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

Yıl 2022, Cilt: 27 Sayı: 2, 204 - 208, 24.05.2022

Fatih Türker Betül Çavuşoğlu Tolga Şahin

https://doi.org/10.21673/anadoluklin.1066158

Öz

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.

Anahtar Kelimeler

hepatitis C;, hepatocellular carcinoma, liver cirrhosis

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

Öz

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.

Anahtar Kelimeler

hepatit C;, hepatosellüler karsinom, karaciğer sirozu

Kaynakça

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