- Email: [email protected]
Factors Affecting Serum AFP in HCC
JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY the patients it was first presentation. More than two third of patient present in advanced stage.
CONFLICTS OF INTEREST
CONFLICTS OF INTEREST
Corresponding author: Shahna S. Fathima. E-mail: [email protected]
The authors have none to declare.
The authors have none to declare.
http://dx.doi.org/10.1016/j.jceh.2016.06.120
Corresponding author: Chethan Govindaraju. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2016.06.119
16
FACTORS AFFECTING SERUM AFP IN HCC Shahna S. Fathima, G. Chethan, T.S. Prasanth, Krishnadas Devadas, Selwyn Noronha, S. Srijaya, A. Shanid, K.S. Prasanth, George Peter, Arun Iyer, B.K. Bincy, Gopu R. Babu, Ponni Krishnan, Santosh Yadav Government Medical College Hospital, Thiruvananthapuram, India
Background and Aim: Previous studies on Alpha FetoProtein (AFP) and (Hepato Cellular Carcinoma) HCC are heterogeneous as far as stage and etiology of liver disease is concerned. Consequently AFP is considered to have suboptimal performance as a diagnostic and surveillance marker. This study aims to find factors affecting serum AFP in HCC so as to find why AFP level varies in HCC. Methods: Observational retrospective study from data collected from discharge records between 2008 and 2014.117 cirrhotic HCC patients with single etiology for CLD were included. Factors affecting AFP levels in HCC were analysed with univariate and multivariate analysis. Patients were grouped into those with high and low AFP using the cut off 200. Association of age, gender CHILD status, BCLC stage, etiology, diabetes with AFP levels were assessed. Results: 117 patients were included. Chronic HBV (37.6%) was the most common cause for HCC closely followed by alcohol (28.2%). Etiology of HCC significantly affected AFP levels. HBV and alcohol associated HCC had higher levels when compared to NASH and HCV associated HCC (P < 0.01). Other factors which affected same was age, gender, diabetes (P < 0.01). Conclusion: Alcohol and HBV related HCC tends to have higher AFP (>200) values compared to HCV & NASH related HCC. Diabetics had lower AFP compared to nondiabetics in HCC. Males had higher AFP than females in HCC. Increased age was associated with higher AFP levels.
NOT ALL PERI-DUCTAL PLAQUE LIKE ENHANCEMENT IS CHOLANGIOCARCINOMA- PRIMER FOR CLINICIANS Sonal Krishan Medanta, Gurgaon, India
Background and Aim: The early diagnosis of periductal infiltrating cholangiocarcinoma can be very difficult because this entity may begin as a benignlooking stricture. The correct diagnosis of peribiliary cholangiocarcinoma depends on differentiating the benign focal stricture from a true malignancy. The aim of this retrospective review was differentiating periductal plaque like cholangiocarcinoma from the benign stricture and identifying any discriminant CT/MR findings. Methods: All histopathologically proven cases of benign lesions/malignant periductal infiltrating cholangiocarcinoma presenting at our institution from January 2012 to 1st January 2015 were retrospectively analysed by two blinded readers. Cases were evaluated for length of stricture, intra/ extrahepatic stricture, multifocality, regularity of margin, asymmetric narrowing, ductal enhancement, and lymph node enlargement as well as any periductal soft-tissue lesion. Simple descriptive statistics was used to describe the findings. Spectrum of imsging of benign pathologies was also evaluated. Results: Isolated short segment asymmetric irregular stricture with small soft tissue was most predictive of malignancy. Multifocal long segment stricture without marginal irregularity or soft tissue was most predictive of benign findings. Conclusion: Not all cases of peri-ductal plaque like enhancement are cholangiocarcinomas the radiologist in tandem with the referring clinician must also evaluate the pattern and morphology of the stricture for distinguishing benign from malignant strictures.
Journal of Clinical and Experimental Hepatology | July 2016 | Vol. 6 | No. S1 | S63–S73
S71
Neoplasms
15
CONFLICTS OF INTEREST
CONFLICTS OF INTEREST
Corresponding author: Shahna S. Fathima. E-mail: [email protected]
The authors have none to declare.
The authors have none to declare.
http://dx.doi.org/10.1016/j.jceh.2016.06.120
Corresponding author: Chethan Govindaraju. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2016.06.119
16
FACTORS AFFECTING SERUM AFP IN HCC Shahna S. Fathima, G. Chethan, T.S. Prasanth, Krishnadas Devadas, Selwyn Noronha, S. Srijaya, A. Shanid, K.S. Prasanth, George Peter, Arun Iyer, B.K. Bincy, Gopu R. Babu, Ponni Krishnan, Santosh Yadav Government Medical College Hospital, Thiruvananthapuram, India
Background and Aim: Previous studies on Alpha FetoProtein (AFP) and (Hepato Cellular Carcinoma) HCC are heterogeneous as far as stage and etiology of liver disease is concerned. Consequently AFP is considered to have suboptimal performance as a diagnostic and surveillance marker. This study aims to find factors affecting serum AFP in HCC so as to find why AFP level varies in HCC. Methods: Observational retrospective study from data collected from discharge records between 2008 and 2014.117 cirrhotic HCC patients with single etiology for CLD were included. Factors affecting AFP levels in HCC were analysed with univariate and multivariate analysis. Patients were grouped into those with high and low AFP using the cut off 200. Association of age, gender CHILD status, BCLC stage, etiology, diabetes with AFP levels were assessed. Results: 117 patients were included. Chronic HBV (37.6%) was the most common cause for HCC closely followed by alcohol (28.2%). Etiology of HCC significantly affected AFP levels. HBV and alcohol associated HCC had higher levels when compared to NASH and HCV associated HCC (P < 0.01). Other factors which affected same was age, gender, diabetes (P < 0.01). Conclusion: Alcohol and HBV related HCC tends to have higher AFP (>200) values compared to HCV & NASH related HCC. Diabetics had lower AFP compared to nondiabetics in HCC. Males had higher AFP than females in HCC. Increased age was associated with higher AFP levels.
NOT ALL PERI-DUCTAL PLAQUE LIKE ENHANCEMENT IS CHOLANGIOCARCINOMA- PRIMER FOR CLINICIANS Sonal Krishan Medanta, Gurgaon, India
Background and Aim: The early diagnosis of periductal infiltrating cholangiocarcinoma can be very difficult because this entity may begin as a benignlooking stricture. The correct diagnosis of peribiliary cholangiocarcinoma depends on differentiating the benign focal stricture from a true malignancy. The aim of this retrospective review was differentiating periductal plaque like cholangiocarcinoma from the benign stricture and identifying any discriminant CT/MR findings. Methods: All histopathologically proven cases of benign lesions/malignant periductal infiltrating cholangiocarcinoma presenting at our institution from January 2012 to 1st January 2015 were retrospectively analysed by two blinded readers. Cases were evaluated for length of stricture, intra/ extrahepatic stricture, multifocality, regularity of margin, asymmetric narrowing, ductal enhancement, and lymph node enlargement as well as any periductal soft-tissue lesion. Simple descriptive statistics was used to describe the findings. Spectrum of imsging of benign pathologies was also evaluated. Results: Isolated short segment asymmetric irregular stricture with small soft tissue was most predictive of malignancy. Multifocal long segment stricture without marginal irregularity or soft tissue was most predictive of benign findings. Conclusion: Not all cases of peri-ductal plaque like enhancement are cholangiocarcinomas the radiologist in tandem with the referring clinician must also evaluate the pattern and morphology of the stricture for distinguishing benign from malignant strictures.
Journal of Clinical and Experimental Hepatology | July 2016 | Vol. 6 | No. S1 | S63–S73
S71
Neoplasms
15