NEW YORK (Reuters Health) - Porphyria cutanea tarda does not appear to independently elevate the risk of hepatocellular carcinoma, according to a report in the July issue of the European Journal of Gastroenterology and Hepatology.
Several studies investigating possible links between porphyria cutanea tarda, the most common form of porphyria, and hepatocellular carcinoma, have yielded conflicting results, the authors explain.
Dr. Javier P. Gisbert and colleagues from Universidad Autonoma de Madrid, Spain evaluated the incidence of hepatocellular carcinoma in 39 patients with porphyria cutanea tarda and looked for possible cofactors associated with the development of cancer.
Hepatocellular carcinoma was diagnosed in only 1 of the 39 patients with porphyria cutanea tarda, for an annual incidence of 0.26%, the authors report.
More than half the patients (56%) had hepatitis C virus (HCV) infection diagnosed, the results indicate, and 20% showed serological evidence of past hepatitis B virus (HBV) infection. Most patients abused alcohol (87%) or smoked cigarettes (76%).
The sole porphyria cutanea tarda patient diagnosed with hepatocellular carcinoma was HBV-negative, but was HCV-positive and abused alcohol, the researchers note, and his liver biopsy 3 years before the diagnosis of hepatocellular carcinoma showed stage 3 fibrosis.
“Our study shows that the risk of developing hepatocellular carcinoma in patients with porphyria cutanea tarda in our area is relatively low, and perhaps attributable, at least in part, to concomitant HCV infection,” the authors conclude.
“Patients presenting with porphyria cutanea tarda should undergo both HCV infection determination and liver biopsy,” the investigators advise, “and those with concomitant HCV infection or advanced fibrosis/cirrhosis should probably be included in a standard surveillance program in order to achieve early diagnosis of hepatocellular carcinoma.”
Source: Eur J Gastroenterol Hepatol 2004;16:689-692. [ Google search on this article ]
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