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616.36-006-02:616.36-002.2 (1) |
Pathology of the digestive system. Complaints of the alimentary canal (1789) |
![]() ŢURCANU, Adela. Conceptul de cancer precoce la pacienții cu hepatopatie cronică virală B, C şi Delta. In: Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2020, nr. 4(68), pp. 136-145. ISSN 1857-0011. |
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Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale | ||||||
Numărul 4(68) / 2020 / ISSN 1857-0011 | ||||||
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CZU: 616.36-006-02:616.36-002.2 | ||||||
Pag. 136-145 | ||||||
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Early hepatocellular carcinoma was defined as a well-differentiated cancer without substantial destruction of the pre-existing hepatic framework. Recent imaging techniques facilitate early detection in patients at risk for regular monitoring of chronic viral hepatitis or liver cirrhosis. Thus, we performed a prospective / retrospective study of hepatocellular carcinoma screening in patients with viral hepatitis B, C and Delta, and this review shows the clinical significance of early detection of HCC with an impact on patient survival. Material and methods: The diagnosis of hepatocellular carcinoma was based on the presence of a liver tumor obtained by imaging, and confirmed histopathologically (in some cases, especially early), on the clinical context, nuanced by the presence of a chronic liver disease (hepatitis or liver cirrhosis), on the assessment of markers serum levels of viral liver infections (B, C, D) and alpha-fetoprotein levels> 400 ng / ml). Data on socio-demographic status, clinical symptoms, clinical biochemistry, haematology, serological data on the three main viruses responsible for persistent liver infections (hepatitis B, C and Delta virus), lifestyle risk factors, infectious risk factors , histological examination of non-tumor liver, tumor number and diameter, lymph node involvement, metastases, duration of treatment and survival time were collected from medical records and stored in a database. Results: Patients with hepatocellular carcinoma were detected in 80% of cases with chronic viral infection B with or without Delta and C antigen, with a mean age of 59.2 ± 10.1 years, and male patients tended to be younger , than women (58.0 ± 10.3 vs 61.9 ± 9.1, P = 0.070). Patients with hepatocellular carcinoma associated with HDV showed a patient profile 6 years younger than patients infected with HCV and HBV (monoinfection) (54.0 ± 8.3 vs 60.5 ± 10.1 years, P = 0, 0041) and with a universal cirrhotic liver vs other patients (95.8 vs 79.2%, OR = 5.96, 95% CI: 0.87-256.95, P = 0.074). Conclusion: In Republic of Moldova hepatocellular carcinoma is about 80% of cases caused by one of the hepatitis infections: HBV, HCV, VHD. And the HCC specific mortality can be reduced by screening and prompt surveillance of patients with chronic viral liver disease. |
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Cuvinte-cheie hepatocellular carcinoma, viral hepatitis, HBV, HCV, HDV, гепатоцеллюлярная карцинома, вирусный гепатит, HBV, HCV, HDV |
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