Ziada Dina H, El Sadany Sherif, Soliman Hanan, Abd-Elsalam Sherief, Salama Marwa, Hawash Nehad, Selim Amal, Hamisa Manal, Elsabagh Hala M
Tropical Medicine, Faculty of Medicine, Tanta University, Egypt.
Tropical Medicine, Faculty of Medicine, Tanta University, Egypt; Faculty of Medicine, King Abdulaziz University KSA, Egypt.
J Egypt Natl Canc Inst. 2016 Dec;28(4):257-262. doi: 10.1016/j.jnci.2016.06.001. Epub 2016 Jul 1.
Hepatocellular carcinoma (HCC) has an increasing incidence worldwide. In this study we aimed to assess the prevalence of HCC among HCV patients in our center in Mid Delta, Egypt.
During the period between April 2013 and January 2015, we screened sequentially chronic HCV patients attending inpatient wards or outpatient Clinic of Tropical Medicine Department in Tanta University Hospital for HCC. Individuals with focal lesion in Ultrasound (US) and/or serum α-fetoprotein (AFP) level >200ng/ml were examined by triphasic computed tomography scanning (CT), and/or magnetic resonance imaging (MRI).
Among 514 HCV patients interviewed and accepted sharing in this study, 90 (17.5%), 144 (28%), and 280 (54.5%) were Child A, B, and C, respectively. We found that 108/514 patients (21%) had focal lesion detected by US. Also, 89/514 (17.3%) had elevated AFP >200, 13 of them (14.6%) had no focal lesion on US, but further work up showed HCC in 2 of them. Overall HCC diagnosis was confirmed in 103 cases, 94 of them (91.3%) were Child B or C. Occurrence of HCC was significantly higher in smokers, diabetics, patients with decompensated liver and those with positive family history of HCC. Only 20/103 (19.4%) were candidates to curative treatments, 8 of them were Child A asymptomatic and discovered accidentally during screening.
The high prevalence of HCC in our HCV patients (22%) was mainly associated with decompensated cirrhosis. A national surveillance program for the detection of HCC in cirrhotic HCV Egyptian patients by combining ultrasound examination and AFP is highly recommended.
肝细胞癌（HCC）在全球的发病率呈上升趋势。本研究旨在评估埃及中部三角洲我们中心丙肝患者中HCC的患病率。
在2013年4月至2015年1月期间，我们对坦塔大学医院热带医学科住院病房或门诊的慢性丙肝患者进行了HCC的序贯筛查。超声（US）检查有局灶性病变和/或血清甲胎蛋白（AFP）水平>200ng/ml的个体接受了三期计算机断层扫描（CT）和/或磁共振成像（MRI）检查。
在接受访谈并同意参与本研究的514例丙肝患者中，分别有90例（17.5%）、144例（28%）和280例（54.5%）为Child A、B和C级。我们发现514例患者中有108例（21%）通过超声检测到局灶性病变。此外，89/514（17.3%）的AFP升高>200，其中13例（14.6%）超声检查无局灶性病变，但进一步检查发现其中2例患有HCC。共确诊103例HCC病例，其中94例（91.3%）为Child B或C级。吸烟者、糖尿病患者、失代偿性肝病患者以及有HCC家族史阳性的患者HCC的发生率显著更高。仅20/103（19.4%）例适合进行根治性治疗，其中8例为无症状的Child A级，在筛查时意外发现。
我们的丙肝患者中HCC的高患病率（22%）主要与失代偿性肝硬化有关。强烈建议通过结合超声检查和AFP对埃及丙肝肝硬化患者进行全国性HCC监测计划。
