Greater biosynthetic liver dysfunction in primary sclerosing cholangitis suggests co-existent or impending cholangiocarcinoma

Panagiotis Trilianos, Abhishek Agnihotri, Enver Ucbilek, Ahmet Gurakar

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Aim: Patients with primary sclerosing cholangitis (PSC) who develop cholangiocarcinoma (CCA) have a median survival of less than 6 months. In half of cases, PSC and CCA will be diagnosed either concurrently or within a year of one another. The aim of the present study is to dem-onstrate that the degree of biochemical liver dysfunction is associated with concomitant or impending CCA. Methods: We did a chart review of patients diagnosed with PSC and CCA up to 18 months from presentation (“CCA” group) as well as patients with PSC that underwent transplantation with no sign of CCA in their explanted liver (“nCCA” group). Along with demographic data and follow-up length, we recorded their presenting liver function tests, including alanine and aspar-tate aminotransferases (ALT, AST), total bilirubin (TBil), alka-line phosphatase (ALP), international normalization ratio (INR), and serum Ca 19-9 levels. Differences between mean values of the two groups were analyzed with a student’s t-test. Results: Twenty-four patients were included. The “CCA” group consisted of eight patients, and the “non-CCA” group had 16 patients. There was no significant difference between the two groups in their presenting values of ALT, ALP, or serum Ca 19-9. However, the “CCA” group had significantly higher levels of AST, TBil, and INR. Conclusion: Patients with PSC and concurrent or impending CCA appear to exhibit significantly greater biochemical liver dysfunction than those who do not develop CCA. Therefore, newly-diagnosed PSC patients presenting with these findings may warrant more rigorous evaluation.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalJournal of Clinical and Translational Hepatology
Volume4
Issue number1
DOIs
StatePublished - 2016

Keywords

  • Cholestatic disease
  • Liver function tests
  • Liver transplantation
  • Malignancy

ASJC Scopus subject areas

  • Hepatology

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