7. Frequency of Hepatocellular Carcinoma and Associated Factors in Patients Presenting to Mayo Hospital, Lahore
Samina Qamar, Shahid Mahmood, Ahmad Hameed and Sobia Ashraf
ABSTRACT
Objective: To determine the frequency of patients having Hepatocellular Carcinoma and major causative factors associated with it, presenting to Mayo Hospital Lahore.
Study Design: Observational / cross-sectional study
Place and Duration of Study: This study was conducted at the Oncology Department of Mayo Hospital, Lahore from Jan 2017 to Dec 2017.
Materials and Methods: This study enrolled clinical data of 151/207 Hepatocellular Carcinoma patients. Their age, sex, socioeconomic status underlying co-morbidity, presence or absence of liver cirrhosis, tumor size, single/multiple tumors, tumor stage, hepatitis serologies, serum AFP levels, and portal vein thrombosis.
Results: Out of 151, 106(70%) were males and 45 (30%) were females. Mean age of presentation was 57.1 ± 8.6 years. Patients with rural background were 115 (76.2%) and urban cases were 36 (23.7%). 136 (90%) patients belonged to lower socioeconomic strata while 15 (10%) were of middle social class. 104 (69%) patients were positive for Hepatitis C virus, 27 (18%) were positive for Hepatitis B virus, 6 (4%) were infected with both viruses, 3 (2%) were alcoholic and 11(7%) patients had no known causative factor .Regarding levels of serum Alpha fetoprotein, 67 (44 %) of patients had AFP more than 400 ng/ml, 48 (32%) had AFP level between 20-400ng/ml and 36 (25%) had AFP levels below 20 ng/ml. Mean tumor size was 8.2 cm ± 2.9 cm. 3 (1.9%) patients were at Stage I, 16(10.7%) had stage II, 84 (55.7%) had stage III and 48(31.7%) of patients were at stage IV of disease., 48(32%) of patients had class A of Child classification, 71 (47%) class B, and 32(21%) had class C.
Conclusion: In our population, Hepatitis C virus is the main causative agent behind Hepatocellular Carcinoma and most of the patients present with large tumor size, multicentric tumor and portal vein thrombosis. Serum AFP levels are low in more than 50% of patients and is not reliable for detecting HCC.
We should implement effective screening programs of viral hepatitis and cirrhosis to save this precious organ and prevent the need of liver transplant.
Key Words: Cirrhosis, Hepatocellular Carcinoma, Serum AFP level, Hepatitis B and C
Citation of articles: Qamar S, Mahmood S, Hameed A, Ashraf S. Frequency of Hepatocellular Carcinoma and Associated Factors in Patients Presenting to Mayo Hospital, Lahore. Med Forum 2018;29(10):27-30.