Department of Internal Medicine and Hepatogastroenterology, Hôpital Principal de Dakar, Dakar, Senegal.
Department of Medical Biology, Hôpital Principal de Dakar, Dakar, Senegal.
Pan Afr Med J. 2021 Jan 28;38:99. doi: 10.11604/pamj.2021.38.99.25195. eCollection 2021.
Hepatocellular carcinoma (HCC) is a major public health problem in Senegal, and the third most common cancer in terms of incidence. However, there are no recent data on the characteristics of this pathology in our country. The aim was to describe the epidemiological, clinical, aetiological and therapeutic aspects of HCC at Hôpital Principal de Dakar, Senegal. We did a descriptive retrospective study, including patients hospitalized from January 2012 to December 2017. We included 229 patients. The mean age was 47.4 years (21 - 88 years), and 77 patients (33.6%) were under 40 years of age. The sex ratio was 6.6. Twelve patients (5.2%) had a family history of 1 degree cirrhosis or HCC. Ten patients (4.4%) were previously treated with nucleotide analogues. The most common clinical sign at diagnosis was abdominal pain (91.7%). Alpha-fetoprotein level was normal in 12.2% of patients, and greater than 400 ng/ml in 68.1% of cases. Abdominal ultrasound found nodular HCC in 122 patients (68.2%), infiltrative HCC in 19 patients (10.6%), and was normal in 38 cases (21.2%). Subjacent cirrhosis was detected in 71.3% of cases. Abdominal computed tomography (CT) scan showed compatible HCC lesions in 88.8% of cases. A histological diagnosis was obtained in 2 patients (0.9%). The most common etiological factor was hepatitis B virus (69.4%), characterized mostly by a younger age (p = 0.001). In 20.9% of cases, no aetiology was found. An advanced or terminal stage (BCLC C/D) was found in 217 cases (94.8%). The treatment was curative in 12 patients (5.2%), and palliative in 7 cases (3.1%). The evolution at one year was favourable in 6 patients (2.6%). Hepatocellular carcinoma (HCC) is a disease that mainly affects young male adults in Senegal. The main aetiological factor remains HBV infection. The diagnosis is made at an advanced stage and the prognosis very bad.
肝细胞癌（HCC）是塞内加尔的一个主要公共卫生问题，也是发病率方面的第三大常见癌症。然而，目前尚无关于我国这种病理学特征的最新数据。目的是描述塞内加尔达喀尔主要医院 HCC 的流行病学、临床、病因和治疗方面的特征。我们进行了一项描述性回顾性研究，包括 2012 年 1 月至 2017 年 12 月住院的患者。共纳入 229 例患者。平均年龄为 47.4 岁（21-88 岁），77 例（33.6%）年龄小于 40 岁。男女比例为 6.6。12 例（5.2%）患者有 1 级肝硬化或 HCC 的家族史。10 例（4.4%）患者曾接受核苷酸类似物治疗。诊断时最常见的临床症状是腹痛（91.7%）。12.2%的患者甲胎蛋白水平正常，68.1%的患者甲胎蛋白水平大于 400ng/ml。腹部超声在 122 例（68.2%）患者中发现结节性 HCC，在 19 例（10.6%）患者中发现浸润性 HCC，在 38 例（21.2%）患者中发现正常。71.3%的患者发现潜在肝硬化。腹部计算机断层扫描（CT）显示 88.8%的病例符合 HCC 病变。2 例（0.9%）患者获得组织学诊断。最常见的病因是乙型肝炎病毒（69.4%），其特征主要是年龄较小（p=0.001）。在 20.9%的病例中，未发现病因。217 例（94.8%）患者为晚期或终末期（BCLC C/D）。12 例（5.2%）患者接受了治愈性治疗，7 例（3.1%）患者接受了姑息性治疗。1 年后病情好转的有 6 例（2.6%）。肝细胞癌（HCC）是一种主要影响塞内加尔年轻成年男性的疾病。主要病因仍然是乙型肝炎病毒感染。诊断时已处于晚期，预后非常差。
