Mean Age Of Hepatocellular Carcinoma Patients Research Articles

Epidemiology of liver cancer in Nile delta over a decade: A single-center study.

Background:In Egypt, there has been a remarkable increase in the proportion of hepatocellular carcinoma (HCC) among chronic liver diseases patients. This rising proportion may be explained by the increasing risk factors as hepatitis C virus (HCV) infection, hepatitis B virus (HBV) infection, improvement of the diagnostic tools of HCC as well as the extended survival among patients with cirrhosis to allow time for some of them to develop HCC. The aim of this study was to study the epidemiology of HCC in Nile delta over the last decade.Methods:The study was carried out on patients diagnosed as HCC in liver cancer clinic in Tanta University Hospital, Egypt, from January 2005 to January 2015. This retrospective study reviewed the files of HCC patients with special stress on age, sex, residence, occupation, smoking, and viral markers.Results:Over the last decade, 1440 HCC patients were diagnosed or referred to liver cancer clinic in Tropical Medicine Department in Tanta University Hospital from January 2005 to January 2015. The mean age of HCC patients was 56.13 ± 9.53 years. Nearly, half of the patients with HCC were smokers and quarter of HCC patients were diabetics. HBV surface antigen-positive patients were only 3.26%, and the majority of patients were HCV-Ab positive (94.86% of patients).Conclusions:In Nile delta, hepatitis C rather than hepatitis B was linked to the development of HCC in our region which may be related to the high prevalence of HCV in this area.

AFLATOXIN AS AN ENVIRONMENTAL RISK FACTOR ATTRIBUTABLE TO LIVER CANCER IN NILE DELTA

Background and Aim: The burden of hepatocellular carcinoma (HCC) has been increasing in Egypt. This fact raises the question, does the high prevalence of HCC in Egypt is related only to HCV? or is it augmented by AFB1 exposure in our patients? The aim of this study was to identify the role of aflatoxin as an environmental risk factor attributable to liver cancer in Nile delta in Egypt. Patients and Methods: This cross sectional study was carried out in tropical medicine department in Tanta university hospital on 160 patients with HCC, 80 cirrhotic patients. Sixty individuals were invited to share in the study as a control group. All patients and control were evaluated for age, sex, residence, occupation, viral markers, liver functions and serum level of aflatoxinB1. Results: Aflatoxin level in serum was significantly higher in HCC patients when compared to cirrhotics and to controls. The mean age of HCC patients was 58.575 ± 9.583 years. HCC was much higher in males than females with male to female ratio 4.7:1. Concerning smoking, 45% of HCC patients were smokers. DM was diagnosed in 42.5% of HCC cases. Anti HCV-Ab was present in 95% of HCC cases. Conclusions: Environmental aflatoxin seems to be a major risk factor for HCC in Nile delta. The high prevalence of HCC in Nile delta in Egypt is related to HCV and it is augmented by AFB1 exposure.

Characteristics Features of Hepatocellular Carcinoma in Bangladesh and their Public Health Implications

Background/Objectives: In spite of being a common cancer, little is known about clinical presentation, etiological factors and prognosis of hepatocellular carcinoma (HCC) in Bangladesh. Accordingly, early detection and efficient management of HCC is not available at this country. Materials and methods: Demographical data, etiological factors and clinical presentations of 57 consecutive patients with HCC were analyzed prospectively at the only medical university of Bangladesh. Results: Ninety-one percent patients with HCC were male. The mean age of HCC patients was 45.8 years (standard deviation: 15.3 years; range: 18-75 years). All patients were symptomatic when they first appeared to the physicians, and many of them were unaware that they had been suffering from liver diseases. Hepatitis B surface antigen was detected in 62% and antibody to hepatitis C virus was found in 6% patients with HCC. Most of the patients with HCC had liver cirrhosis (77%). Single HCC nodule was detected in 61% patients. Sixty-four percent patients had intermediate stage of liver cancer. Conclusion: Containment of HCC-related morbidity and mortality and better prognosis of HCC in Bangladesh depends on early diagnosis of hepatitis viruses.

Mo1899 Hepatocellular Carcinoma Among the Golestan Cohort Study Participants Infected With Hepatitis B Virus: A Population-Based Study

Background and Aim: Hepatitis B virus (HBV) infection is the most common cause of cirrhosis and end-stage liver disease in Golestan province, Northeast Iran where 95% of HBV is of the genotype D. Hepatocellular carcinoma (HCC) is not amongst the 10 most common cancers according to the Golestan Cancer Registry. We aimed to prospectively evaluate the incidence of HBV-associated HCC in the Golestan Cohort Study (GCS) participants. Methods: We evaluated 49,338 participants of the GCS who have been systematically followed up from 2004 2011 with the follow up success rate of 98%. All participants were tested for HBsAg and HCVAb. Subsequently, HBsAg positive individuals and their family members were tested for HBsAg, HBsAb, and HBcAb. In case of hospitalization or death, participants or their family members and the corresponding medical centers were contacted. Diagnosis of HCC was independently made by reviewing the documents and ‘verbal autopsy' forms by two internists. Disagreements were resolved by a senior hepatologist. Results: 74.4% of the participants of the GCS are of Turkmen ethnicity and 57.6% are female. Overall, 3502 (7.1%) HBV, 155 (0.3%) HCV, and 26 HBV/HCV co-infection cases were identified. 1931 (55.2%) cases of HBV infected population were male. The mean age of HBV infected participants was 57 years (range 43 82). The participants were followed up for 21012 person-years (average of 6 years). Overall, 12 (0.03%) individuals (11 male, 1 female) developed HCC; 9 of whom were HBV infected. The mean age of HCC patients was 68 years (range 49-79). The other 3 cases of HCC were not associated with either HBV or HCV infection. After 6 years of follow up, 9 (0.25%) of HBV infected participants developed HCC with the overall incidence of 0.42 per 1000 person-years. Conclusion: Despite the intermediate prevalence rate of HBV in our study population (7.1%), we found a very low incidence of HBV (D genotype)-induced HCC.

Value of serum anti-p53 antibodies as a prognostic factor in Egyptian patients with hepatocellular carcinoma

Objectivep53 antigen is an oncoprotective antigen and when damaged, leads to production of anti-p53 and also predisposes to various cancers, including hepatocellular carcinoma (HCC). Serum anti-p53 has been proven to have a prognostic value in patients with HCC. The objective of this study was to determine the prevalence and prognostic utility of serum anti-p53 in Egyptian patients with HCC. MethodsForty one patients with HCC, 26 patients with liver cirrhosis and 29 healthy controls were included in this study. For all the studied groups, we studied the clinical data, abdominal ultrasound (US) findings, biochemical liver function tests, serum alpha-fetoprotein (AFP) levels detected by enzyme immunoassay (EIA) kit and anti-p53 antibody levels by a modified enzyme-linked immunosorbent assay (ELISA). The severity of liver disease was assessed by Child–Pugh and MELD scores. Tumor characteristics were detected by (US) with or without computed tomography (CT) scan. These characteristics included tumor size, number and site. Tumor staging was done using Okuda, Cancer Liver Italian Program (CLIP) and Tokyo staging systems. Also, the overall survival of patients with HCC with reference to p53 antibody level was studied. ResultsThe mean age of HCC patients was 57.95±8.41. There was a male predominance among HCC patients with male-to-female ratio of 3.6:1. Anti-p53 antibodies were detected in the sera of 68.3% of HCC patients, 50% of liver cirrhosis patients and 17.2% of healthy control subjects. The data showed that HCC patients had a significantly higher mean anti-p53 antibody values (p=0.0001), than both liver cirrhosis patients and healthy control groups. Our results revealed that anti-p53 has a positive significant correlation with AFP (p=0.002), severity of liver disease [Child Pugh score (p=0.02) and MELD score (p=0.0003)], tumor size (p<0.0001), tumor number (p=0.003) and tumor staging systems [Okuda (p=0.04), CLIP (p=0.006) and Tokyo (p<0.0001)]. Also, our results revealed that serum anti-p53 antibodies had a significant association with overall survival of patients with HCC (p=0.019) with a shorter survival time in anti-p53 positive status patients and with higher anti-p53 antibody levels within 19 months follow up. ConclusionThe detection of anti-p53 antibodies may be suitable for assessing the prognosis of HCC patients. The higher percentage of positivity of anti-p53 antibodies in Egyptian control subjects than reported elsewhere needs further thorough investigation.

Hepatitis B Virus Genotypes and Hepatocellular Carcinoma in Japan

Hepatitis B virus (HBV) is one of the major causative agents of hepatocellular carcinoma (HCC) in Southeast Asia where HBV genotype B (HBV/B) and genotype C (HBV/C) are prevalent. Clinical and virological differences were evaluated between HCC patients in Japan and Taiwan, all of whom were infected with HBV/B and HBV/C. In Japan, the prevalence rates of HBV/B and HBV/C were 12 and 85%, respectively, in patients with chronic HBV infection, which is similar to those of 13 and 86% in patients with HCC. In the HCC patients with HBV/B, the mean age was 70 years and higher than that of 55 years in those with HBV/C. In Taiwan, however, HBV/B was detected in 61% and HBV/C in 31% of patients with HCC. Furthermore, the mean age of HCC patients with HBV/B in Taiwan was 50 years and younger compared to the 59 years of those with HBV/C. These differences may be explained by a distinct distribution of subtypes of HBV/B between the two countries. In Taiwan as well as in most Asian countries only the subtype Ba of HBV/B is found, while the majority of Japanese patients with HBV/B have the subtype Bj. Although the risk factors associated with HCC should be investigated with respect to host and environmental factors, the differences in genotypes and subtypes of HBV would need to be taken into consideration in etiological and clinical studies on HCC.

Alpha 1-antitrypsin in patients with hepatocellular carcinoma and chronic active hepatitis.

Forty-seven Italian patients suffering from hepatocellular carcinoma (HCC) and 58 patients with chronic active hepatitis (CAH) were screened for alpha 1-antitrypsin (alpha 1 AT) levels and types and compared with a previously screened healthy Italian population. Serum alpha 1 AT concentrations were significantly raised among the HCC patients compared to the controls, whereas the CAH group showed no differences. The incidence of non-M phenotypes (MS, MZ and S) is significantly higher in patients with HCC than in the CAH group and the controls. The mean age of HCC patients with a non-M phenotype is significantly lower than the mean age of HCC patients with an M phenotype.