O-43 RISK FACTORS FOR CANCER DEVELOPMENT IN PATIENTS WITH PRIMARY BILIARY CHOLANGITIS

ISSN: 1665-2681

Annals of Hepatology (AoH) is an international, open access journal published bi-monthly with funds from the Fundación Clínica Médica Sur. It is the official journal of the Mexican Association of Hepatology (AMH), the Latin American Association for the Study of the Liver (ALEH), the Canadian Association for the Study of the Liver (CASL) and the Czech Society of Hepatology (CSH). AoH publishes editorials, opinions, concise reviews, original articles, brief reports, letters to the editor, news from affiliated associations, clinical practice guidelines and summaries of congresses in the field of Hepatology.

Topics covered by AoH include alcoholic liver disease, autoimmune hepatitis, biliary diseases, drug-induced liver injury, genetic liver diseases, NAFLD/NASH and viral hepatitis (HAV, HBV, HCV, HDV, HEV). Our journal seeks to publish articles on basic clinical care and translational research focused on preventing rather than treating the complications of end-stage liver disease.

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Michelle Harriz Braga1, Guilherme Grossi Lopes Cançado2,3, Paulo Lisboa Bittencourt4,5, Cláudia Alves Couto2, Laura Vilar Guedes1, André Mourão Costa Lima2, Maria Lucia Gomes Ferraz6, Cristiane Alves Villela-Nogueira7, Jorge Nardelli Mateus2, Luciana Costa Faria2, Nathalia Mota De Faria Gomes6, Maria Gomes Oliveira Elze8, Vivian Rotman7, Maria Beatriz Oliveira9, Simone Muniz Carvalho Fernandes Cunha10, Marlone Cunha-Silva11, Liliana Sampaio Costa Mendes12, Claudia Alexandra Pontes Ivantes13, Liana Codes5, Valéria Ferreira De Almeida Borges14,15..., Fabio Heleno De Lima Pace16, Mario Guimarães Pessoa1, Izabelle Venturini Signorelli17, Gabriela Perdomo Coral18, João Galizzi Filho2, Aline Lopes Chagas1, Debora Raquel Benedita Terrabuio1, Eduardo Luiz Rachid Cançado1Ver más

1 Gastroenterology Department, Medical Faculty of São Paulo University, São Paulo, Brazil

2 Gastroenterology Alfa Institute, Clinic Hospital of Federal University of Minas Gerais, Belo Horizonte, Brazil

3 Military Police Hospital of Minas Gerais, Belo Horizonte, Brazil

4 Bahian School of Medicine and Public Health, Salvador, Brazil

5 Portuguese Hospital, Salvador, Brazil

6 Discipline of Gastroenterology, Federal University of São Paulo, São Paulo, Brazil

7 Clementino Fraga Filho Univesitary Hospital and, e Department of Internal Medicine, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

8 Lusíada Universitary Center- Unilus, Santos, Brazil

9 Municipal Viral Hepatitis Outpatient Clinic of São José Dos Campos, São José Dos Campos, Brazil

10 Professor Edgard Santos Universitary Hospital, Federal University of Bahia, Salvador, Brazil

11 Gastroenterology Division (Gastrocentro), Faculty Of Medical Sciences, State University of Campinas, Campinas, Brazil

12 Base Hospital of the Federal District, Brasília, Brazil

13 Gastroenterology, Hepatology and Liver Transplantation Service, Nossa Senhora das Graças Hospital, Curitiba, Brazil

14 Institute of Gastroenterology, Endoscopy and Proctology, Uberlândia, Brazil

15 Federal University of Uberlândia, Uberlândia, Brazil

16 Gastroenterology and Hepatology Service, FederalUniversity of Juiz de Fora, Juiz de Fora, Brazil

17 Universitary Hospital; São Paulo, Brazil

18 Brotherhood of Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil

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Special issue

This article is part of special issue:

Vol. 28. Issue S1

Abstracts of the 2022 Annual Meeting of the ALEH

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Introduction 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 aimed to assess potential risk factors associated with cancer development in PBC and AIH/PBC patients.

Materials and Methods

The Brazilian Cholestasis Study Group database was reviewed and analyzed.

Results

Among the 752 PBC patients enrolled, 64 of them with AIH/PBC, and 87 cancers were identified in 79 patients, including 20 cases of HCC and 67 of EHM. Patients with HCC had a higher prevalence of cirrhosis (95% vs. 32.5%, 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) previous use, compared with their counterparts. Patients with EHM had a higher prevalence of smoking (42.3% vs. 12.3%, p= <0.001), AMA positivity (96.6% vs 80.6%, p = <0.001), azathioprine use (21% vs 8%, 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.

Conclusions

The prevalence of EHM is higher when compared to HCC in PBC patients. Cirrhosis, obesity, prior azathioprine use, and concurrent autoimmune diseases were significantly associated with cancer in PBC, while fibrate use was apparently protective against EHM.

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