Abstract
to correlate clinical and epidemiological data with the pathological analysis of liver explants from patients undergoing liver transplantation for hetapocarcinoma in the UNICAMP HC and to verify whether the MELD and MELD-Na scores are reliable factors to predict a worse post-transplant prognosis. we studied liver transplants carried out between May 2010 and November 2017. After excluding 38 patients, we included 87, analyzing clinical and laboratory data for correlation with the outcome Microvascular Invasion (MVI). Subsequently, we computed the MELD and MELD-Na scores and performed a descriptive analysis of clinical and laboratory data and, finally, calculated ROC curves to assess the association between these laboratory parameters and mortality in these patients. most patients were male (78.30%), with an average age of 58.53 years. Most liver diseases were caused by HCV (53.26%). We found no predictors for MVI among the laboratory parameters. The ROC curves for death identified the MELD score as the cutoff point with the highest combined sensitivity (90.91%) and specificity (37.50%), with a value of 10 points, whereas in the MELD-Na the cutoff point was 7 points, with a sensitivity of 90.91% and a specificity of 33.33%, both scores being significant. there were no reliable predictors of MVI between clinical, laboratory, and epidemiological variables. The MELD-Na score is more sensitive than the MELD one for predicting mortality in patients undergoing liver transplantation.
Highlights
The World Health Organization (WHO) estimates that in 2030, one million people will die from liver cancers worldwide[1]
The development of Hepatocellular carcinoma (HCC) is related to risk factors that substantially increase the probability of occurrence of this cancer, such as hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease (ALD), non alcoholic fatty liver disease (NAFLD), and cirrhosis due to any etiology[5,7]
Clinical impact of the Model for End Liver Disease (MELD) score on the presence of microvascular invasion and on the postoperative outcome in patients undergoing liver transplantation go through the stage of liver fibrosis before culminating in hepatocellular carcinoma, which does not exclude the possibility of direct evolution to HCC, though[8]
Summary
The World Health Organization (WHO) estimates that in 2030, one million people will die from liver cancers worldwide[1]. Hepatocellular carcinoma (HCC), the most prevalent type of primary malignant liver tumors, is one of the biggest world health problems and has been increasing in incidence[2,3,4]. The development of HCC is related to risk factors that substantially increase the probability of occurrence of this cancer, such as hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease (ALD), non alcoholic fatty liver disease (NAFLD), and cirrhosis due to any etiology[5,7]. One quarter of adults with NAFLD have non-alcoholic steatohepatitis (NASH), which usually leads to progressive liver fibrosis, cirrhosis, and eventually evolves to hepatocellular carcinoma[11,12,13]
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