Hepatocellular carcinoma: Clinical, aetiological and pathological features in British patients

✍ Scribed by Arthur A. Dunk; Haris Spiliadis; Sheila Sherlock; Martin J. F. Fowler; Jon P. Monjardino; Peter J. Schruer; Howard C. Thomas

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: French
• Weight: 824 KB
• Volume: 41
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/ijc.2910410105

✦ Synopsis

We have examined the clinical, prognostic, aetiological and pathological features of 41 consecutive British patients with hepatocellular carcinoma (HCC). Presenting symptoms were often vague, and patients were generally in poor condition at diagnosis, 5 6 1 being of W H O grade 2 performance score or higher. Ascites (46Oh) and jaundice (35%) were often present at diagnosis, and the median duration of survival from diagnosis was only 6 weeks. Only initial performance grade @<O.OOOI) and serum bilirubin concentration @ = 0.02) significantly affected prognosis. Serum alphafoetoprotein (AFP) was positive by counter-immune electrophoresis in only 34%. but increased to 68% when radioimmunoassay was used. Cirrhosis was present in 33 patients (80%) and was most often cryptogenic (12) or alcoholic (7) in origin. Serum HB,Ag was detected in 5 patients (12%) and, of the remainder tested, 21 O/ o had serological evidence of past HBV exposure. None of 8 serum HB,Ag-negative tumour specimens had detectable HBV-DNA integration into the tumour cell genome. Livercell dysplasia was noted in 56% of patients with liver biopsies predating the diagnosis of HCC, and in 78% of biopsies taken at the time of HCC diagnosis. The commonest histological pattern was trabecular (71 %). Other forms were rare; the fibrolamellar pattern was only seen in 2 patients. 4To whom reprint requests should be sent, at the Gastroenterology Research Unit, Room 11055, 1st Floor, Phase 1, Royal Infirmary, Foresterhill,