Increased Porphyrins in Primary Liver Cancer Mainly Reflect a Parallel Liver Disease

Jerzy Kaczynski,Göran Hansson,Sven Wallerstedt

doi:10.1155/2009/402394

Jerzy Kaczynski, Göran Hansson + Show 1 more

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https://doi.org/10.1155/2009/402394

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Abstract

Hepatic porphyries have been associated with an increased risk of primary liver cancer (PLC), which on the other hand may cause an increased porphyrin production. To evaluate the role of an underlying liver disorder we analyzed porphyrins in patients with hepatocellular carcinoma (HCC) (n = 65), cholangiocellular carcinoma (n = 3), or suspected PLC, which turned out to be metastases (n = 18) or a benign disorder (n = 11). None of the patients had a family history of porphyry or clinical signs of porphyry. Increased aminolevulinic acid or porphyrin values were common not only in patients with PLC (43%) but also in metastatic (50%) and benign (64%) liver disorders. The corresponding proportion for HCC patients with liver cirrhosis (55%) was higher (P < .05) than in those without cirrhosis (17%). We conclude that symptomatic porphyries are unusual in PLC, whereas elevated urinary and/or faecal porphyrins are common, primarily reflecting a parallel liver disease and not the PLC.

Highlights

Primary liver cancer (PLC), and its most predominant histological type, hepatocellular carcinoma (HCC), is one of the most common malignancies in the world [1]
The characteristics of the PLC patients in our study with regard to frequency of cirrhosis, age, and sex are in agreement with findings in a large comprehensive retrospective study from the same area and should be regarded as representative for PLC in Sweden [43]
It seemed appropriate to compare porphyrin divergences in our PLC cases not with healthy people but with patients suffering from other liver disorders, especially patients with clinical signs suspect of PLC

Summary

Introduction

Primary liver cancer (PLC), and its most predominant histological type, hepatocellular carcinoma (HCC), is one of the most common malignancies in the world [1]. Sweden is a low-rate area where PLC accounts for less than 2% of all diagnosed cancers [3]. Cirrhosis of the liver plays an important role for the PLC development, and important etiological factors for HCC are reported to be hepatitis B and C viruses, alcohol, and diabetes [2, 4,5,6,7,8]. The incidence of HCC in PCT has been reported to be from zero% to 34% [20, 21, 28,29,30]

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