肝细胞癌的概况:来自三级保健医院的经验

Laiba Naseer, Sharoon Sabir, M. Azeem, S. Zaman, A. Mahmood, M. Mastoor
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摘要

背景与目的:肝细胞癌(HCC)是世界范围内的原发性肝癌,目前已成为癌症相关死亡的第三大原因。随着全球发病率的增加,HCC正在成为一个主要的健康负担。在亚洲国家,HCC的发病率从0.3%到1.6%不等。本研究旨在评估三级医院肝细胞癌的临床和病因。方法:对2019年6月至2022年5月拉合尔真纳医院消化内科124例肝癌患者进行回顾性研究。所有年龄在10岁到75岁之间符合诊断标准的患者均被纳入本研究。记录和分析患者的细胞组织学、临床、放射学和病因学资料。在预先设计的形式中注意到个别相关特征。采用SPSS 25版本进行数据分析。结果:124例HCC患者中,男性78例(62.9%),女性46例(37.1%)。总平均年龄48.63±6.78岁。91例(73.4%)患者出现肝硬化,其中14例(15.4%)无症状。肝功能失代偿的常见症状为腹水67例(54%),黄疸23例(18.5%)。根据病因学资料,隐匿性、乙型和丙型肝炎患病率分别为58例(46.8%)、20例(16.1%)和6例(4.8%)。肿瘤血栓形成18例(14.5%)。根据活检标本,19例(15.3%)HCC伴脂肪变性。在监测期间,约32例(25.8%)肝硬化HCC患者被诊断。结论:本研究发现,最常见的病因是肝细胞癌。大多数患者无症状,主要主诉腹痛并伴有某些特定的合并症。高血压、糖尿病和缺血性心脏病是肝细胞癌患者的特殊合并症。在我国人群中,HCC的主要病因是乙型肝炎。关键词:临床特点,病因学,肝细胞癌
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Profile of Hepatocellular Carcinoma: An Experience from a Tertiary Care Hospital
Background and Aim: Hepatocellular carcinoma (HCC) is the primary liver cancer around the world, and it has now become the third leading cause of cancer-related mortality. With an increasing global incidence, HCC is becoming a major health burden. The incidence of HCC varies from 0.3% to 1.6% in Asian countries. The present study aimed to assess the clinical and etiological profile of hepatocellular carcinoma in a tertiary care hospital. Methodology: This retrospective study was conducted on 124 hepatocellular carcinoma patients in the Department of Gastroenterology, Jinnah Hospital, Lahore from June 2019 to May 2022. All the patients of age 10 years to 75 years fulfilling the diagnostic criteria were enrolled in this study. Patient’s cytohistological, clinical, radiological, and etiological data were recorded and analyzed. Individual relevant features were noted in pre-designed proforma. SPSS version 25 was used for data analysis. Results: Of the total 124 HCC patients, there were 78 (62.9%) male and 46 (37.1%) females. The overall mean age was 48.63±6.78 years. Liver cirrhosis was present in 91 (73.4%) patients out of which 14 (15.4%) were asymptomatic. The prevalent signs of hepatic decompensation were ascites 67 (54%) and Jaundice 23 (18.5%). Based on etiological data, the prevalence of the cryptogenic, Hepatitis B, and C were 58 (46.8%), 20 (16.1%), and 6 (4.8%) respectively. Tumor thrombosis was found in 18 (14.5%). Based on biopsy specimens, HCC with steatosis were seen in 19 (15.3%) patients. During surveillance, about 32 (25.8%) cirrhotic HCC patients were diagnosed. Conclusion: The present study found that the most prevalent etiology was hepatocellular carcinoma. Most patients were asymptomatic and had major complaints of abdominal pain with certain specific comorbidities. Hypertension, diabetes, and ischemic heart disease were the specific co-morbidities in hepatocellular carcinoma patients. In our population, the prevalent cause of HCC was Hepatitis B. Keywords: Clinical profile, Etiology, Hepatocellular Carcinoma
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