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Retrospective analysis of predictive factors for hepatocellular carcinoma development in patients with chronic hepatitis C-induced cirrhosis

Year 2022, Volume: 27 Issue: 2, 204 - 208, 24.05.2022
https://doi.org/10.21673/anadoluklin.1066158

Abstract

Aim: This study aimed to investigate the factors affecting the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C-induced cirrhosis

Methods: Totally 119 patients of >18 years of age, who were followed up with the diagnosis of chronic hepatitis C-induced cirrhosis in the gastroenterology and internal medicine outpatient clinics of T.C. Demiroğlu Bilim University between January 2010 and January 2019, were included in this study. The patients were divided into two groups: HCC cirrhosis and non-HCC cirrhosis groups. Biochemical parameters, demographic characteristics, MELD (Model for End-stage Liver Disease) and CHILD (Child-Pugh) scores, and metabolic parameters (body mass index; BMI, metabolic syndrome) were evaluated for both groups.

Results: Forty-eight patients in this study were assigned to the HCC group, whereas 71 patients were assigned to the non-HCC cirrhosis group. The mean age was 55.9±7.7 years and 68 were male and 51 were female in the study when HCC and non-HCC groups were compared, mean age, male gender, and presence of metabolic syndrome were significantly higher in the HCC group. In the HCC group; MELD, CHILD scores, International Normalized Ratio (INR ), total bilirubin, blood urea nitrogen (BUN) values were lower and hemoglobin, hematocrit, Alanine Aminotransferase (ALT), Gama Glutamyl Transferase (GGT) and albumin values were found to be significantly higher. The development of ascites, spontaneous bacterial peritonitis, and hepatic encephalopathy was found lower in the HCC group. ALT, increased albumin level, and the presence of metabolic syndrome was found to be independent risk factors that could predict the formation of HCC.

Conclusion: ALT, increased albumin levels, and the presence of metabolic syndrome may be important markers for the development of HCC in hepatitis C virus-related cirrhosis patients.

References

  • Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108
  • Chang UK, Kim MS, Han CJ, Lee DH. Clinical result of stereotactic radiosurgery for spinal metastasis from hepatocellular carcinoma: comparison with conventional radiation therapy. J Neurooncol. 2014;119(1):141-8.
  • Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer. 1999;83(6):870-3.
  • Khudoleĭ VV, Balanski RM.Tobacco smoking as a cancer risk factor. Vopr Onkol. 1989;35(11):1283-90.
  • Yeo Y, Gwack J, Kang S, Koo B, Jung SJ, Dhamala P et al. Viral hepatitis and liver cancer in Korea: an epidemiological perspective. Asian Pac J Cancer Prev. 2013;14(11):6227-31.
  • Collier J, Sherman M. Screening for hepatocellular carcinoma. Hepatology. 1998;27(1):273-8.
  • Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinomain cirrhosis: incidence and risk factors. Gastroenterology. 2004;127(5):35-50.
  • Pawlotsky JM. Pathophysiology of hepatitis C virus infection and related liver disease. Trends Microbiol. 2004;12(2):96-102.
  • Borzio M, Colloredo G, Pioltelli P, Quagliuolo M. Epidemiology and outcome of hepatocellular carcinoma in Lombardy. Dig Liver Dis. 2007;39(11):1011-7.
  • Thomas MB, Zhu AX. Hepatocellular carcinoma: the need for progress. J Clin Oncol. 2005;23(13):2892-9.
  • Gurtsevitch VE. Human oncogenic viruses: hepatitis B and hepatitis C viruses and their role in hepatocarcinogenesis. Biochemistry. 2008;73(5):504-13.
  • Colombo M, de Franchis R, Del Ninno E, Sangiovanni A, De Fazio C, Tommasini M et al. Hepatocellular carcinoma in Italian patients with cirrhosis. N Engl J Med. 1991;325(10):675-80.
  • Szalay F. A hepatitis C-vírus-fertôzés és hepatocarcinogenesis [Hepatitis C virus infection and hepatocarcinogenesis]. Orv Hetil. 2010;151(38):1524-9.
  • Murugavel KG, Mathews S, Jayanthi V, Shankar EM, Hari R, Surendran R,, et al. Alpha-fetoprotein as a tumor marker in hepatocellular carcinoma: investigations in south Indian subjects with hepatotropic virus and aflatoxin etiologies. Int J Infect Dis. 2008;12(6):71-6
  • Arhan M, Akdoğan M, İbiş M, Kılıç ZMY, Kaçar S, Tunç B, Şaşmaz N. Tek merkeze ait hepatosellüler karsinom verileri; retrospektif çalışma. Akademik Gastroenteroloji Dergisi. 2009;8(1):18-23.
  • El-Serag HB. Epidemiology of hepatocellular carcinoma. Clin Liver Dis 2001;5(1):87-107.
  • Chaudhari R, Fouda S, Sainu A, Pappachan JM. Metabolic complications of hepatitis C virus infection. World J Gastroenterol. 2021;27(13):1267-82.
  • Mahl TC. Approach to the patient with abnormal liver tests. Lippincotts Prim Care Pract. 1998;2(4):379-89.
  • Carr BI, Guerra V. Serum albumin levels in relation to tumor parameters in hepatocellular carcinoma patients. Int J Biol Markers. 2017;32(4):391-6.

Hepatit C’ye bağlı siroz hastalarında hepatosellüler karsinom gelişiminde öngördürücü faktörlerin retrospektif analizi

Year 2022, Volume: 27 Issue: 2, 204 - 208, 24.05.2022
https://doi.org/10.21673/anadoluklin.1066158

Abstract

Amaç: Bu çalışmanın amacı kronik hepatit C’ye bağlı siroz hastalarında, hepatosellüler karsinom (HSK) gelişimini etkileyen faktörlerin değerlendirilmesidir.

Yöntemler: Ocak 2010-Ocak 2020 yılları arasında T.C. Demiroğlu Bilim Üniversitesi Tıp Fakültesi Gastroenteroloji ve İç Hastalıkları polikliniklerinde hepatit C virüsüne (HCV) bağlı karaciğer sirozu nedeniyle takip edilen 18 yaş üstü 119 hasta çalışmaya dâhil edildi. Hastalar HSK’nin eşlik ettiği siroz ve HSK’ye eşlik etmeyen (non-HSK) siroz olguları olarak iki gruba ayrıldı. Biyokimyasal parametreler, demografik karakteristikler, MELD (Son Dönem Karaciğer Hastalığı Modeli) ve CHILD (Child-Pugh) skorları ve metabolik parametreler (vücut kitle indeksi [VKİ], metabolik sendrom) her iki grup için değerlendirildi.

Bulgular: Hastaların 48’i HSK ve 71’i ise non-HSK siroz idi. Hastaların yaş ortalaması 55,9±7,7 ve 68’i erkek, 51’i kadındı. HSK ile non-HSK grupları karşılaştırıldığında ortalama yaş, erkek cinsiyet ve metabolik sendrom varlığı, HSK grubunda istatistiksel olarak anlamlıydı. MELD ve CHILD skorları, Uluslararası Düzeltme Oranı (International Normalized Ratio: INR) değeri, total bilirubin, kan üre azotu (Blood Urea Nitrogen: BUN) değerleri HSK grubunda daha düşük ve hemoglobin, hematokrit, Alanin Aminotransferaz (ALT), Gama Glutamil Transferaz (GGT) ve albumin değerleri HSK grubunda anlamlı derecede yüksek saptandı. Komplikasyon gelişimi yönünden karşılaştırıldığında hepatik ensefalopati, spontan bakteriyel peritonit, asit gelişimi HSK grubunda istatistiksel olarak anlamlı derecede düşüktü. ALT, artmış albümin düzeyi ve metabolik sendrom varlığının HSK oluşumunu öngördürebilecek bağımsız risk faktörü olduğu görüldü.

Sonuç: ALT, artmış albümin düzeyi, metabolik sendrom varlığı HCV bağlı siroz hastalarında HSK gelişimi için önemli birer belirteç olabilirler.

References

  • Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108
  • Chang UK, Kim MS, Han CJ, Lee DH. Clinical result of stereotactic radiosurgery for spinal metastasis from hepatocellular carcinoma: comparison with conventional radiation therapy. J Neurooncol. 2014;119(1):141-8.
  • Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer. 1999;83(6):870-3.
  • Khudoleĭ VV, Balanski RM.Tobacco smoking as a cancer risk factor. Vopr Onkol. 1989;35(11):1283-90.
  • Yeo Y, Gwack J, Kang S, Koo B, Jung SJ, Dhamala P et al. Viral hepatitis and liver cancer in Korea: an epidemiological perspective. Asian Pac J Cancer Prev. 2013;14(11):6227-31.
  • Collier J, Sherman M. Screening for hepatocellular carcinoma. Hepatology. 1998;27(1):273-8.
  • Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinomain cirrhosis: incidence and risk factors. Gastroenterology. 2004;127(5):35-50.
  • Pawlotsky JM. Pathophysiology of hepatitis C virus infection and related liver disease. Trends Microbiol. 2004;12(2):96-102.
  • Borzio M, Colloredo G, Pioltelli P, Quagliuolo M. Epidemiology and outcome of hepatocellular carcinoma in Lombardy. Dig Liver Dis. 2007;39(11):1011-7.
  • Thomas MB, Zhu AX. Hepatocellular carcinoma: the need for progress. J Clin Oncol. 2005;23(13):2892-9.
  • Gurtsevitch VE. Human oncogenic viruses: hepatitis B and hepatitis C viruses and their role in hepatocarcinogenesis. Biochemistry. 2008;73(5):504-13.
  • Colombo M, de Franchis R, Del Ninno E, Sangiovanni A, De Fazio C, Tommasini M et al. Hepatocellular carcinoma in Italian patients with cirrhosis. N Engl J Med. 1991;325(10):675-80.
  • Szalay F. A hepatitis C-vírus-fertôzés és hepatocarcinogenesis [Hepatitis C virus infection and hepatocarcinogenesis]. Orv Hetil. 2010;151(38):1524-9.
  • Murugavel KG, Mathews S, Jayanthi V, Shankar EM, Hari R, Surendran R,, et al. Alpha-fetoprotein as a tumor marker in hepatocellular carcinoma: investigations in south Indian subjects with hepatotropic virus and aflatoxin etiologies. Int J Infect Dis. 2008;12(6):71-6
  • Arhan M, Akdoğan M, İbiş M, Kılıç ZMY, Kaçar S, Tunç B, Şaşmaz N. Tek merkeze ait hepatosellüler karsinom verileri; retrospektif çalışma. Akademik Gastroenteroloji Dergisi. 2009;8(1):18-23.
  • El-Serag HB. Epidemiology of hepatocellular carcinoma. Clin Liver Dis 2001;5(1):87-107.
  • Chaudhari R, Fouda S, Sainu A, Pappachan JM. Metabolic complications of hepatitis C virus infection. World J Gastroenterol. 2021;27(13):1267-82.
  • Mahl TC. Approach to the patient with abnormal liver tests. Lippincotts Prim Care Pract. 1998;2(4):379-89.
  • Carr BI, Guerra V. Serum albumin levels in relation to tumor parameters in hepatocellular carcinoma patients. Int J Biol Markers. 2017;32(4):391-6.
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section ORIGINAL ARTICLE
Authors

Fatih Türker 0000-0002-8281-0319

Betül Çavuşoğlu 0000-0002-8041-1904

Tolga Şahin 0000-0003-1569-4941

Publication Date May 24, 2022
Acceptance Date March 28, 2022
Published in Issue Year 2022 Volume: 27 Issue: 2

Cite

Vancouver Türker F, Çavuşoğlu B, Şahin T. Hepatit C’ye bağlı siroz hastalarında hepatosellüler karsinom gelişiminde öngördürücü faktörlerin retrospektif analizi. Anatolian Clin. 2022;27(2):204-8.

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