Etiology of premalignant diseases of liver in patients with hepatocellular carcinoma and some broading of risk group
Abstract
Aim of investigation. To assess etiological factors of hepatocellular carcinomas (HCC) and prognostic value of б-fetoprotein level in retrospective study.
Materials and methods. Case records of 103 HCC patients and 244 patients with liver cirrhosis, that underwent investigation by standard laboratory and instrumental methods were analyzed.
Results. 103 patients with HCC were investigated: in 65 (63,1 %) the tumor has developed on a background of liver cirrhosis (LC), in 38 (36,9%) – on a background of non-cirrhotic diseases. Etiology of LC, precursor of HCC included: HBV – 24,6%, HCV – 9,2%, alcohol – 53,9% of cases. In comparison to original data, published previously by same authors, decrease in number viral and increase of alcoholic LC was marked. The etiological spectrum of non-cirrhotic liver diseases as a background for HCC, was close to that in LC. 244 patients of the LC were investigated. Patients were monitored for 4,3 years. Of 55 cases with initially elevated level of b-fetoprotein HCC has developed in 11 (20,0%), of 189 patients with normal level – in 3 (1,6%).
Conclusions. Alcohol-induced LC and steatohepatites, as well as similar viral liver diseases, are risk factors of HCC and are subject to dynamic cancer surveillance. Patients of the LC with high b-fetoprotein level require especial careful observation for HCC screening at asymptomatic (early) stage.
About the Authors
A. I. PavlovRussian Federation
A. I. Khazanov
Russian Federation
S. V. Plyusnin
Russian Federation
V. A. Igonin
Russian Federation
A. P. Vasilyev
Russian Federation
S. V. Skvortsov
Russian Federation
A. N. Bobrov
Russian Federation
References
1. Блюм Х.Е. Гепатоцеллюлярная карцинома: современное состояние проблемы // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2005. – Т. 15, № 2. – С. 33–41.
2. Блюм Х.Е. Новое в диагностике и лечении гепатоцеллюлярной карциномы // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2007. – Т. 17, № 5. – С. 11–15.
3. Буеверов А.О. Злокачественные опухоли печени // Болезни печени и желчевыводящих путей: Руководство для врачей / Под ред. В.Т. Ивашкина. – Изд. 2-е., испр. и доп. – М.: Изд. «М-Вести», 2005. – С. 405–411.
4. Павлов А.И., Хазанов А.И., Плюснин С.В. и др. Гепатоцеллюлярная карцинома и этиология фоновых заболеваний печени // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2006. – Т. 16, № 2. – С. 45–48.
5. Павлов Ч.С., Ивашкин В.Т. Как оценить и уменьшить риск фиброза, цирроза и гепатоцеллюлярной карциномы у пациентов с хронической инфекцией вирусами В и С // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2007. – Т. 17, № 5. – С. 16–23.
6. Скворцов С.В., Калинин А.В. Рак печени и опухолевые маркеры // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 1997. – Т. 7, № 5 (прил. 4). – С. 159.
7. Хазанов А.И. К взаимоотношениям цирроза и цирроз-рака печени // Клин. мед. – 1977. – Т. 55, № 4. – С. 76–81.
8. Хазанов А.И. Первичный рак печени и циррозы печени // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 1999. – Т. 9, № 1. – С. 83–88.
9. Хазанов А.И., Герасимов Г.М. Диагностическое и прогностическое значение АФП-теста при раке и циррозе печени // Клин. мед. – 1986. – Т. 64, № 4. – С. 80–85.
10. Хазанов А.И., Плюснин С.В., Павлов А.И. и др. Различие в этиологической структуре циррозов и цирроз-раков печени, включая заболевания с летальным исходом у стационарных больных // Рос. мед. вести. – 2005. – Т. 10, № 3. – С. 21–27.
11. Bruix J., Sherman M., Lovet J.M. et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona – 2000/ EASL Conference // J. Hepatol. – 2001. – Vol. 35, N 3 – P. 421–430.
12. Durr R., Caselmann W.H. Carcinogenesis of primary liver malignancies // Langenbecks Arch. Chir. – 2000. – Vol. 385. – P. 154–161.
13. El-Seray H.B. Hepatocellular carcinoma and hepatitis C in the United States // J. Hepatol. – 2002. – Vol. 36. (suppl. 5). – P. 74–83.
14. Forner A., Rodriguez de Lope C., Varela M., Bruix J. Hepatocellular carcinoma. In chronic hepatitis: metabolic, cholestatik, viral and autoimmune / Eds. A.M. Diel et al. – Dordrecht: Springer, 2007. – P. 229–242.
15. Llovet J.M., Fuster J., Bruix J. The Barcelona approach: diagnosis, staging and treatment of hepatocellular carcinoma // Liver Transplant. – 2004. – Vol. 10. – P. 115–120.
16. Parkin D.M., Bray F., Ferlay J. et al. Global cancer statistics // CA Cancer J. Clin. – 2005. – Vol. 55. – P. 74–108.
17. Sangiovani A., Prati G.M., Fasani P. et al. The natural history of compensated cirrhosis due to hepatitis C virus: a 17-year cohort study of 214 patients // J. Hepatol. – 2000. – Vol. 43. – P. 1303–1310.
18. Sypsa V., Touloumi G., Papatheodiridis G.V. et al. Future trends of HCV-related cirrhosis and hepatocellular carcinoma under currently available treatments // J. Hepatol. – 2004. – Vol. 40 (suppl. 1). – P. 84.
Review
For citations:
Pavlov A.I., Khazanov A.I., Plyusnin S.V., Igonin V.A., Vasilyev A.P., Skvortsov S.V., Bobrov A.N. Etiology of premalignant diseases of liver in patients with hepatocellular carcinoma and some broading of risk group. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(6):51-56. (In Russ.)
Views:
67
JATS XML
Email this article 
