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  1. Etiologic factors and clinical presentation of hepatocellular carcinoma : differences between cirhotic and noncirrhotic Italian patients.

    Article - En anglais

    Background

    It is not known whether the prevalence of hepatocarcinogenic factors differs between cirrhotic and noncirrhotic patients with hepatocellular carcinoma (HCC) or whether the clinical presentation of HCC in these two groups differs.

    Methods

    The prevalence of the putative etiologic factors of HCC and its clinical presentation in 373 patients with cirrhosis and 102 without cirrhosis seen from 1981 to 1992 were evaluated.

    Results

    Hepatitis C virus infection (76 vs. 48%, P=0.003) and both current (22.5 vs. 10%, P=0.007) and past (50.5 vs. 34.5%, P=0.045) hepatitis B virus infections were more common in cirrhotic than in noncirrhotic patients with HCC.

    The absence of exposure to both viruses was much less frequent in the former (7 vs. 40%, P<0.001).

    Heavy alcohol intake prevailed in patients with cirrhosis (30 vs. 16.5%, P=0.01).

    Abdominal pain was the most common presenting symptom in both groups.

    Signs of hepatic decompensation prevailed in cirrhotic patients, whereas a « toxic syndrome » dominated the clinical picture of the noncirrhotic patients.

    Conclusions

    Hepatitis viruses are associated more with carcinogenesis of the cirrhotic than of the noncirrhotic liver.

    Alpha-fetoprotein is not a sensitive neoplastic marker, particularly in noncirrhotic patients.

    In the latter, HCC appears more advanced at diagnosis and symptoms of neoplastic toxicity are prominent.

    Cancer 1995 ; 75 : 2220-32.

    Mots-clés Pascal : Hépatome, Homme, Cirrhose, Epidémiologie, Etiologie, Hépatite virale, Virose, Infection, Tabagisme, Alcoolisme, Symptomatologie, Diagnostic, Italie, Europe, Marqueur tumoral, Antigène oncofoetal, Foetoprotéine alpha, Histopathologie, Appareil digestif pathologie, Foie pathologie, Tumeur maligne

    Mots-clés Pascal anglais : Liver cell carcinoma, Human, Cirrhosis, Epidemiology, Etiology, Viral hepatitis, Viral disease, Infection, Tobacco smoking, Alcoholism, Symptomatology, Diagnosis, Italy, Europe, Tumoral marker, Oncofetal antigen, alpha-Fetoprotein, Histopathology, Digestive diseases, Hepatic disease, Malignant tumor

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0398847

    Code Inist : 002B13C01. Création : 01/03/1996.