Abstract
Objective: To describe the epidemiological, clinical, biological and morphological aspects of primary liver cancer (PLC). Patients and Methods: We conducted a 38-month cross-sectional study in the Department of hepatogas-troenterology and Internal Medicine “Amitie Sino-Centrafraine” University Hospital Center in Bangui. Included in the study were all patients with a diagnosis of PLC. The PLC’s diagnostic arguments were the large tumor liver associated or not with the elevation of alpha-fetoprotein, the heteronodular liver hypervascularized on abdominal ultrasound. Data analysis was done using Epi Info 3.5.1 software. Results: We collected 115 cases of CPF among 2410 hospitalized patients (4.7%). There were 86 men and 29 women (sex ratio: 2.9). The average age was 50 years old. The main risk factors were alcohol consumption (72.2%) and chronic hepatitis B infection (67.4%). Frequent clinical signs were pain in the right hypochondrium and/or epigastric (93.86%), large tumor liver under examination (91.3%), weight loss (74.78%). The serum alpha-fetoprotein concentration was ≥ 400 ng/ml in 73% of the cases. The abdominal ultrasound found a heteronodular liver in all patients. The nodules were multiple hyperechoic in 66.1% of the cases. According to the Child-Pugh classification, the patients were classified as B (49.5%) and C (33.9%). The Okuda Classification ranked patients at stage 1 in 16.5% cases, stage 2 in 52.1% cases and stage 3 in 31.3% cases. According to the BCLC classification, 5.2% of patients were in stage A, 12.2% in stage B, 52.2 in stage C and 30.4% in stage D. Death was recorded during hospitalization in 89 cases (77.4%). Conclusion: CPF is a frequent and serious pathology in Bangui. Its diagnosis is often late, preventing curative treatment. The main causes are alcohol consumption and the hepatitis B virus. The population should be educated to reduce the incidence of this disease.
Highlights
Primary liver cancer (PLC) is a public health problem worldwide
The primary liver cancer (PLC)’s diagnostic arguments were the large tumor liver associated or not with the elevation of alpha-fetoprotein, the heteronodular liver hypervascularized on abdominal ultrasound
In sub-Saharan Africa, hepatocellular carcinoma is common in young people, most often male [5]
Summary
Primary liver cancer (PLC) is a public health problem worldwide. It is the sixth cancer in the world and the fourth leading cause of neoplastic death after cancer of the lung, colon rectum and stomach [1]. Hepatocellular carcinoma (HCC) is the most common histological form. In Congo, the HCC represents the first malignant disease and the fourth cause of hospitalizations for liver diseases [4]. In sub-Saharan Africa, hepatocellular carcinoma is common in young people, most often male [5]. The most common aetiologies of HCC are hepatitis B virus (HBV), alcohol and hepatitis C virus (HCV) [1]. In East Asia and sub-Saharan Africa, the most dominant risk factor is chronic infection with the HBV [7]. The serious nature of HCC leads us to study its epidemiological, clinical, biological and morphological characteristics in a country with limited resources, in order to contribute to the improvement of its management
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