Joshi Nayana, Kumar Ajit, Rani M Sudha, Chandra Naval, Ramanjaneyulu E R
Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, Panjagutta, Hyderbad.
Trop Gastroenterol. 2003 Apr-Jun;24(2):73-5.
Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. Infection with the hepatitis B virus (HBV) is one of the high-risk factors for the development of HCC, particularly in Asia and Africa. Other risk factors include hepatitis C virus (HCV) infection and, to a certain extent, exposure to a liver-specific carcinogen such as aflatoxin B, and alcohol consumption. In the present retrospective study, we analysed the clinical profile and aetiological role of HBV and HCV in HCC. A total of 40 cases of HCC (33 males and 7 females, age range 22-80 years) were seen from January 1999 to June 2001 at our institute. A detailed history of age, sex, past history of liver disease, clinical symptoms and presenting complaints was recorded. The most common presenting complaints were abdominal distention, pedal oedema and pain abdomen. Underlying cirrhosis of the liver was seen in 30 cases (75%), Child's A in 6, Child's B in 11 and Child's C in 13 cases. A history of alcoholism was present in 6 patients. All the patients were tested for HBsAg and anti-HCV by ELISA. HBsAg and anti-HCV was positive in 19 (47.5%) and 8 patients (20%), respectively. The diagnosis in the majority of cases was derived by FNAC and in a few by imaging techniques plus alfa-fetoprotein (AFP) evaluation. The diagnosis was confirmed by FNAC in 34, CT scan and AFP in 2, and ultrasound abdomen and AFP in 4 cases. We conclude that viral infection (HBV > HCV) is still a major aetiological factor and the incidence of HCV infection appears to be increasing. The majority of the cases of HCC studied had a cirrhotic background.
肝细胞癌（HCC）是世界上最常见的癌症之一。感染乙型肝炎病毒（HBV）是HCC发生的高危因素之一，在亚洲和非洲尤为如此。其他危险因素包括丙型肝炎病毒（HCV）感染，以及在一定程度上接触肝脏特异性致癌物如黄曲霉毒素B和饮酒。在本回顾性研究中，我们分析了HBV和HCV在HCC中的临床特征及病因学作用。1999年1月至2001年6月，我院共收治40例HCC患者（男33例，女7例，年龄范围22 - 80岁）。记录了详细的年龄、性别、既往肝脏疾病史、临床症状及就诊主诉。最常见的就诊主诉是腹胀、足部水肿和腹痛。30例（75%）患者存在潜在肝硬化，其中Child's A级6例，Child's B级11例，Child's C级13例。6例患者有酗酒史。所有患者均通过酶联免疫吸附测定（ELISA）检测HBsAg和抗HCV。HBsAg和抗HCV阳性分别为19例（47.5%）和8例（20%）。大多数病例通过细针穿刺抽吸活检（FNAC）确诊，少数通过影像学技术加甲胎蛋白（AFP）评估确诊。通过FNAC确诊34例，CT扫描及AFP确诊2例，腹部超声及AFP确诊4例。我们得出结论，病毒感染（HBV > HCV）仍是主要病因，且HCV感染发病率似乎在上升。所研究的大多数HCC病例都有肝硬化背景。
