDY4NjUiDJELT%2BiFkrkUJxO2qCqPBSrKGCx%2BASNcW9kCv%2BqgbWIe8Nrgqy3G1AMfOpisIE%2FHrXQOeCeZJsHRRyDowcw%2FV5lNSzxoAMfr055DM9aWP3PSTDiy7RP9m5mKlR9rf4xCIBFMUw0Pl8oATFi%2BguBEwKtQ6MTcZHmmo%2FvqIcj1R3wQbs%2FWLm8B098HfHPKSTnKFO%2B00Nlcq6%2BCYmKRlaDKSo8pwy0J%2BMP5YpfWUrnq%2BeXmZwte2w%2FB8SXcBSOzI%2F4fLAH5y28xhRPyOZzrueynIDqwXu87WSdKbTsXAM%2BJr0LhfN5jZj20baU8XXOCvELTAgC5cwS%2B30k6iMeSUJXClcq7Pgihgftprb%2BDALqIR2SSf1uyp9tfy6WCwwnJWesyb%2FdPsxnsHy5MyQ9g4knd5t2D9O%2FBJPnRUneFZgDm5RNAZTTyzH8kI%2BbDyabbOMDTcGR03zbry3EmQc2wHUD7Dbj%2FkDMaEwVaw2C2Ixb2mk1cs8kj3JpGbjTeJJ1BzcaFVm%2Bu%2FoSrutCP0SsMCfkkAiLGN3AVS2ktZN%2BCme51h41bfNhWEuZ%2B8ObH8Rd5yY%2FOTC8vwXKsZDbrgFD08h7%2F%2FzVrWzqidsmw3Y9UunKnj5Wg1hFG%2BiH3Kidw%2FzB4kjrx4N3O9Y%2F4NT8CLaRVRY3MC3tp6mSQX5BMcajTcbgrI0VJlUQ46XTAvkDkuu1fBz1EM3E0VL7F0ZT3tQbD3CVknkWyk5z9fwSropmIfGgwz%2BIFwWFIScIpav22pOGtdLEN%2BOd5JEyiStUdv7ngpvitNpkKqXXrRRogmsZwp0JNgPTvwuFp0CDy6FDTjdJa%2B9e2qbvz4%2BwDF%2FcpQywNirzeHexL5%2FVnBI2Kj9swUQfX1kmVIwavWUddSSa6mcGcvGQwl%2FHzvAY6sQHHQ6md1okJvwE4my%2FTL08nLWPU2HzfCI1dop%2FANINu4UrRSHJpN3BzpaxUSOFb6MpuS7xFJxAWIFn5c0q6jx5pDpS9Qzyu2EJk7XMTySJYtRiusHOCYJuu8dPwDF%2B88IjrnF%2Bi99nxEd%2Fu8OOIj1rQ%2BHtHpiI%2BFLfVCJ1RsR0T4%2BwqmeXhjZKTy3T2LTBZxax%2Bb2jRJXBP06RotLwokMeJfaON5PK4KeLs%2BriM6%2FFWX4c%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250131T173447Z&X-Amz-SignedHeaders=host&X-Amz-Expires=299&X-Amz-Credential=ASIAQ3PHCVTY6BNGC2OM%2F20250131%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=dc35321384411f6621a1059e68ecacd19fa3ba5aecaf2dc93318bcab2b7d91c9&hash=1f1d8f3e35cc1e19c91b4f966860c75241364d38e7ab622c5b6d3d77cd38c251&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S1665268123002090&tid=spdf-59ef5a55-7719-44e2-a71c-0d777cd7695e&sid=802f9fd2729f79420738a7e0f1e71793d1b3gxrqa&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=041c5c53030559525756&rr=90ab7456db86a17c&cc=br

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