HEPATOCELLULAR CARCINOMA;

DIFFERENT CHILD-PUGH CLASSES BASED ON α-FETOPROTEIN LEVEL

Abstract

Objective: To determine the frequency of hepatocellular carcinoma in different Child-Pugh classes based on Alfa fetoprotein level. Study design: Case series study. Period: Six months Setting: Medical Unit-I of Liaquat University Hospital, Hyderabad Sindh Pakistan. Patients & Methods: A total of 100 patients admitted (inpatients) in Medical Unit I with the diagnosis of cirrhosis were enrolled in the study. Patients with cirrhosis of liver (more than six month duration) of either gender were included. If patients had metastatic lesion of the liver, liver abscess, or acute liver failure then they were excluded. Child-Pugh score was calculated which included ascites, encephalopathy, prothrombin time, albumin and serum bilirubin. The levels of α-fetoprotein were measured and HCC was diagnosed. The primary outcome variable was presence of HCC in cirrhotic patients. Results: The proportion of males (53%) was higher as compared to females (47%). The mean age of the study patients was 40.47 years with a standard deviation of 11.5. At the beginning patients were categorized according to Child Pugh Classes (A= up to 6, B=7-9 and C=10-11), age groups (15-30 years, 31-50 years and 51-70 years respectively). The mean Child Pugh score was 6.83 with ± 1.8 S.D. The majority of the cases of HCC (75.61%) occurred in the Child Class A, whereas 21.95% occurred in Child Class B and finally only one case of HCC (2.44%) was present in Child Class C. Conclusions: This study comprehensively demonstrated that hepatocellular carcinoma (HCC) is far more common in compensated cirrhosis (Child Pugh Class A) vs. decompensated cirrhosis (Child Pugh Class B and C).