title: Primary liver cancer in genetic hemochromatosis: a clinical, pathological, and pathogenetic study of 54 cases.
abstract: BACKGROUND
  Although liver cancer arises frequently in the course of genetic hemochromatosis (GH), it has not been previously studied in a large series of patients with well-defined GH.
  
  
  METHODS
  The bioclinical and pathological data from 1 cholangiocarcinoma and 53 hepatocellular carcinomas (HCCs) complicating GH in 32 untreated and 22 de-ironed patients are reported.
  
  
  RESULTS
  This study (1) adds three new well-documented cases of HCC in noncirrhotic but only fibrotic hemochromatotic liver, (2) shows the high prevalence (83%) of proliferative and often dysplastic (70%) iron-free foci in the nontumorous liver of untreated patients, and (3) emphasizes the significant increase of cirrhosis (81% vs. 28%) and of associated noniron-related risk factors, mainly chronic alcoholism (48% vs. 25%) and tobacco smoking (50% vs. 18%) in patients with HCC compared with matched hemochromatotic patients without HCC.
  
  
  CONCLUSIONS
  These data (1) suggest that iron-free foci may be markers of an early stage of HCC in GH and (2) supply the basis for defining a cost-effective policy for the screening of HCC in GH patients.
authors.affiliation: Clinique des Maladies du Foie and INSERM U 49, CHRU Pontchaillou, Rennes, France.
authors.forename: Y M
authors.initials: YM
authors.lastname: Deugnier
authors.forename: D
authors.initials: D
authors.lastname: Guyader
authors.forename: L
authors.initials: L
authors.lastname: Crantock
authors.forename: J M
authors.initials: JM
authors.lastname: Lopez
authors.forename: B
authors.initials: B
authors.lastname: Turlin
authors.forename: J
authors.initials: J
authors.lastname: Yaouanq
authors.forename: H
authors.initials: H
authors.lastname: Jouanolle
authors.forename: J P
authors.initials: JP
authors.lastname: Campion
authors.forename: B
authors.initials: B
authors.lastname: Launois
authors.forename: J W
authors.initials: JW
authors.lastname: Halliday
mesh_terms: D005260:Female; D006432:Hemochromatosis / Q000097:blood / Q000150:complications / Q000235:genetics*; D006801:Humans; D007501:Iron / Q000097:blood; D008113:Liver Neoplasms / Q000150:complications* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D007501:Iron