We analyzed 166 patients with hepatocellular carcinoma (HCC) retrospectively for 3 years duration. The diagnosis was made by serologically, histologically and/or radiologically. They were 136 males and 30 females and ages ranged from 31 to 80
(mean: 56)
years with a peak incidence during the sixth decade. Serum AST was normal in 39 (23%) and ALT in 113 (68%). In 20% of the patients, AST/ALT was greater than 3:1. Serum HBsAg was positive in 110 patients (66%), anti HCV in 26 (16%), and no viral
markers
were dectected in 30 (18%). Among 110 HBsAg positive patients, 30 (27%) were positive for HBeAg and 34 (31%) 2343 positive for HBV-DNA. Of the 30 patients who were both HBsAg and anti-HCV negative, evidence of past HBV infection (anti-HBs or
anti-HBc)_
was found in 12. Using the polymerized chain reaction (PCR), HBxAg was detected in 90 (74%) of 122 patients studied: 71/82 (87%) in HBsAg positive, and 19/40 (48%) in HBsAg negative. The anti-HCV or HCV-RNA was detected in 8 (17%) of 48 patients
who
were positive for HBsAg and in 28 (56%) of 32 patients who were neagtive. Liver cirrhosis was found in 148 patients (89%) when they initially came to the hospital. Portal vein thrombosis was noted in 63 patients (38%) by ultrasonography and/or
angiographically. Serum alpha fetoprotein (AFP) was elevated (greater than 400 ng/dl) in 9(60%). No correlation was found between the level of AFP and the extent of the tumor. Among 166 patients. small tumor (less than 5cm in diameter)was found
in
17 of
whom surgical resection was done in 3, and 11 received transarterial embolization (TAE) and/or percutaneous ethanol injection (PEI). In conclusion, most of the patients with HCC were complicated with decompensated liver cirrhosis when they
initially
came to the hoopital. Therefore, it is absolutely recommended to perform the serial alpha fetoprotein measurement and ultrasonographic examination regularly to all the patients with chronic hepatitis regardless of the etiology of the liver
disease.
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