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Updated: Jan 25, 2026

A "Patient-Like" Orthotopic Syngeneic Mouse Model of Hepatocellular Carcinoma Metastasis
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The Alpha-1 Pi*MZ Genotype Is an Independent Risk Factor for Hepatocellular Carcinoma Development in Patients With

Lorenz Balcar1,2, Georg Semmler1,2, Bernhard Scheiner1,2

  • 1Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.

Alimentary Pharmacology & Therapeutics
|January 23, 2026
PubMed
Summary

The SERPINA1 Pi*MZ genotype increases hepatocellular carcinoma (HCC) risk in patients with advanced chronic liver disease (ACLD). This genetic factor elevates HCC development independently of other known risk factors.

Keywords:
HCCPNPLA3SERPINA1cirrhosisportal hypertension

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Area of Science:

  • Hepatology
  • Genetics
  • Oncology

Background:

  • The SERPINA1 Pi*Z allele causes alpha-1 antitrypsin deficiency-related liver disease.
  • The Pi*MZ genotype is a significant genetic risk factor for advanced chronic liver disease (ACLD).

Purpose of the Study:

  • To investigate the impact of the Pi*MZ genotype on hepatocellular carcinoma (HCC) development in patients with ACLD.
  • To determine if Pi*MZ genotype is an independent risk factor for HCC in ACLD patients.

Main Methods:

  • Included 815 ACLD patients without HCC undergoing HVPG measurement and genotyping.
  • Performed competing risk analyses with HCC as the outcome and death/liver transplantation as competing events.

Main Results:

  • 4% of patients (30/815) had the Pi*MZ genotype.
  • Pi*MZ genotype was associated with increased HCC risk (aSHR: 3.31; p=0.015) in multivariable analyses.
  • This association remained significant after adjusting for the aMAP score (aSHR: 2.94; p=0.003).

Conclusions:

  • The SERPINA1 Pi*MZ genotype is an independent risk factor for HCC development in ACLD patients.
  • This finding highlights the importance of genetic screening for SERPINA1 in liver disease management.