Turcanu Adela, Pitel Ecaterina, Dumbrava Vlada-Tatiana, Tcaciuc Eugen, Donscaia Ana, Peltec Angela, Pineau Pascal
Department of Gastroenterology, Nicolae Testemitanu State University of Medicine and Pharmacy, Bd. Stefan cel Mare 165,Chisinau, Republic of Moldova.
Institute of Oncology of the Republic of Moldova, str. Testemitanu 30,Chisinau.
Rom J Intern Med. 2019 Mar 1;57(1):37-46. doi: 10.2478/rjim-2018-0026.
Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital.
A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation.
The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases.
The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.
摩尔多瓦是欧洲男女肝细胞癌（HCC）发病率最高的国家。然而，该国尚无全面描述HCC临床表现和危险因素的数据。我们决定分析摩尔多瓦首都基希讷乌一家三级医疗机构最近收治的HCC病例。
对148例原发性肝肿瘤（包括139例HCC）进行回顾性分析，以了解其人口统计学特征、血清学和生化数据以及临床表现。
患者的平均年龄为59±10岁（范围：19 - 66岁），男女比例为1.9。83%的病例肿瘤出现在晚期肝硬化上，36%的患者在诊断时肿瘤由多个结节组成。76%的病例血清甲胎蛋白超过10ng/mL。34%的病例同时发现肝肿瘤和肝炎。超过81%的肝细胞癌与至少一种肝炎病毒有关。丙型肝炎病毒携带者占主导（55%的病例），高于乙肝病毒表面抗原血清阳性患者（36%）。后者中有一半还感染了丁型肝炎病毒。总的来说，24%的病例存在双重感染，7%的病例存在三重感染。
在摩尔多瓦，肝炎病毒感染负担尤为严重，这与南半球国家常见的情况相符。摩尔多瓦应迅速实施一项针对HCC高危人群（>50岁）的持续性肝脏感染筛查积极政策，并对检测呈阳性的病例分发抗病毒药物，以降低原发性肝癌的发病率。
