Predictors of malignancies and overall mortality in Japanese patients with biopsy‐proven non‐alcoholic fatty liver disease. Issue 7 (30th September 2014)

• Record Type: Journal Article
• Authors: Seko, Yuya; Sumida, Yoshio; Tanaka, Saiyu; Taketani, Hiroyoshi; Kanemasa, Kazuyuki; Ishiba, Hiroshi; Okajima, Akira; Nishimura, Takeshi; Yamaguchi, Kanji; Moriguchi, Michihisa; Mitsuyoshi, Hironori; Yasui, Kohichiroh; Minami, Masahito; Itoh, Yoshito
• Is Part Of: Hepatology research. Volume 45:Issue 7(2015:Jul.)
• Page Start: 728
• Page End: 738
• Publication Date: 2014-09-30
• Subjects: Liver -- Diseases -- Periodicals; Liver Diseases -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1111/hepr.12407
• Languages: English
• ISSNs: 1386-6346

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hepr12407-sec-0001" sec-type="section"> <title>Aim</title> <p>Some patients with non‐alcoholic fatty liver disease (NAFLD) develop hepatocellular carcinoma (HCC) and have higher mortality than others. The evidence causally linking NAFLD to extrahepatic malignancies is scarce. Our aim was to determine the incidence of and risk factors for HCC, extrahepatic cancer and mortality in Japanese patients with biopsy‐proven NAFLD.</p> </sec> <sec id="hepr12407-sec-0002" sec-type="section"> <title>Methods</title> <p>This retrospective cohort study analyzed outcomes including onset of malignant tumors and death in 312 patients with NAFLD diagnosed by liver biopsy.</p> </sec> <sec id="hepr12407-sec-0003" sec-type="section"> <title>Results</title> <p>Of 312 patients, 176 (56.4%) were diagnosed with non‐alcoholic steatohepatitis. During a median follow‐up period of 4.8 years (range, 0.3–15.8), six patients (1.9%) developed HCC, and 20 (6.4%) developed extrahepatic cancer. Multivariate analysis identified fibrosis stage (≥3; hazard ratio [HR], 12.3; 95% confidence interval [CI], 1.11–136.0; <italic>P</italic> = 0.041) as a predictor for HCC and type IV collagen 7s (>5 ng/mL; HR, 1.74; 95% CI, 1.08–2.79; <italic>P</italic> = 0.022) as a predictor for extrahepatic cancer. Eight patients (2.6%) died during the follow‐up period. The most common cause of death was extrahepatic malignancy. None died of cardiovascular disease. Multivariate analysis identified type IV collagen 7s (>5 ng/mL; HR, 3.38; 95% CI, 1.17–9.76; <italic>P</italic> = 0.024) as a predictor for mortality.</p> </sec> <sec id="hepr12407-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The incidence of extrahepatic cancer was higher than that of HCC. Severe fibrosis was a predictor for HCC. Patients with NAFLD and elevated type IV collagen 7s levels are at increased risk for extrahepatic cancer and overall mortality.</p> </sec> </abstract>