Clinical Manifestations and Laboratory Examination Findings of Hepatocellular Carcinoma at a Tertiary Care Facility in Bandung: An Annual Observation Study

Grace Amanda Maharani; Eka Surya Nugraha; Adhi Kristianto Sugianli

doi:10.15850/amj.v8n3.2333

Clinical Manifestations and Laboratory Examination Findings of Hepatocellular Carcinoma at a Tertiary Care Facility in Bandung: An Annual Observation Study

Grace Amanda Maharani, Eka Surya Nugraha, Adhi Kristianto Sugianli

Abstract

Background: Hepatocellular Carcinoma (HCC) is the most prevalent liver cancer with high mortality. Early detection is important for better patient outcomes. The aim of this study was to explore clinical manifestations and laboratory examinations among HCC patients in a tertiary care facility.

Methods: This was a cross-sectional descriptive study with a total sampling method, reviewing the medical record of patients with HCC in the Outpatient Clinic of Dr. Hasan Sadikin General Hospital between January to December 2019. Clinical manifestations, laboratory findings, and imaging results data were collected.

Results: Of the 112 HCC patients included in this study, the HCC findings among new patients at the outpatient clinic were 8.4%, with hepatitis B (80.8%) as the major etiology. Complaints of abdominal pain (65.2%) was frequent. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were increased in 89.8% and 67% of patients, as well as total bilirubin levels in 58.8% of patients. In contrast, hemoglobin and albumin levels decreased in 55.3% and 78.1% of patients, respectively. The characteristics of tumor were mainly multinodular, with a size of 3-10 cm.

Conclusions: The annual proportion of HCC in Dr. Hasan Sadikin General Hospital in 2019 is 8.4% among all outpatient gastrointestinal and hepatology cases, with hepatitis B as the most common etiology. Abdominal pain is the predominantly prevalent clinical manifestation with increased ALT and AST levels.

Keywords

Clinical manifestation, hepatocellular carcinoma, supporting examination

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References

Sia D, Villanueva A, Friedman SL, Llovet JM. Liver cancer cell of origin, molecular class, and effects on patient prognosis. Gastroenterology. 2017;152(4):745–61.

Dimitroulis D, Damaskos C, Valsami S, Davakis S, Garmpis N, Spartalis E, et al. From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world. World J Gastroenterol. 2017;23(29):5282–94.

Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology. 2016;150(4):835–53.

Carr BI, editor. Hepatocellular carcinoma: diagnosis and treatment. 3rd ed. Switzerland: Springer International Publishing; 2016.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

International Agency for Research on Cancer (IARC). Indonesia-Globocan 2020. [cited 2021 February 5]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/360-indonesia-fact-sheets.pdf

Hasan I, Loho IM, editors. Konsensus nasional penatalaksanaan karsinoma sel hati. Jakarta: Perhimpunan Peneliti Hati Indonesia; 2017.

Yano Y, Utsumi T, Lusida MI, Hayashi Y. Hepatitis B virus infection in Indonesia. World J Gastroenterol. 2015;21(38):10714–20.

Muljono DH. Epidemiology of hepatitis B and C in Republic of Indonesia. Euroasian J Hepato-gastroenterol. 2017;7(1):55–9.

Zhang J, Chen G, Zhang P, Zhang J, Li X, Gan D, et al. The threshold of alpha-fetoprotein (AFP) for the diagnosis of hepatocellular carcinoma: a systematic review and meta-analysis. PLoS One. 2020;15(2):e0228857.

Singal AG, Marrero JA. Hepatocellular Carcinoma. In: Podolsky DK, Camilleri M, Fitz JG, Kalloo AN, Shanahan F, Wang TC, editors.Yamada’s textbook of gastroenterology Part 4. 6th ed. Hoboken: John Wiley & Sons Ltd; 2016. p. 2146–65.

Aljumah AA, Kuriry H, Al-Zunaitan M, Al Ghobain M, Al Muaikeel M, Al Olayan A, et al. Clinical presentation, risk factors, and treatment modalities of hepatocellular carcinoma: A single tertiary care center experience. Gastroenterol Res Pract. 2016;2016:1989045.

Kuftinec GN, Levy R, Kieffer DA, Medici V. Hepatocellular carcinoma and associated clinical features in Latino and Caucasian patients from a single center. Ann Hepatol. 2019;18(1):177–86.

Loho IM, Hasan I, Rinaldi C, Dewiasty E, Gani RA. Hepatocellular carcinoma in a tertiary referral hospital in Indonesia: lack of improvement of one-year survival rates between 1998–1999 and 2013–2014. Asian Pac J Cancer Prev. 2016;17(4):2165–70.

Wong PY, Xia V, Imagawa DK, Hoefs J, Hu KQ. Clinical presentation of hepatocellular carcinoma (HCC) in Asian-Americans versus non-Asian-Americans. J Immigr Minor Health. 2011;13(5):842–8.

Gkamprela E, Deutsch M, Pectasides D. Iron deficiency anemia in chronic liver disease: etiopathogenesis, diagnosis and treatment. Ann Gastroenterol. 2017;30(4):405–13.

Subbiah V, West HJ. Jaundice (Hyperbilirubinemia) in cancer. JAMA Oncol. 2016;2(8):1103.

Carvalho JR, Machado MV. New insights about albumin and liver disease. Ann Hepatol. 2018;17(4):547–60.

Abbasoglu O. Role of liver resection in the management of multinodular hepatocellular carcinoma. World J Hepatol. 2015;7(20):2237–40.

Wu G, Wu J, Wang B, Zhu X, Shi X, Ding Y. Importance of tumor size at diagnosis as a prognostic factor for hepatocellular carcinoma survival: A population-based study. Cancer Manag Res. 2018;10:4401–10.

DOI: https://doi.org/10.15850/amj.v8n3.2333