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Hepatocellular carcinoma in Karachi.
H Qureshi1, S J Zuberi, N A Jafarey
1Pakistan Medical Research Council, Research Centre, Basic Medical Sciences Institute (Pathology), Karachi.
Journal of Gastroenterology and Hepatology
|January 1, 1990
Summary
Hepatocellular carcinoma (HCC) in Karachi is strongly linked to Hepatitis B virus (HBV) infection and aflatoxin exposure. Most patients presented with a mass and pain, and tragically, nearly all died within six months.
Area of Science:
- Hepatology
- Oncology
- Epidemiology
Background:
- Hepatocellular carcinoma (HCC) is a significant global health concern.
- Understanding etiological factors and clinical presentation is crucial for effective management.
- Karachi, Pakistan, presents a unique demographic for studying HCC.
Purpose of the Study:
- To define the clinical presentation of HCC in Karachi.
- To investigate potential etiological factors contributing to HCC occurrence.
- To analyze survival rates and histopathological findings.
Main Methods:
- Retrospective analysis of 366 histologically confirmed HCC cases over 16 years.
- Clinical data collection including demographics, presenting features, and history.
- Laboratory investigations: alpha-Fetoprotein (AFP) levels, Hepatitis B surface antigen (HBsAg), anti-Hepatitis B core (anti-HBc), anti-delta, and aflatoxin contamination assessment.
Main Results:
- Maximum HCC frequency observed in the 51-60 age group (male to female ratio 2.5:1).
- Key presenting features included right hypochondrial mass (85%) and pain (79%).
- High positivity rates for HBsAg (60% by RIA) and anti-HBc (60%), with 41% anti-delta positive.
- Significant association suggested between HCC, HBsAg, and aflatoxin contamination (10-17% in Karachi).
- 73% of HCC cases were trabecular type; 1.2% mortality within 6 months.
Conclusions:
- Hepatitis B virus infection and aflatoxin exposure are likely major contributors to HCC in Karachi.
- Early detection and intervention strategies targeting these factors are warranted.
- The high mortality rate underscores the aggressive nature of HCC and the need for improved outcomes.