This prospective, longitudinal study was to determine the incidence of hepatocellular carcinoma (HCC) and the risk factors of the development of HCC in patients with liver cirrhosis in Korea. We enrolled 285 patients with liver cirrhosis who had
experienced the esophageal variceal bleeding and liad been treated by endoscopic injection sclerotherapy in our hospital and survived more than 3 months. They were closely rollowed up with ultrasonography (USG) of the liver and determination of
serum
alpha-fetoprotein (α-FP) levels for the detection of HCC. The mean age of the patients at the time of the first episode of esophageal variceal bleeding was 47.9±9.6 with the male to female ratio of 3.75:1. The positive rate of serum HBsAg was
64.6%
and decreased with aging.
The cumulative incidence was 2.6%, 6.7%, 12.3%, 18.8% and 21.5% in 1, 2, 3, 4 and 5 years, respectively. The annual incidence of HCC in HBsAg positive and negative patients was 5.2% and 2.4%, respectively and the difference was statistically
significant
(p<0.05). Among HBsAg positive patients, the annual incidence (9.9%) of HCC in elderly patients (>50 years) was significantly higher than that of younger (3.2%). The annual incidence in male patients (4.5%) was likely to be higher than in female
(2.8%)
though the difference was not statistically significant.
In conclusion, the high incidence of HCC in patients with liver cirrhosis was reconfirmed by prospective study HBsAg positivity, old age (above 50 years) and male sex turned out to be factors which increased the risk of the development of HCC.
|