SPECTRUM OF HEPATOCELLULAR CARCINOMA AT SHIFA INTERNATIONAL HOSPITAL, ISLAMABAD
Abstract
Background: The aim of this study was to review etiological and clinical features of patients with hepatocellular carcinoma (HCC) at a tertiary care centre in past nine years. Relevant data on HCC in other parts of country and world were reviewed. Methods: Patients who had biopsy proven HCC were reviewed retrospectively. Demographic features were noted and positivity for serology, presence of cirrhosis, level of alpha-fetoprotein, tumour size and distribution of liver lesions were noted. Results: A total of 67 patients were found to have biopsy proven HCC. Mean age was 58.64 ± 12.77 years. Males were 79%. Hepatitis B surface antigen was noted to be positive in 23% of the patients, who were tested and hepatitis C antibody was found to be positive in 67% of the patients who were tested. Alpha fetoprotein level was 632.09 ± 1332.31. Cirrhosis was noted in 69% patients. Tumour size in patients with single lesion was 6.6 ± 1.14 cm. Patients with single lesion had 70% time involvement of the left lobe and 30% times had involvement of the right lobe. Fifty one percent of the patients in this series had multilocular distribution. Conclusion: Hepatocellular carcinoma has become a common tumour in Pakistan and studies are showing that this cancer is related to hepatitis C virus infection in majority of the patients. A large number of them have underlying cirrhosis and are multifocal in origin and are presented in an advanced condition.Key words: Hepatocellular carcinoma, Hepatitis C, Hepatitis B, Alpha fetoprotein, CirrhosisReferences
Yoshizawa H. Hepatocellular carcinoma associated with hepatitis C virus infection in Japan: Projection to other countries in the foreseeable future. Oncol 2002; 62(Suppl): 8-17.
Tanaka Y, Hanada K, Mizokami M, Yeo AE, Shih JW, Gojobori T, et al. Inaugural article: A comparison of the molecular clock of hepatitis C virus in the United States and Japan predicts that hepatocellular carcinoma incidence in the United States will increase over the next two decades. Proc Natl Acad Sci USA 2002; 99: 15584-9.
El-Serag HB. Hepatocellular carcinoma and hepatitis C in the United States. Hepatol 2002; 36 (5 Suppl 1): S 74-83.
Ogunbiyi JO. Hepatocellular carcinoma in the developing world. Semin Oncol 2001;28:179-87.
Taseer JH, Malik IH, Mustafa G, Arshad M, Zafar MH, Shabbir I, et al. Association of primary hepatocellular carcinoma with hepatitis B virus. Bio Medica 1996; 12: 79-81.6. Malik IA, Ahmad N, Butt SA, Tariq WUZ, Muzaffar M, Bukhtiari N. The role of hepatitis B and C viruses in the etiology of hepatocellular carcinoma in Northern Pakistan. J Coll Phy Surg Pak 1995; 5: 26-8.
Kausar S, Shafqat F, Shafi F, Khan AA. The association of hepatocellular carcinoma with hepatitis B and C viruses. Pak J Gastroenterol 1998; 12: 1-3.
Farooqi JI, Farooqi RJ. Relative frequency of hepatitis B and C viruses infections in cases of hepatocellular carcinoma in North West Frontier Province, Pakistan. J Coll Phy Surg Pak 2000; 10: 128-30.
Butt A, Khan A, Alam A, Ahmad S, Shah S, Shafqat F, et al. Hepatocellular carcinoma: analysis of 76 cases. J Pak Med Assoc 1998; 48: 197-201.
Qureshi H, Zuberi SJ, Jafarey NA, Zaidi SH. Hepatocellular carcinoma in Karachi. J Gastroenterol Hepatol 1990; 5: 1-6.
Rehman AU, Murad S. Hepatocellular carcinoma: A retrospective analysis of 118 cases. J Coll Phy Surg Pak 2002; 12: 108-9.
Mumtaz MS, Iqbal R, Umar M, Khar B, Mumtaz MO, Anwar F, et al. Sero-prevalence of hepatitis B and C viruses in hepatocellular carcinoma. J Rawalpindi Med Coll 2001; 5: 78-80.
Chohan AR, Umar M, Khar B, Khurram m, Zahid M, Shah SF, et al. Demographic features of hepatocellular carcinoma: A study of 30 cases. J Rawalpindi Med Coll 2001; 5: 81-83.
Mujeeb SA, Jamal Q, Khanani R, Iqbal N, Kaher S. Prevalence of hepatitis B surface antigen and HCV antibodies in hepatocellular carcinoma cases in Karachi, Pakistan. Trop Doct 1997; 27: 45-6.
Omata M, Dan Y, Daniele B, Plentz R, Rudolph KL, Manna M, et al. Clinical features, etiology and survival of hepatocellular carcinoma among different countries. J Gastroenterol Hepatol 2002; 17 (Suppl) 540-9.
Shah GG, Qureshi IA, Hakim T, Tarin BA, Farooq MA, Qureshi PS. Radiological aspects of hepatocellular carcinoma: A hospital based study. Pak Armed Forces Med Jour 1999; 49: 54-7.
Del Olmo JA, Serra MA, Rodriguez F, Escudoro A, Gilabert S, Rodrigo JM. Incidence and risk factors for hepatocellular carcinoma in 967 patients with cirrhosis. J Cancer Res Clin Oncol 1998; 124: 560-4.
Castells L, Vargas V, Gonzalez A, Esteban L, Esteba R, Guardia J. Long interval between HCV infection and development of hepatocellular carcinoma. Liver 1995; 15: 159-63.
Yang HI, Lu SN, Liaw YF, You SL, Sun CA, Wang LY, et al. Hepatitis Be antigen and risk of hepatocellular carcinoma. N Eng J Med 2002; 347: 168-74.
Hassan MM, Hwang LY, Hatten CJ, Swaim M, Li D, Abbruzzese JL, et al. Risk factors for hepatocellular carcinoma: synergism of alcohol with viral hepatitis and diabetes mellitus. Hepatol 2002; 36: 1206-13.
Parvez T, Anwar MS. Association of social class in HBsAg and hepatocellular carcinoma. J Coll Phy Surg Pak 2001; 11: 669-71.
Petry W, Heintges T, Hensel F, Erhardt A, Wenning M, Niederau C, et al. Hepatocellular carcinoma in Germany. Epidemiology, etiology, clinical aspects and prognosis in 100 consecutive patients of a university clinic. Z Gastroenterol 1997; 35: 1059-67.
Sharieff S, Burney I, Salam A. Lack of correlation between alpha fetoprotein and tumor size in hepatocellular carcinoma. J Pak Med Assoc 2001;51: 123-4.
Khokhar N, Jadoon HA. Percutaneous liver biopsy using spinal needle. Pak J Gastroenterol 2002; 16: 9-11.
Yusuf NW, Jafri S, Masood G. The diagnostic role of targeted fine needle aspiration cytology of liver in malignant focal mass lesions–A cytohistological correlation. J Coll Phys Surg Pak 2000; 10: 109-12.
Khokhar N. Multi locular presentation of hepatocellular carcinoma. J Pak Med Assoc 2001; 51: 407-8.
Sarin SK, Thakur V, Guptan RC, Saigal S, Malhotra V, Thyagarajan SP, et al. Profile of hepatocellular carcinoma in India: An insight into possible etiologic associations. J Gastroenterol Hepatol 2001; 16: 666.
Hwang SJ, Tong MJ, Lai PP, Ko ES, CO RL, Chien D, et al. Evaluation of hepatitis B and C viral markers: Clinical significance in Asian and Caucasian patients with hepatocellular carcinoma in the United States of America. J Gastroenterol Hepatol 1996; 11: 949-54.
Wang BE, Ma WM, Sulaiman A, Noer S, Sumoharjo S, Sumarsidi D, et al. Demographic, clinical and virological characteristics of hepatocellular carcinoma is Asia: Survey of 414 patients from four countries. J Med Virol 2002; 67: 394-400.
Dick EA, Taylor-Robinson SD, Thomas HC, Gedoryc WM. Ablative therapy for liver tumors. Gut 2002;50:733-9.
Farooqi JI, Hameed K, Khan IU, Shah S. Efficacy of intrahepatic absolute alcohol in unresectable hepatocellular carcinoma. J Coll Phys Surg Pak 2001; 11: 383-6.
Farooqi JI, Farooqi RJ. Efficacy of Octreotide in cases of inoperable hepatocellular carcinoma: A clinical trial. J Coll Phys Surg Pak 2000; 10: 258-60.
Johnson PJ. Hepatocellular carcinoma: is current therapy really altering outcome? Gut 2002; 51: 459-62
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