Liver iron excess in patients with hepatocellular carcinoma developed on viral C cirrhosis.
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.
Chapoutot
C
C
Service de Médecine Interne E, Hôpital St Eloi, Montpellier, France.
Esslimani
M
M
Joomaye
Z
Z
Ramos
J
J
Perney
P
P
Laurent
C
C
Fabbro-Peray
P
P
Larrey
D
D
Domergue
J
J
Blanc
F
F
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