الفهرس 
Introduction and aim of the work
EpidemiologyOnly 14 pages are availabe for public view
 |  | from | 96 |  |  |
| | | from | 96 | | |
Abstract
Liver cancer grows silently and does not cause symptoms until the disease is advanced, at which time there is little chance for recovery and life expectancy is usually in the range of a few months. Therefore, the only hope of effective treatment lies in early detection with screening of high-risk populations.
All patients were subjected to screening with abdominal ultrasound and alpha feto protein.
With analysis of the clinical ,laboratory and imaging data of all patients , we found that only 184 \ 416 (44.23%) patients were actually had hepatocellular carcinoma and all of them had hepatic focal lesions in abdominal sonar and high value of alpha feto protein .
All cases of hepatocellular carcinoma were on top of liver cirrhosis only 184 \ 184 (100%) and these patients show the following characteristic :-
Males had higher frequency of hepatocellular carcinoma 152 \184 (82.6%)than females 32\ 184 (17.4%).hepatocellular carcinoma occurs in old age with median age was 58.86 ±7.38 years also smokers had significantly higher frequency of hepatocellular carcinoma 98 \ 184 (53.3%) than those without hepatocellular carcinoma 62 \ 152 (39.7%) and rural patients had higher frequency of hepatocellular carcinoma 132 \ 184 (71.7 %) than urban patients 52\184 (28.3%).
So we advice that any cirrhotic patients especially if male , old age , smoker and from rural areas to be regularly screened for early detection of hepatocellular carcinoma .
According to the laboratory data we found that patients with hepatocellular carcionma had more increase in serum trans aminases with AST and ALT mean 109.52 ±151.96 U\L and 72.06 ± 86.29 U\L respectively and high serum bilirubin with mean 57.54 ± 81.32 mmol \ L than those with out hepato cellular carcinoma .
And according to Child pugh class we found that 60 \184 ( 32.6 %) of patients with hepatocellular carcinoma were Child class A while 46 \184 (25 %) were Child class C and this result may be due to the attend of our department to admit any patient with hepatic focal lesions while we admit patients with child C only due to complication of hepatic decompensation as hepatic encephalopathy or bleeding varcies due to portal hypertension.
Almost all cases of hepatocellular carcinoma were on top of post hepatitic HCV liver cirrhosis 182 \184 (98.9%) and only 2 \ 184 ( 1.1%) were on top of post hepatitic HBV liver cirrhosis and this may be due to low incidence of HBV infection owing to successful international immunization programms for HBV.
Patients with hepatocellular carcinoma were more susceptible to complications such as refractory ascites , hepatic encephalopathy and portal vein thrombosis.
Also with screening that 98 \ 184 of cases with hepatocellular carcinoma were eligible to treatment and in 92 \ 98 cases intervention was done in the form of percutaneus ethanol injection in 34 \ 184 ( 18.5 %) , radiofrequency in 10\ 184 (5.4 %) while trans arterial chemo emoblization 48 \ 184 and 8 \184 with other intervention in the form of (2 \ 8 percutaneus ethanol injection & radiofrequency and 6 \ 8 percutaneus ethanol injection & trans arterial chemo emoblization) while the other six was eligible to trans arterial chemo emoblization waiting for fund.