Clinical features, biochemical parameters, and virological profiles of patients with hepatocellular carcinoma in Hong Kong
Version of Record online: 25 JUL 2006
Alimentary Pharmacology & Therapeutics
Volume 24, Issue 4, pages 573–583, August 2006
How to Cite
CHEUNG, T.-K., LAI, C.-L., WONG, B. C.-Y., FUNG, J. and YUEN, M.-F. (2006), Clinical features, biochemical parameters, and virological profiles of patients with hepatocellular carcinoma in Hong Kong. Alimentary Pharmacology & Therapeutics, 24: 573–583. doi: 10.1111/j.1365-2036.2006.03029.x
- Issue online: 25 JUL 2006
- Version of Record online: 25 JUL 2006
- Publication data Submitted 15 May 2006 First decision 1 June 2006 Resubmitted 9 June 2006 Accepted 13 June 2006
Background Clinical features of hepatocellular carcinoma patients are changing because of screening.
Aim To examine the clinical features of hepatocellular carcinoma patients in Hong Kong and validity of different staging systems.
Methods A total of 223 Chinese patients with hepatocellular carcinoma were studied.
Results Seventy-eight percent of hepatocellular carcinoma patients had chronic hepatitis B (43% diagnosed by screening). Hepatitis B positivity, weight loss, jaundice, encephalopathy, alpha-fetoprotein level, portal vein thrombosis, extrahepatic metastasis, and treatment were shown to be independent factors affecting survival. Of chronic hepatitis B patients, hepatitis B virus DNA levels (P = 0.001) and portal vein thrombosis (P = 0.008) were independent factors affecting survival. Seventy-six percent of chronic hepatitis B patients with hepatocellular carcinoma were hepatitis B e antigen negative. Screening patients had hepatocellular carcinoma detected at an earlier stage and better survival (median survival: 21 vs. 4 months, P < 0.0001). All staging systems had good stratification of survival. Prognosis and median survival generated were different when compared with the US data.
Conclusions Chronic hepatitis B was the most common cause of hepatocellular carcinoma in Hong Kong. High-risk chronic hepatitis B patients should be followed irrespective of the hepatitis B e antigen status. Hepatitis B virus DNA levels at the time of diagnosis are an important survival predictor. Screening detected hepatocellular carcinoma at an earlier stage and prolonged survival. Staging systems should be validated in different populations.