Prevalence of primary sclerosing cholangitis in patients with ulcerative colitis and the risk of developing malignancies. A large prospective study.
OBJECTIVE
primary sclerosing cholangitis (PSC) is associated with ulcerative colitis (UC) and seems to be a risk factor for colon cancer. However, taking into account that no data are available in South American population, we analyzed the prevalence of PSC in 1,333 patients with UC and the risk for developing colon cancer.


METHODS
patients with persistent increases of alkaline phosphatase were studied by cholangiography and liver biopsy. To assess the risk of colon cancer, each patient with PSC and UC was matched with two control patients with UC without PSC of the same age, gender, extent and duration of UC.


RESULTS
the whole prevalence of PSC was 2.9% (39 patients) reaching 6.2% in extensive colitis. Seven (18%) out of 39 patients with PSC developed colorectal carcinoma compared with 2 out of 78 (2.6%) in the control group (p=0.006). The cumulative risk of colorectal carcinoma was 11% and 18% after 10 and 20 years in the PSC group compared with 2% and 7% in the control group, respectively (p=0.002).


CONCLUSIONS
this is the first prospective study performed in Latin America showing that the prevalence of PSC in patients with UC is similar to that reported in the Anglo-Saxon population. Patients with UC and PSC have a high risk of colorectal cancer.
Liver Unit and Inflammatory Bowel Diseases Section, Hospital de Gastroenterología Dr Carlos Bonorino Udaondo, Buenos Aires, Argentina. fundhig@speedy.com.ar
Rubén
R
Terg
Alicia
A
Sambuelli
Emma
E
Coronel
Juan
J
Mazzuco
Mariano
M
Cartier
Silvia
S
Negreira
Alberto
A
Muñoz
Aníbal
A
Gil
Carlos
C
Miguez
Sergio
S
Huernos
Gustavo
G
Romero
Silvina
S
Goncalvez
Diana
D
Levi
Raquel
R
Abecasis
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood*; D001118:Argentina / Q000453:epidemiology; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000209:etiology*
D014408:Biomarkers, Tumor; D000469:Alkaline Phosphatase