A team from Scandinavia examined the signs and risk factors for developing hepatobiliary carcinoma (HBC) in patients with primary sclerosing cholangitis (PSC).
36 consecutive patients with PSC and HBC (32 with bile duct carcinoma and 4 with hepatocellular carcinoma) were included in the study. All were pair-matched to control patients who were referred for liver transplantation because of PSC, but did not have HBC.
Gender and age at referral were used as matching factors.
The researchers registered clinical and biochemical data.
|Clinical features of bile duct carcinoma:|
- Short PSC duration
- Absence of varices
|Journal of Hepatology|
PSC patients with bile duct carcinoma were found to have a shorter median duration of PSC (1 year) compared with the controls (7 years), and PSC patients with hepatocellular carcinoma (8 years).
There were no statistically significant differences in the liver biochemistry between the patient groups.
The researchers found that varices were more common in patients with PSC and hepatocellular carcinoma (100%) than in controls (56%). They were also more prevalent than in patients with PSC and HBC (12%). There were no varices in the patients with bile duct carcinoma.
Marjut Leidenius, of the Helsinki University Hospital, Finland, concluded on behalf of fellow authors, "Patients with bile duct carcinoma have a relatively short duration of PSC and an absence of varices.
"This suggests that bile duct carcinoma, unlike hepatocellular carcinoma, is not necessarily a late complication of end-stage PSC, as was previously assumed."