{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:35:01Z","timestamp":1791412501440,"version":"4.3.3"},"reference-count":48,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[2008,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and aim:<\/jats:title>\n                    <jats:p>To analyse the characteristics of and the factors associated with the development of hepatocellular carcinoma (HCC) in patients with Budd\u2013Chiari syndrome (BCS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods:<\/jats:title>\n                    <jats:p>97 consecutive patients with BCS and a follow-up \u2a7e1 year were evaluated retrospectively. Liver nodules were evaluated using serum \u03b1-fetoprotein (AFP) level and imaging features (CT\/MRI). Biopsy of nodules was obtained when one of the following criteria was met: number \u2a7d3, diameter \u2a7e3 cm, heterogeneity, washout on portal venous phase, increase in size on surveillance, or increase in AFP level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients were mainly Caucasian (69%) and female (66%). Mean age at the diagnosis of BCS was 35.8 (SE 1.2 years), and median follow-up 5 years (1\u201320 years). The inferior vena cava (IVC) was obstructed in 13 patients. Liver nodules were found in 43 patients, 11 of whom had HCC. Cumulative incidence of HCC during follow-up was 4%. Liver parenchyma adjacent to HCC showed cirrhosis in nine patients. HCC was associated with male sex (72.7%\n                      <jats:italic>v<\/jats:italic>\n                      29.0%, p\u200a=\u200a0.007); factor V Leiden (54.5%\n                      <jats:italic>v<\/jats:italic>\n                      17.5%, p\u200a=\u200a0.01); and IVC obstruction (81.8%\n                      <jats:italic>v<\/jats:italic>\n                      4.6%, p&lt;0.001). Increased levels of serum AFP were highly accurate in distinguishing HCC from benign nodules: PPV\u200a=\u200a100% and NPV\u200a=\u200a91% for a cut-off level of 15 ng\/ml.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The incidence of HCC in this large cohort of BCS patients was similar to that reported for other chronic liver diseases. IVC obstruction was a major predictor for HCC development. Serum AFP appears to have a higher utility for HCC screening in patients with BCS than with other liver diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gut.2007.139477","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T20:34:23Z","timestamp":1201206863000},"page":"828-835","source":"Crossref","is-referenced-by-count":166,"title":["Hepatocellular carcinoma in Budd\u2013Chiari syndrome: characteristics and risk factors"],"prefix":"10.1136","volume":"57","author":[{"given":"R","family":"Moucari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P-E","family":"Rautou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Cazals-Hatem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Geara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Bureau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Consigny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Francoz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M-H","family":"Denninger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Vilgrain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Belghiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Durand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Valla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Plessier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2008,1,24]]},"reference":[{"key":"2025120521302260000_57.6.828.1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280436"},{"key":"2025120521302260000_57.6.828.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199903113401001"},{"key":"2025120521302260000_57.6.828.3","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50415"},{"key":"2025120521302260000_57.6.828.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(02)00434-8"},{"key":"2025120521302260000_57.6.828.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra020282"},{"key":"2025120521302260000_57.6.828.6","doi-asserted-by":"publisher","DOI":"10.1177\/000331976801900805"},{"key":"2025120521302260000_57.6.828.7","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(71)90319-6"},{"key":"2025120521302260000_57.6.828.8","first-page":"28","article-title":"Membranous obstruction of the inferior vena cava and hepatic veins. Budd\u2013Chiari syndrome? A treatable disease.","volume":"73","author":"Espana","year":"1980","journal-title":"Am J Gastroenterol"},{"key":"2025120521302260000_57.6.828.9","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/0016-5085(82)90001-4","article-title":"Membranous obstruction of the inferior vena cava and hepatocellular carcinoma in South Africa.","volume":"82","author":"Simson","year":"1982","journal-title":"Gastroenterology"},{"key":"2025120521302260000_57.6.828.10","first-page":"116","article-title":"Long-term follow-up result of portopulmonary shunt by splenopneumopexy on membranous obstruction of the inferior vena cava.","volume":"95","author":"Ono","year":"1984","journal-title":"Surgery"},{"key":"2025120521302260000_57.6.828.11","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1016\/0016-5085(92)90336-W","article-title":"Histopathology of membranous obstruction of the inferior vena cava in the Budd\u2013Chiari syndrome.","volume":"102","author":"Kage","year":"1992","journal-title":"Gastroenterology"},{"key":"2025120521302260000_57.6.828.12","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/00005792-198503000-00005","article-title":"Membranous obstruction of the inferior vena cava in the United States.","volume":"64","author":"Rector","year":"1985","journal-title":"Medicine (Baltimore)"},{"key":"2025120521302260000_57.6.828.13","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840090121"},{"key":"2025120521302260000_57.6.828.14","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.09.023"},{"key":"2025120521302260000_57.6.828.15","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.071423"},{"key":"2025120521302260000_57.6.828.16","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21354"},{"key":"2025120521302260000_57.6.828.17","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50076"},{"key":"2025120521302260000_57.6.828.18","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1148\/radiology.210.2.r99fe13443","article-title":"Hepatic nodules in Budd\u2013Chiari syndrome: imaging features.","volume":"210","author":"Vilgrain","year":"1999","journal-title":"Radiology"},{"key":"2025120521302260000_57.6.828.19","doi-asserted-by":"publisher","DOI":"10.1136\/gut.48.2.264"},{"key":"2025120521302260000_57.6.828.20","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510310307"},{"key":"2025120521302260000_57.6.828.21","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20939"},{"key":"2025120521302260000_57.6.828.22","doi-asserted-by":"crossref","first-page":"329","DOI":"10.7326\/0003-4819-103-3-329","article-title":"Primary myeloproliferative disorders and hepatic vein thrombosis: a prospective study of erythroid colony formation in vitro in 20 patients with Budd\u2013Chiari syndrome.","volume":"103","author":"Valla","year":"1985","journal-title":"Ann Intern Med"},{"key":"2025120521302260000_57.6.828.23","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/0016-5085(86)90855-3","article-title":"Risk of hepatic vein thrombosis in relation to recent use of oral contraceptives. A case\u2013control study.","volume":"90","author":"Valla","year":"1986","journal-title":"Gastroenterology"},{"key":"2025120521302260000_57.6.828.24","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20933"},{"key":"2025120521302260000_57.6.828.25","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1148\/radiographics.22.4.g02jl17847","article-title":"Benign regenerative nodules in Budd\u2013Chiari syndrome and other vascular disorders of the liver: radiologic\u2013pathologic and clinical correlation.","volume":"22","author":"Brancatelli","year":"2002","journal-title":"Radiographics"},{"key":"2025120521302260000_57.6.828.26","doi-asserted-by":"crossref","first-page":"869","DOI":"10.2214\/ajr.178.4.1780869","article-title":"Benign hepatic nodules in Budd\u2013Chiari syndrome: radiologic\u2013pathologic correlation with emphasis on the central scar.","volume":"178","author":"Maetani","year":"2002","journal-title":"AJR Am J Roentgenol"},{"key":"2025120521302260000_57.6.828.27","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20064"},{"key":"2025120521302260000_57.6.828.28","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.30274"},{"key":"2025120521302260000_57.6.828.29","first-page":"1712","article-title":"Myeloproliferative disease in the pathogenesis and survival of Budd\u2013Chiari syndrome.","volume":"91","author":"Smalberg","year":"2006","journal-title":"Haematologica"},{"key":"2025120521302260000_57.6.828.30","first-page":"2364","article-title":"Factor V Leiden mutation, prothrombin gene mutation, and deficiencies in coagulation inhibitors associated with Budd\u2013Chiari syndrome and portal vein thrombosis: results of a case\u2013control study.","volume":"96","author":"Janssen","year":"2000","journal-title":"Blood"},{"key":"2025120521302260000_57.6.828.31","doi-asserted-by":"publisher","DOI":"10.1136\/gut.40.6.798"},{"key":"2025120521302260000_57.6.828.32","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/00005792-199401000-00003","article-title":"Hepatic outflow obstruction (Budd\u2013Chiari syndrome). Experience with 177 patients and a review of the literature.","volume":"73","author":"Dilawari","year":"1994","journal-title":"Medicine (Baltimore)"},{"key":"2025120521302260000_57.6.828.33","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(95)80252-5"},{"key":"2025120521302260000_57.6.828.34","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1440-1746.1995.tb01095.x","article-title":"Membranous obstruction of inferior vena cava in Taiwan.","volume":"10","author":"Lu","year":"1995","journal-title":"J Gastroenterol Hepatol"},{"key":"2025120521302260000_57.6.828.35","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.1996.tb00056.x"},{"key":"2025120521302260000_57.6.828.36","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.2001.02577.x"},{"key":"2025120521302260000_57.6.828.37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1478-3231.2005.01194.x","article-title":"Membranous obstruction of the inferior vena cava and its causal relationship to hepatocellular carcinoma.","volume":"26","author":"Kew","year":"2006","journal-title":"Liver International"},{"key":"2025120521302260000_57.6.828.38","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.09.014"},{"key":"2025120521302260000_57.6.828.39","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2004.03642.x"},{"key":"2025120521302260000_57.6.828.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.09.003"},{"key":"2025120521302260000_57.6.828.41","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(97)80442-4"},{"key":"2025120521302260000_57.6.828.42","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510270224"},{"key":"2025120521302260000_57.6.828.43","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/ajcn\/80.5.1106","article-title":"Human aflatoxicosis in developing countries: a review of toxicology, potential health consequences, and interventions.","volume":"80","author":"Williams","year":"2004","journal-title":"Am J Clin Nutr"},{"key":"2025120521302260000_57.6.828.44","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)00053-2"},{"key":"2025120521302260000_57.6.828.45","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07183.x"},{"key":"2025120521302260000_57.6.828.46","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/00042737-200403000-00012","article-title":"Characteristic clinical features of hepatocellular carcinoma associated with Budd\u2013Chiari syndrome: evidence of different carcinogenic process from hepatitis B virus-associated hepatocellular carcinoma.","volume":"16","author":"Shin","year":"2004","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025120521302260000_57.6.828.47","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.2214\/ajr.182.4.1821011","article-title":"Pretransplantation diagnosis and staging of hepatocellular carcinoma in patients with cirrhosis: value of dual phase helical CT.","volume":"182","author":"Valls","year":"2004","journal-title":"AJR Am J Roentgenol"},{"key":"2025120521302260000_57.6.828.48","doi-asserted-by":"crossref","first-page":"699","DOI":"10.2214\/ajr.183.3.1830699","article-title":"Multiarterial phase dynamic MRI of small early enhancing hepatic lesions in cirrhosis or chronic hepatitis: differentiating between hypervascular hepatocellular carcinomas and pseudolesions.","volume":"183","author":"Ito","year":"2004","journal-title":"AJR Am J Roentgenol"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.2007.139477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:30:36Z","timestamp":1764999036000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.2007.139477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,1,24]]},"references-count":48,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2008,5,13]]},"published-print":{"date-parts":[[2008,6]]}},"alternative-id":["10.1136\/gut.2007.139477"],"URL":"https:\/\/doi.org\/10.1136\/gut.2007.139477","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,1,24]]}}}