title: Liver iron excess in patients with hepatocellular carcinoma developed on viral C cirrhosis.
abstract: BACKGROUND
  Liver iron deposits are frequent in viral C cirrhotic patients but their role is not well defined.
  
  
  OBJECTIVE
  To investigate the effect of liver iron excess on the prevalence of hepatocellular carcinoma (HCC) in patients with viral C cirrhosis.
  
  
  METHODS
  Hepatic iron was evaluated retrospectively using a semiquantitative method in liver biopsies of 104 viral C cirrhotic patients, 48 with HCC and 56 controls (HCC free). Corrected total iron score (0-60) was defined by the sum of three scores: hepatocytic iron score (0-36), sinusoidal iron score (0-12), and portal iron score (0-12), multiplied by 3/3, 2/3, or 1/3 according to the heterogeneous iron localisation in the nodules.
  
  
  RESULTS
  After adjustment for known risk factors for HCC, regression analysis showed that iron deposits (corrected total iron score >0) were more frequent in HCC patients than in controls (odds ratio 4.94; 95% confidence interval 1.59-15. 32; p=0.0056). The median of corrected total iron score was significantly higher in HCC patients than in controls (odds ratio 1. 092; 95% confidence interval 1.01-1.13; p=0.021). This liver iron overload was sinusoidal (odds ratio 5.2; 95% confidence interval 1. 82-15.11; p=0.0022).
  
  
  CONCLUSIONS
  Liver iron deposition was more frequent and more important in viral C cirrhotic patients with HCC than in HCC free controls. Liver iron overload seems to contribute to the development of HCC in patients with viral C cirrhosis.
authors.affiliation: Service de Médecine Interne E, Hôpital St Eloi, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Chapoutot
authors.forename: M
authors.initials: M
authors.lastname: Esslimani
authors.forename: Z
authors.initials: Z
authors.lastname: Joomaye
authors.forename: J
authors.initials: J
authors.lastname: Ramos
authors.forename: P
authors.initials: P
authors.lastname: Perney
authors.forename: C
authors.initials: C
authors.lastname: Laurent
authors.forename: P
authors.initials: P
authors.lastname: Fabbro-Peray
authors.forename: D
authors.initials: D
authors.lastname: Larrey
authors.forename: J
authors.initials: J
authors.lastname: Domergue
authors.forename: F
authors.initials: F
authors.lastname: Blanc
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000378:metabolism; D006801:Humans; D019190:Iron Overload / Q000150:complications* / Q000378:metabolism; D008103:Liver Cirrhosis / Q000378:metabolism / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis