Management in Health, Vol 18, No 3 (2014)

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CONTROVERSIES IN DIAGNOSIS AND MANAGEMENT OF HEPATOCELLULAR CARCINOMA

Ruxandra OPRIȚĂ

Abstract


INTRODUCTION

Evolution of patients with advanced HCC is generally bleak, so early diagnosis is crucial to provide effective therapy. Early detection of hepatocellular carcinoma is the result of screening protocols applied to high-risk patients, including those patients with viral cirrhosis (eg HBV, HCV), hemochromatosis, alpha 1-antitrypsin deficiency or alcohol drinkers.

THE AIM of the study was to highlight the important role of early  imaging diagnosis of HCC in the management of patients with HCC. 

MATERIALS AND METHODS

The group of patients studied was represented by patients of the Clinic of Gastroenterology of Emergency Clinical Hospital “Floreasca” Bucharest, for a period of two years (2007-2009). They included 79 patients aged between  32 years old and 82 years old  (60.22 ± 10.66 years) of which 54 males and 25 females.

RESULTS

Of the group of 79 patients, 68 (86.1%) had cirrhosis of the liver, a total of 9 (11.4%) with chronic hepatitis without cirrhosis, and a number of  2(2.5%) did not have hepatitis . Child-Pugh stage B was the highest among patients with liver cirrhosis. Etiologic factor was, in most cases, chronic HBV viral infection (30.4%) and HCV (56.96%), 2 patients infected with the dual viruses of hepatitis (HBV + HCV), and 10 patients had mixed etiology : B virus and ethanol.

The vast majority of lesions were located in the right lobe (34 cases, 43.04%) and left + right (36 cases, 45.57%). A total of 7 patients (8.86%) had no liver nodules, but all showed parenchymal fibrosis. In a large number of cases (30 patients, representing 38%)  we found liver multinodular appearance.

 

Keywords: hepatocellular carcinoma, diagnosis, screening, prevention programs, costs

 


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