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Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients
BACKGROUND: As a result of the lack of screening programs and the difficulty in making a proper diagnosis, the majority of hepatocellular carcinoma (HHC) patients present late in low-resource countries. The study therefore assesses the clinical features, stage and prognostic variables of patients wi...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510158/ https://www.ncbi.nlm.nih.gov/pubmed/37730538 http://dx.doi.org/10.1186/s12876-023-02952-8 |
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author | Bittaye, Sheikh Omar Kambi, Abubacarr Tekanyi, Momodou A. I. Tamba, Saydiba Sanneh, Lamin Sisawo, Momodou Musa Jatta, Abdoulie Fatty, Gibril Jeng, Adam Jallow, Momodou Salieu Leigh, Ousman Njie, Ramou |
author_facet | Bittaye, Sheikh Omar Kambi, Abubacarr Tekanyi, Momodou A. I. Tamba, Saydiba Sanneh, Lamin Sisawo, Momodou Musa Jatta, Abdoulie Fatty, Gibril Jeng, Adam Jallow, Momodou Salieu Leigh, Ousman Njie, Ramou |
author_sort | Bittaye, Sheikh Omar |
collection | PubMed |
description | BACKGROUND: As a result of the lack of screening programs and the difficulty in making a proper diagnosis, the majority of hepatocellular carcinoma (HHC) patients present late in low-resource countries. The study therefore assesses the clinical features, stage and prognostic variables of patients with HCC in The Gambia. METHODS: From December 2015 to January 2019, patients with a confirmed diagnosis of HCC were enrolled. All patients’ medical history, ultrasound scan, FibroScan and laboratory details were collected. RESULTS: Two hundred and sixty (260) patients were enrolled. The mean age of HCC patients was 40 years, and 210 (80.7%) of them were male. The most common gastrointestinal symptoms were early satiety 229 (88.1%) and abdominal pain 288 (87.7%), while the most common constitutional symptoms were weight loss 237 (91.2%) and easy fatiguability 237 (91.2%). Hepatomegaly 205 (78.8%) was the most common sign. On ultrasound scan, lesions were mostly multifocal 175 (67.3%), and the median FibroScan score was 75 kPa. The median fibrosis 4 and aspartate transferase platelet ratio index were 4.6 and 2.2, respectively. Hepatitis B surface antigen (HBsAg) was positive in 170 (65.4%) patients, and the median AFP level was 3263 ng/ml. HCC patients with positive HBsAg were more likely to be male 145 (85.3%) vs 62 (72.1%) (p = 0.011), much younger 39.9 vs 51.4 yrs (p = < 0.0001), more likely to have abdominal pain 156 (91.8%) vs 68 (79.1%) (p = 0.002), jaundice 78 (45.9%) vs 29 (33.7%) (p = 0.042), dark urine 117 (68.8%) vs 46 (53.5%) (p = 0.018), raised transaminases (Aspartate transaminases 224.5 (32–7886) vs 153 (18–610), p = < 0.01, Alanine transferases 71 (5–937) vs 47 (8–271), p = < 0.001) and decreased platelet count 207 (33–941) vs 252 (52- 641) (p = 0.021) compared to patients with HCC who were HBsAg-negative. CONCLUSIONS: The prognosis of patients with HCC is poor in developing countries such as The Gambia, where screening programs and treatment modalities are scarce. Young males are disproportionately affected, and HBV is a major cause of HCC in The Gambia. |
format | Online Article Text |
id | pubmed-10510158 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105101582023-09-21 Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients Bittaye, Sheikh Omar Kambi, Abubacarr Tekanyi, Momodou A. I. Tamba, Saydiba Sanneh, Lamin Sisawo, Momodou Musa Jatta, Abdoulie Fatty, Gibril Jeng, Adam Jallow, Momodou Salieu Leigh, Ousman Njie, Ramou BMC Gastroenterol Research BACKGROUND: As a result of the lack of screening programs and the difficulty in making a proper diagnosis, the majority of hepatocellular carcinoma (HHC) patients present late in low-resource countries. The study therefore assesses the clinical features, stage and prognostic variables of patients with HCC in The Gambia. METHODS: From December 2015 to January 2019, patients with a confirmed diagnosis of HCC were enrolled. All patients’ medical history, ultrasound scan, FibroScan and laboratory details were collected. RESULTS: Two hundred and sixty (260) patients were enrolled. The mean age of HCC patients was 40 years, and 210 (80.7%) of them were male. The most common gastrointestinal symptoms were early satiety 229 (88.1%) and abdominal pain 288 (87.7%), while the most common constitutional symptoms were weight loss 237 (91.2%) and easy fatiguability 237 (91.2%). Hepatomegaly 205 (78.8%) was the most common sign. On ultrasound scan, lesions were mostly multifocal 175 (67.3%), and the median FibroScan score was 75 kPa. The median fibrosis 4 and aspartate transferase platelet ratio index were 4.6 and 2.2, respectively. Hepatitis B surface antigen (HBsAg) was positive in 170 (65.4%) patients, and the median AFP level was 3263 ng/ml. HCC patients with positive HBsAg were more likely to be male 145 (85.3%) vs 62 (72.1%) (p = 0.011), much younger 39.9 vs 51.4 yrs (p = < 0.0001), more likely to have abdominal pain 156 (91.8%) vs 68 (79.1%) (p = 0.002), jaundice 78 (45.9%) vs 29 (33.7%) (p = 0.042), dark urine 117 (68.8%) vs 46 (53.5%) (p = 0.018), raised transaminases (Aspartate transaminases 224.5 (32–7886) vs 153 (18–610), p = < 0.01, Alanine transferases 71 (5–937) vs 47 (8–271), p = < 0.001) and decreased platelet count 207 (33–941) vs 252 (52- 641) (p = 0.021) compared to patients with HCC who were HBsAg-negative. CONCLUSIONS: The prognosis of patients with HCC is poor in developing countries such as The Gambia, where screening programs and treatment modalities are scarce. Young males are disproportionately affected, and HBV is a major cause of HCC in The Gambia. BioMed Central 2023-09-20 /pmc/articles/PMC10510158/ /pubmed/37730538 http://dx.doi.org/10.1186/s12876-023-02952-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Bittaye, Sheikh Omar Kambi, Abubacarr Tekanyi, Momodou A. I. Tamba, Saydiba Sanneh, Lamin Sisawo, Momodou Musa Jatta, Abdoulie Fatty, Gibril Jeng, Adam Jallow, Momodou Salieu Leigh, Ousman Njie, Ramou Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients |
title | Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients |
title_full | Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients |
title_fullStr | Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients |
title_full_unstemmed | Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients |
title_short | Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients |
title_sort | clinical manifestation, staging and prognosis of hepatocellular carcinoma in gambian patients |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510158/ https://www.ncbi.nlm.nih.gov/pubmed/37730538 http://dx.doi.org/10.1186/s12876-023-02952-8 |
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