Abstract
Background
Esophageal varices (EV), one feature of portal hypertension, have been regarded as a late complication of liver diseases. However, accumulating evidence indicates that EV sometimes develop early during the course of primary biliary cirrhosis (PBC). The prognosis is usually poorer for patients with symptomatic PBC than for those with asymptomatic PBC. Nevertheless, the clinical features and prognosis of patients with PBC whose initial symptoms are EV have not been clarified.
Methods
The clinical features and the prognosis of patients who initially developed EV without other symptoms (v-PBC) were retrospectively investigated in 54 patients with symptomatic PBC.
Results
The leukocyte and platelet counts were lower in patients with v-PBC than in those with PBC accompanied by other symptoms (s-PBC). Liver function tests, autoantibodies, and histological stage did not differ between patients with v-PBC and those with s-PBC. Although the prognosis did not differ, the incidence of hepatocellular carcinoma was significantly higher in v-PBC than in s-PBC (P = 0.0037).
Conclusions
These data indicate that v-PBC is a hypercarcinogenic state and constitutes a new subgroup of PBC.
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References
MM Kaplan ME Gershwin (2005) ArticleTitlePrimary biliary cirrhosis N Engl J Med 353 1261–73 Occurrence Handle16177252 Occurrence Handle10.1056/NEJMra043898 Occurrence Handle1:CAS:528:DC%2BD2MXhtVeltLbI
P Scheuer (1967) ArticleTitlePrimary biliary cirrhosis Proc R Soc Med 60 1257–60 Occurrence Handle6066569 Occurrence Handle1:STN:280:DyaF1c%2FptVOguw%3D%3D
MI Prince A Chetwynd WL Craig JV Metcalf OF James (2004) ArticleTitleAsymptomatic primary biliary cirrhosis: clinical features, prognosis, and symptom progression in a large population based cohort Gut 53 865–70 Occurrence Handle15138215 Occurrence Handle10.1136/gut.2003.023937 Occurrence Handle1:STN:280:DC%2BD2c3jvFyjug%3D%3D
E Takesita T Kumagi H Matsui M Abe S Furukawa Y Ikeda et al. (2003) ArticleTitleEsophagogastric varices as a prognostic factor for the determination of clinical stage in patients with primary biliary cirrhosis J Gastroenterol 38 1060–5 Occurrence Handle10.1007/s00535-003-1196-6
BM Goudie AD Burt GJ Macfarlane P Boyle CR Gillis RN MacSween et al. (1989) ArticleTitleRisk factors and prognosis in primary biliary cirrhosis Am J Gastroenterol 84 713–6 Occurrence Handle2741881 Occurrence Handle1:STN:280:DyaL1MzgtVKktA%3D%3D
A Rydning E Schrumpf M Abdelnoor K Elgjo E Jenssen (1990) ArticleTitleFactors of prognostic importance in primary biliary cirrhosis Scand J Gastroenterol 25 119–26 Occurrence Handle2305209 Occurrence Handle1:STN:280:DyaK3c7mtFyrsg%3D%3D
E Takeshita H Matsui N Shibata S Furukawa T Yokota H Murakami et al. (2004) ArticleTitleEarlier recurrence of esophageal varices, following therapy, in patients with primary biliary cirrhosis (PBC) compared with non-PBC patients J Gastroenterol 39 1085–9 Occurrence Handle15580402 Occurrence Handle10.1007/s00535-004-1447-1
MC Kew RR Varma HA Dos Santos PJ Scheuer S Scherlock (1971) ArticleTitlePortal hypertension in primary biliary cirrhosis Gut 12 830–4 Occurrence Handle5123264 Occurrence Handle1:STN:280:DyaE38%2FltVehsg%3D%3D
GJ Gores RH Wiesner ER Dickson AR Zinsmeister RA Jorgensen A Langworthy (1989) ArticleTitleProspective evaluation of esophageal varices in primary biliary cirrhosis: development, natural history, and influence on survival Gastroenterology 96 1552–9 Occurrence Handle2785470 Occurrence Handle1:STN:280:DyaL1M3jt1Gktg%3D%3D
R Zeegen AG Stansfeld AM Dawson AH Hunt (1969) ArticleTitleBleeding oesophageal varices as the presenting feature in primary biliary cirrhosis Lancet 2 9–13 Occurrence Handle4182832 Occurrence Handle10.1016/S0140-6736(69)92595-1 Occurrence Handle1:STN:280:DyaF1M3hvVKquw%3D%3D
M Navasa A Pares M Bruguera J Caballeria J Bosch J Rodes (1987) ArticleTitlePortal hypertension in primary biliary cirrhosis. Relationship with histological features J Hepatol 5 292–8 Occurrence Handle3429837 Occurrence Handle10.1016/S0168-8278(87)80035-1 Occurrence Handle1:STN:280:DyaL1c7hs1GqtA%3D%3D
AH Baggenstoss WT Foulk HR Butt RC Burn (1964) ArticleTitleThe pathology of primary biliary cirrhosis with emphasis on histogenesis Am J Clin Pathol 42 259–76 Occurrence Handle14212760 Occurrence Handle1:STN:280:DyaF2M%2FhslWmsA%3D%3D
Y Nakanuma G Ohta (1987) ArticleTitleNodular hyperplasia of the liver in primary of early histological stages Am J Gastroenterol 82 8–10 Occurrence Handle3799585 Occurrence Handle1:STN:280:DyaL2s%2FpslWqtA%3D%3D
S Sherock (1982) ArticleTitleNoncirrhotic extrahepatic and intrahepatic portal hypertension Semin Liver Dis 2 202–10 Occurrence Handle10.1055/s-2008-1040708
DE Jones JV Metcalf JD Collier MF Bassendine OF James (1997) ArticleTitleHepatocellular carcinoma in primary biliary cirrhosis and its impact on outcomes Hepatology 26 1138–42 Occurrence Handle9362353 Occurrence Handle10.1002/hep.510260508 Occurrence Handle1:STN:280:DyaK1c%2Fis1KktA%3D%3D
A Shibuya K Tanaka H Miyakawa M Shibata M Takatori K Sekiyama et al. (2002) ArticleTitleHepatocellular carcinoma and survival in patients with primary biliary cirrhosis Hepatology 35 1172–8 Occurrence Handle11981767 Occurrence Handle10.1053/jhep.2002.33157
PK Nijhawan TM Therneau ER Dickson J Boynton KD Lindor (1999) ArticleTitleIncidence of cancer in primary biliary cirrhosis: the Mayo experience Hepatology 29 1396–8 Occurrence Handle10216121 Occurrence Handle10.1002/hep.510290511 Occurrence Handle1:STN:280:DyaK1M3jsVWiug%3D%3D
L Caballeria A Pares A Castells A Gines C Bru J Rodes (2001) ArticleTitleHepatocellular carcinoma in primary biliary cirrhosis: similar incidence to that in hepatitis C virus-related cirrhosis Am J Gastroenterol 96 1160–3 Occurrence Handle11316164 Occurrence Handle1:STN:280:DC%2BD3MzntVWntQ%3D%3D
A Floreani A Baragiotta V Baldo T Menegon F Farinati R Naccarato (1999) ArticleTitleHepatic and extrahepatic malignancies in primary biliary cirrhosis Hepatology 29 1425–8 Occurrence Handle10216125 Occurrence Handle10.1002/hep.510290501 Occurrence Handle1:STN:280:DyaK1M3jsVWhsA%3D%3D
Y Nakanuma T Terada K Doishita A Miwa (1990) ArticleTitleHepatocellular carcinoma in primary biliary cirrhosis: an autopsy study Hepatology 11 1010–6 Occurrence Handle1694811 Occurrence Handle1:STN:280:DyaK3czgs1yrug%3D%3D
J Rudi R Waldherr R Raedsch B Kommerell (1995) ArticleTitleHepatocyte proliferation in primary biliary cirrhosis as assessed by proliferating cell nuclear antigen and Ki-67 antigen labelling J Hepatol 22 43–9 Occurrence Handle7751586 Occurrence Handle10.1016/0168-8278(95)80258-4 Occurrence Handle1:STN:280:DyaK2M3ntV2hsw%3D%3D
K Tarao A Shimizu S Ohkawa M Harada Y Ito S Tamai et al. (1991) ArticleTitleIncreased uptake of bromodeoxyuridine by hepatocytes from early stage of primary biliary cirrhosis Gastroenterology 100 725–30 Occurrence Handle1993493 Occurrence Handle1:STN:280:DyaK3M7jtVOltA%3D%3D
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Murata, Y., Abe, M., Furukawa, S. et al. Clinical features of symptomatic primary biliary cirrhosis initially complicated with esophageal varices. J Gastroenterol 41, 1220–1226 (2006). https://doi.org/10.1007/s00535-006-1914-y
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DOI: https://doi.org/10.1007/s00535-006-1914-y