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Risk of malignancies in autoimmune hepatitis type 1 patients with a long‐term follow‐up in Japan
Author(s) -
ArinagaHino Teruko,
Ide Tatsuya,
Miyajima Ichiro,
Ogata Kei,
Kuwahara Reiichiro,
Amano Keisuke,
Kawaguchi Toshihiro,
Nakamura Toru,
Kawaguchi Takumi,
Koga Hironori,
Yonemoto Koji,
Torimura Takuji
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12973
Subject(s) - medicine , autoimmune hepatitis , gastroenterology , malignancy , incidence (geometry) , cancer , cirrhosis , hepatitis , confidence interval , standardized mortality ratio , physics , optics
Aim The risk of malignancies in autoimmune diseases is high and is regarded to be due to immunological abnormalities, the use of immunosuppressive agents, and/or chronic inflammation. The aim of this study was to investigate the incidence and risk of malignancies in patients with autoimmune hepatitis (AIH) type 1 in Japan. Methods Two hundred and fifty‐six patients diagnosed with AIH were enrolled. A person‐year calculation was carried out for AIH patients, and the numbers of expected events were clarified using data from “The Monitoring of Cancer Incidence in Japan Project” in order to examine the standard incident rate (SIR) of each type of malignancy. Biochemical data regarding carcinogenesis and its background factors were also examined. Results Twenty‐seven patients (10.5%) developed malignancies; 11 (4.3%) with hepatobiliary cancer and 16 (6.3%) with extrahepatic malignancies. The overall SIR for malignancies in AIH was significantly high at 2.04 (95% confidence interval [CI], 1.34–2.96), and was high among female patients at 2.49 (95% CI, 1.60–3.71). The SIR for hepatobiliary cancer was 14.14 (95% CI, 7.05–25.30), and was markedly high for female patients at 21.83 (95% CI, 10.45–40.16). The SIR for oral/pharyngeal cancer was significantly high for female patients at 14.61 (95% CI, 1.64–52.77). The risk factors for hepatobiliary cancer at the diagnosis of AIH were low levels of alanine aminotransferase ( P = 0.0226), low platelet counts ( P < 0.0001), and cirrhosis ( P = 0.0004). The risk factor for extrahepatic malignancy was relapse of AIH ( P = 0.0485). Conclusion The risk of malignancies was generally high among AIH patients. Those with the risk factors of malignancies should be carefully followed up.