Liver iron excess in patients with hepatocellular carcinoma developed on non-alcoholic steato-hepatitis.
OBJECTIVE
Liver iron deposits are frequent in patients with non-alcoholic steato-hepatitis (NAFLD), but their role is not well defined. To investigate the effect of liver iron excess on the prevalence of hepatocellular carcinoma (HCC) in patients with NASH-related cirrhosis.


METHODS
Hepatic iron was measured retrospectively with a semiquantitative method in liver biopsies of 153 patients with NASH-related cirrhosis: 51 with HCC and 102 controls without HCC, matched for age, sex and stage of liver disease. The corrected total iron score (0-60) was the sum of three scores: the 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 depending on the localisation of the iron in the nodules.


RESULTS
Conditional logistic regression analysis showed that iron deposits (corrected total iron score>0) were more frequent in HCC patients than in controls. The median corrected total iron score was significantly higher in HCC patients than in controls. The liver iron overload was sinusoidal.


CONCLUSIONS
Iron deposition in the liver was more frequent in patients with NASH-related cirrhosis with HCC than in HCC-free controls. Liver iron overload may be associated with development of HCC in patients with NASH-related cirrhosis.
Sorrentino
Paolo
P
Liver Unit, Clinical and Experimental Hepatology, Department of Internal Medicine, S.G. Moscati Hospital, Avellino, Italy. paolosorrmed@tin.it
D'Angelo
Salvatore
S
Ferbo
Umberto
U
Micheli
Pietro
P
Bracigliano
Alessandra
A
Vecchione
Raffaela
R
D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000378:metabolism*; D005234:Fatty Liver / Q000150:complications* / Q000378:metabolism; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008099:Liver / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000150:complications / Q000378:metabolism; D008113:Liver Neoplasms / Q000209:etiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
D007501:Iron