Liver iron excess in patients with hepatocellular carcinoma developed on non-alcoholic steato-hepatitis

• Published in: Journal of hepatology Vol. 50; no. 2; pp. 351 - 357
• Main Authors: Sorrentino, Paolo, D’Angelo, Salvatore, Ferbo, Umberto, Micheli, Pietro, Bracigliano, Alessandra, Vecchione, Raffaela
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 01-02-2009; Elsevier
• Subjects: Biological and medical sciences; Carcinoma, Hepatocellular - etiology; Carcinoma, Hepatocellular - metabolism; Diabetes-mellitus; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fatty Liver - complications; Fatty Liver - metabolism; Female; Ferritin; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; HCC; Hepatocellular carcinoma; Humans; Iron; Iron - metabolism; Liver; Liver - metabolism; Liver Cirrhosis - complications; Liver Cirrhosis - metabolism; Liver Neoplasms - etiology; Liver Neoplasms - metabolism; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; NASH; Other diseases. Semiology; Tumors; NAFLD; non-alcoholic fatty liver disease; sinusoidal iron score; Liver; Ferritin; HCC; Iron; NASH; non-alcoholic steato-hepatitis; corrected total iron score; HIS; cTIS; portal iron score; hepatitis C virus; total iron score; Diabetes-mellitus; HCV; PIS; SIS; hepatocytic iron score; hepatocellular carcinoma; TIS; Hepatocellular carcinoma; Endocrinopathy; Human; Diabetes mellitus; Hepatic disease; Malignant tumor; Non alcoholic steatohepatitis; Gastroenterology; Digestive diseases; Cancer
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2008.09.011

Background/Aims 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.