Profile of hepatocellular carcinoma in the Republic of Moldova: first-hand information on the presentation, distribution and etiologies
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ŢURCANU, Adela; PITEL, Ecaterina; DUMBRAVA, Vlada-Tatiana; TCACIUC, Eugen; DONSCAIA, Anna; PELTEC, Angela; PINEAU, Pascal. Profile of hepatocellular carcinoma in the Republic of Moldova: first-hand information on the presentation, distribution and etiologies. In: Romanian journal of internal medicine. 2019, nr. 1(57), pp. 37-46. ISSN 2501-062X.
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Romanian journal of internal medicine
Numărul 1(57) / 2019 / ISSN 2501-062X

Profile of hepatocellular carcinoma in the Republic of Moldova: first-hand information on the presentation, distribution and etiologies


DOI: 10.2478/rjim-2018-0026
Pag. 37-46

Ţurcanu Adela1, Pitel Ecaterina1, Dumbrava Vlada-Tatiana1, Tcaciuc Eugen1, Donscaia Anna2, Peltec Angela1, Pineau Pascal3
 
1 ”Nicolae Testemițanu” State University of Medicine and Pharmacy,
2 Institute of Oncology,
3 Institut Pasteur
 
Disponibil în IBN: 2 mai 2019


Rezumat

INTRODUCTION: Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital. METHODS: A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation. RESULTS: The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases. CONCLUSIONS: The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.

Cuvinte-cheie
cirrhosis, Hepatitis viruses, hepatocellular carcinoma, Liver cancer, Moldova, Multiple infections