TUNCER TEMEL, Ugur BİLGE, Ayşegül ÖZAKYOL HARMANCI

Hepatosellüler Karsinomlu Hastaların Geriye-Dönük Değerlendirilmesi-Tek Merkez Deneyimi

Amaç: Primer karaciğer kanserleri, dünyada en sık ve en ölümcül tümörlerden birisidir. Hepatosellüler formları tüm primer karaciğer tümörlerinin yaklaşık %80’idir. Bu çalışmada amacımız kliniğimize başvuran hepatosellüler kanserli olguların retrospektif değerlendirmesini yapmaktır. Yöntem: Öncelikle hepatosellüler karsinomalı her birey, tanı koyma aşamasında ve hepatosellüler karsinoma gelişimi döneminde var olan viral hepatit serolojisi yönünden ve antiviral tedavi alıp almadıkları yönünden incelendi. Sirotik hastalarda Child-Pugh evresi, non-sirotik vakalarda viral hepatitin evresi ve yaşam beklentisi bilinen hastalarda ortalama yaşam beklentisi değerlendirildi. Alfa-feto protein, kompüterize tomografi, ultrason ve manyetik rezonans görüntüleme bulguları retrospektif olarak değerlendirildi. Alfa-feto Protein seviyeleri ve tümör sayıları arasında ki ilişki istatistiksel olarak araştırıldı. Bulgular: Toplam 69 hasta değerlendirildi. Başvurudaki ortalama yaş değerleri 62,8 (25-80 yaş) yıldı. Ortalama yaşam beklentisi tüm hastalar için 7,0 ay (0-145 ay) olarak hesaplandı. 18 hasta (%41,9) Child-Pugh sınıf A, 12 (%27,9) hasta ChildPugh sınıf B ve 13 hasta (%30,2) Child-Pugh sınıf C olarak değerlendirildi. Aşırı alfa-feto protein seviyesi (>200 ng/ml) olan hastalarda multipl karaciğer kitlesine rastlanma riski 4 kat (OR: 4,05, %95 CI: 1,22-13,42) daha yüksek bulundu. Karaciğer kitlesini hepatosellüler karsinom olarak tanımlamada ki etkilerine bakıldığında tanısal etkinlik kompüterize tomografide %54,3, manyetik rezonans görüntülemede ise %55,8 olarak bulundu. Sonuç: Sonuç olarak hepatosellüler karsinom tanısı laboratuvar ve görüntüleme teknikleri ile konur. Alfa-feto protein seviyeleri bu hastaların takibinde ve çoklu kitleleri tanımlamada önemlidir

Anahtar Kelimeler:

Hepatosellüler Karsinom, Alfa-Feto Protein, Görüntüleme, Retrospektif

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Objective: Primary liver cancer is one of the most common and lethal type of tumors in the world. Hepatocellular forms compose about 80% of all primary liver tumors. Our aim is to evaluate the patients with hepatocellular carcinoma admitted to our clinic retrospectively. Methods: First we identified viral hepatitis serology and whether antiviral treatment was administered before the diagnosis and the period until the development of hepatocellular carcinoma for each case with hepatocellular carcinoma. Child-Pugh stage in cirrhotic cases, the stage of viral hepatitis in non-cirrhotic cases, and the treatment method suggested for hepatocellular carcinoma and the average life expectancy (for the patients whose life expectancy is known) were evaluated. Alphafeto protein levels and computerized tomography, ultrasound, magnetic resonance imaging findings were evaluated retrospectively. Correlation between alpha-feto protein levels and tumor numbers were evaluated statistically. Results: Total of 69 patients were evaluated. The median age at presentation was 62.8 (ranging from 25 to 80) years. Median (overall survival) OS was 7.0 (ranging from 0 to 145) months in all patients. 18 patients (41.9%) were Child-Pugh Class A, 12 (27.9%) patients were Child-Pugh Class B and 13 (30.2%) patients were ChildPugh Class C. It was found that patients with severely high alpha-feto protein levels (>200 ng/ml), have 4 fold risk of multiple liver masses (OR: 4.05, 95% CI: 1.2213.42). For the characterization of a liver mass as hepatocellular carcinoma, the diagnostic effectiveness of computerized tomography was 54.3%, and that of magnetic resonance imaging was 55.8%. Conclusion: As a result the patients with hepatocellular carcinoma can be diagnosed with combination of laboratory findings and imaging techniques. Alpha-feto protein levels are important for follow up of such patients and identifying the multiple mass presences

Keywords:

Hepatocellular Carcinoma, Alpha-Feto Protein, Imaging, Retrospective,

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez