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Background <p>The incidence of HCC in patients with autoimmune hepatitis (AIH) is low and, due to the paucity of data in the literature, a thorough characterization of these patients is missing.</p> Aim <p>To describe the main characteristics and outcome of patients with AIH and HCC.</p> Methods <p>Among patients with HCC included in the Italian Liver Cancer (ITA.LI.CA) database during the period 2009–2022, we selected those with AIH, and we described their liver disease characteristics, modality of HCC diagnosis, tumor stage, treatment, and outcome.</p> Results <p>Among 10,026 patients with HCC, we identified 23 patients (0.2%) with AIH (43.5% males, 69.6% aged &gt; 65&#xa0;years, 91.0% with cirrhosis). Fifteen patients (65.2%) had co-factors of liver disease [8 patients (34.8%) metabolic dysfunction-associated steatotic liver disease, 4 patients (17.4%) alcohol abuse, 3 patients (13.0%) AIH/Primary Biliary Cholangitis overlap syndrome]. Tumors diagnosed under surveillance (60.9%) were more frequently uninodular (85.7% <i>vs</i> 66.6%, <i>p</i> = 0.146) and Milan-in (85.7% <i>vs</i> 44.4%, <i>p</i> = 0.066) than those diagnosed outside surveillance. Treatment with curative intent was more frequent among patients under surveillance (78.6% <i>vs</i> 33.3%, <i>p</i> = 0.077). Median overall survival was 41.7&#xa0;months and was remarkably longer in patients under surveillance than in those diagnosed outside surveillance (68.2 <i>vs</i> 27.4&#xa0;months, <i>p</i> = 0.032).</p> Conclusion <p>AIH accounts for a minimal fraction of patients with HCC, and in most patients, risk co-factors for HCC are present. In patients with AIH, too, surveillance is associated with better tumor stage, higher access rate to potentially curative treatments, and improved survival.</p>

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Characteristics and Outcomes of Hepatocellular Carcinoma in Patients with Autoimmune Hepatitis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月3日

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  • Andrea Pasta,
  • Giulia Pieri,
  • Maria Corina Plaz Torres,
  • Gabriele Missale,
  • Francesco Giuseppe Foschi,
  • Fabio Piscaglia,
  • Sara Boninsegna,
  • Andrea Mega,
  • Nora Cazzagon,
  • Filippo Pelizzaro,
  • Mauro Viganò,
  • Franco Trevisani,
  • Laura Bucci,
  • Francesco Azzaroli,
  • Maurizia Rossana Brunetto,
  • Claudia Campani,
  • Ciro Celsa,
  • Giorgia Ghittoni,
  • Donatella Magalotti,
  • Andrea Martini,
  • Filomena Morisco,
  • Gerardo Nardone,
  • Francesca Romana Ponziani,
  • Rodolfo Sacco,
  • David Sacerdoti,
  • Carlo Saitta,
  • Angelo Sangiovanni,
  • Lorenzo Lani,
  • Gianluca Svegliati-Baroni,
  • Gianpaolo Vidili,
  • Alessandro Vitale,
  • Edoardo G. Giannini,
  • Maurizio Biselli,
  • Benedetta Stefanini,
  • Alessandro Granito,
  • Francesco Tovoli,
  • Mariarosa Marseglia,
  • Bernardo Stefanini,
  • Elisa Pinto,
  • Fabio Farinati,
  • Federica Bertellini,
  • Giorgio Palano,
  • Maria Piera Kitenge,
  • Gloria Allegrini,
  • Giuseppe Cabibbo,
  • Roberta Ciccia,
  • Valeria Gaudioso,
  • Alessandro Grova,
  • Alba Sparacino,
  • Sofia Rao,
  • Luigi Caopdicasa,
  • Mauro Salvato,
  • Guido Cusimano,
  • Alessio Quartararo,
  • Gaetano Giusino,
  • Fabio Marra,
  • Tancredi Li Cavoli,
  • Lucia Ragozzino,
  • Stefano Gitto,
  • Martina Rosi,
  • Valentina Adotti,
  • Lucia Napoli,
  • Alberto Borghi,
  • Alice Saccomandi,
  • Fabio Conti,
  • Luca Ielasi,
  • Marco Ferronato,
  • Nicola Reggidori,
  • Laura Schiadà,
  • Chiara Scorzoni,
  • Giulia Scandali,
  • Francesco Santopaolo,
  • Lucia Cerrito,
  • Nicoletta de Matthaeis,
  • Antonio Gasbarrini,
  • Sara Grasselli,
  • Elisabetta Biasini,
  • Andrea Olivani,
  • Maria Guarino,
  • Mario Capasso,
  • Valentina Cossiga,
  • Ester Marina Cela,
  • Antonio Facciorusso,
  • Camilla Graziosi,
  • Valentina Lauria,
  • Giorgio Pelecca,
  • Fabrizio Chegai,
  • Armando Raso,
  • Pierluigi Aloisio,
  • Serena Dell’Isola,
  • Maria Stella Franzè,
  • Roberto Filomia,
  • Concetta Pitrone,
  • Giovanni Raimondo,
  • Marco Arru,
  • Elton Dajti,
  • Alberto Porro,
  • Filippo Oliveri,
  • Gabriele Ricco,
  • Veronica Romagnoli,
  • Alessandro Inno,
  • Fabiana Marchetti,
  • Leonardo Natola,
  • Leonardo De Marco,
  • Aldo Filice,
  • Andrea Dalbeni,
  • Pietro Coccoli,
  • Alba Rocco,
  • Alberta Cappelli,
  • Cristina Mosconi,
  • Matteo Renzulli,
  • Luca Marzi,
  • Pietro Guerra,
  • Silvia Cagnin

摘要

Background

The incidence of HCC in patients with autoimmune hepatitis (AIH) is low and, due to the paucity of data in the literature, a thorough characterization of these patients is missing.

Aim

To describe the main characteristics and outcome of patients with AIH and HCC.

Methods

Among patients with HCC included in the Italian Liver Cancer (ITA.LI.CA) database during the period 2009–2022, we selected those with AIH, and we described their liver disease characteristics, modality of HCC diagnosis, tumor stage, treatment, and outcome.

Results

Among 10,026 patients with HCC, we identified 23 patients (0.2%) with AIH (43.5% males, 69.6% aged > 65 years, 91.0% with cirrhosis). Fifteen patients (65.2%) had co-factors of liver disease [8 patients (34.8%) metabolic dysfunction-associated steatotic liver disease, 4 patients (17.4%) alcohol abuse, 3 patients (13.0%) AIH/Primary Biliary Cholangitis overlap syndrome]. Tumors diagnosed under surveillance (60.9%) were more frequently uninodular (85.7% vs 66.6%, p = 0.146) and Milan-in (85.7% vs 44.4%, p = 0.066) than those diagnosed outside surveillance. Treatment with curative intent was more frequent among patients under surveillance (78.6% vs 33.3%, p = 0.077). Median overall survival was 41.7 months and was remarkably longer in patients under surveillance than in those diagnosed outside surveillance (68.2 vs 27.4 months, p = 0.032).

Conclusion

AIH accounts for a minimal fraction of patients with HCC, and in most patients, risk co-factors for HCC are present. In patients with AIH, too, surveillance is associated with better tumor stage, higher access rate to potentially curative treatments, and improved survival.