Banu Demet COŞKUN, Eylem SEVİNÇ, EROL ÇAKMAK

Hepatosellüler karsinomlu olguların klinik olarak değerlendirilmesi

Giriş ve Amaç: Primer hepatosellüler karsinom, Türkiyede yaygındır ve prognozu oldukça kötüdür. Türkiye'deki hepatosellüler karsinom ile ilgili veriler oldukça kısıtlıdır. Gereç ve Yöntem: Bu çalışmada Ocak 2013-Aralık 2015 tarihleri arasında iki farklı merkezde hepatosellüler kanser tanısı alan 54 hastanın risk faktörleri, demografik özellikleri ve laboratuvar/radyolojik bulguları retrospektif olarak değerlendirildi. Bul- gular: Çalışmaya alınan hastaların yaş ortalaması 62,7±8,5 idi. Hasta- ların 42'si (%77,7) erkek ve 12'si (%22.3) kadın idi. Hastaların 24'ü (%44.4) hepatit B, 20'si (%37.3) hepatit C, 5'i (%9.2) hepatit B,+hepa- tit delta, 3'ü (%5.5) hepatit B,+hepeatit C, iken 2'si de (%3.7) nonal- kolik steatohepatit idi. Hastaların 47'sinde (%87) siroz vardı. Siroz olan hastaların 22'si (%46.8) Child A, 20'si (%42.5) Child B ve 5'i (%10.6) Child C idi. Olguların 13'ünde (%24.1) portal ven trombozu vardı. Has- taların 20'sinde (%37) tek kitle izlenirken, 31'sinde (%57.4) multipl kitle ve 3'ünde (%5.6) diffüz hepatosellüler karsinom izlenmiştir. Ortalama tümör çapı 10,4 cm (aralık 2-30 cm) idi. Hastaların 34'ü (%63) sempto- matik izlenirken, 10'una (%18.5) radyofrekans ablasyon, 8'ine (%14.8) kemoembolizasyon, 1'ine (%1.85) cerrahi ve 1'ine (%1.85) karaciğer transplantasyonu uygulanmıştır. Sonuç: Gelişmekte olan ülkelerde ol- duğu gibi ülkemizde de hepatosellüler karsinom etiyolojisinde viral he- patitler en önemli risk faktörüdür. Viral hepatitlere bağlı morbidite ve mortalitenin azaltılması için halkın bilinçlendirilmesi ve aşı programlarına uyumun artırılması gereklidir. Hepatosellüler karsinom geliştirme riski yüksek olan hastalar ise sıkı tarama programlarına dahil edilmelidir.

Clinical evaluation of hepatocellular carcinoma cases

Background and Aims: Primary hepatocellular cancer is common in Turkey, and its prognosis is poor. There are limited data associated with hepatocellular cancer in Turkey. Material and Methods: In the current study, clinical, demographic, and laboratory/radiologic data on 54 patients who were diagnosed with hepatocellular cancer in the De- partment of Gastroenterology of two different centers were retrospec- tively evaluated. Results: There were 54 patients (77.7% male, 22.3% female) with a mean age of 62.7±8.5 years. The etiology of hepato- cellular cancer was hepatitis B virus in 24 (44.4%) patients, hepatitis C virus in 20 (37.3%), hepatitis B virus + hepatitis D virus in 5 (9.2%), hepatitis B virus + hepatitis C virus in 3 (5.5%), and steatohepatitis in 2 (3.7%). Liver cirrhosis was present in 47 (87%) patients. Of the cir- rhotic patients, 22 (46.8%) had Child A, 22 (42.5%) had Child B, and 5 (10.6%) had Child C. Portal vein thrombosis was found in 13 (24.1%) patients. There was a single nodule in 20 (37%), multiple nodules in 31 (57.4%), and diffuse involvement in 3 (5.6%) patients. The mean tumor diameter was 10.4 cm (range 2-30 cm). Whereas 34 (63%) of the patients received symptomatic therapy, 10 patients (18.5%) were treated with radiofrequency ablation, 8 (14.8%) with chemoemboliza- tion, 1 (1.85%) with surgery, and 1 (1.85%) with liver transplantation. Conclusion: The results of this study indicate that viral hepatitis is the major risk factor for HCC in Turkey. Increased public awareness and compliance with vaccination programs are required to reduce the disas- ter of viral hepatitis. Patients at high risk for developing hepatocellular cancer should be entered into surveillance programs.

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