Comparision of coagulation profile trends in case of liver cirrhosis with HCC versus cirrhosis without HCC: Analysis of 150 cases in a tertiary health care

Abstract

The physiology of haemostasis and blood coagulation is intimately linked to the hepatic function. Liver disorders can be associated with deranged coagulation profile, thrombocytopenia, and dysfibrinogenemia. In hepatocellular injury, both quantitative and qualitative abnormalities in coagulation factors are often seen. Hepatocellular carcinoma (HCC), peculiar as both cancer and liver cirrhosis to dismay the haemostatic balance towards a prothrombotic state. Our study aims to assess the hemostatic changes and the comparision of coagulation profile trends that occur in cases of liver cirrhosis with HCC versus cirrhosis without HCC: The present study is the hospital based cross-sectional study in a tertiary care centre, New Delhi. A maximum 150 cases of liver cirrhosis with and without hepatocellular carcinoma (HCC) studied from Dec 2017 to Nov 2019 and analysed for parameters related to coagulation i.e. prothrombin time (PT/INR), fibrinogen level and platelet count 1 day prior to the liver transplant. Statistical analysis used: Statistical analysis was done using SPSS 20.0. Comparisons between groups frequencies were made using Chi-square test. P< 0.05 was considered as significant.: Prothrombin time was found to be increased in all the cirrhotic patients (both with and without HCC). Decrease in the level of fibrinogen was observed in 90 % cases of cirrhosis with HCC and 80% of cases of cirrhosis without HCC. Platelet count were almost in normal range among majority of the cirrhosis cases both with and without HCC (86.0% and 75.0% respectively).No significant difference was observed in prothrombin time, fibrinogen level and platelet count among the cases with and without hepatocellular carcinoma (p>0.05).: All the cases showed haemostatic abnormalities in the form of hypofibrinogenemia and increase PT/INR. There is no significant difference in the coagulation profile in cases of cirrhosis with HCC in comparison to cases of cirrhosis without HCC.