Hepatic iron overload in the portal tract predicts poor survival in hepatocellular carcinoma after curative resection.


BACKGROUND & AIMS Hepatic iron overload is associated with liver injury and hepatocarcinogenesis; however, it has not been evaluated in patients with hepatocellular carcinoma (HCC) in Asia. The aim of this study was to clarify the degree and distribution of intrahepatic iron deposition, and their effects on the survival of HCC patients. METHODS Intrahepatic iron deposition was examined using non-tumorous liver tissues from 204 HCC patients after curative resection, and they were scored by 2 semi-quantitative methods: simplified Scheuer's and modified Deugnier's methods. For the Scheuer's method, iron deposition in hepatocytes and Kupffer cells was separately evaluated, while for the modified Deugnier's method, hepatocyte iron score (HIS), sinusoidal iron score (SIS) and portal iron score (PIS) were systematically evaluated, and the corrected total iron score (cTIS) was calculated by multiplying the sum (TIS) of the HIS, SIS, and PIS by the coefficient. RESULTS The overall prevalence of hepatic iron was 40.7% with the simplified Scheuer's method and 45.1% with the modified Deugnier's method with a mean cTIS score of 2.46. During a median follow-up of 67 months, the cTIS was not associated with overall survival. However, a positive PIS was significantly associated with a lower 5-year overall survival rate (50.0%) compared with a negative PIS (73.7%, P = .006). In the multivariate analysis, a positive PIS was an independent factor for overall mortality (hazard ratio, 2.310; 95% confidence interval, 1.181-4.517). CONCLUSIONS Intrahepatic iron deposition was common, and iron overload in the portal tract indicated poor survival in curatively resected HCC patients.

DOI: 10.1111/liv.13619

Cite this paper

@article{Chung2017HepaticIO, title={Hepatic iron overload in the portal tract predicts poor survival in hepatocellular carcinoma after curative resection.}, author={Jung Wha Chung and Eun Shin and Haeryoung Kim and Ho-Seong Han and Jai Young Cho and Young Rok Choi and Sukho Hong and Eun Sun Jang and Jin-Wook Kim and Sook-Hyang Jeong}, journal={Liver international : official journal of the International Association for the Study of the Liver}, year={2017} }