CLINICAL APPEARANCES AND LABORATORY RESULTS OF

HEPATOCELLULAR CARCINOMA PATIENTS IN H. ADAM MALIK

HOSPITAL MEDAN

Gontar A Siregar, Leonardo B Dairy, Juwita Sembiring, Mabel Sihombing, Betthin Marpaung, Sri Sutadi, Abiran Nababan, Lukman Hakim Zain,

Pengarapen Tarigan,

Div. Gastroentero-Hepatology, Dept Of Int. Medicine Univ Of North Sumatera/H. Adam

Malik Hospital Medan

INTRODUCTION

HEPATOMA IS HEPATOCYCTE CELL THAT DIFFERENTIATE OR

CONTINUES OF HEPATOCELLULAR ADENOMA THAT SHOW ANAPLASTIC FORM AND

DIFFERENTIATE IN ABNORMAL CONDITION WITH LESS OF NORMAL HEPATOCYCTE.

HEPATOMA

THE MOST COMMONLY CARCINOMA FOUND IN THE WORLD, ESPECIALY IN ASIA AND SUB SAHARA AFRICA. UNITED STATES AND EUROPEAN COUNTRY -> RARE MALE : FEMALE = 4:1 STARTED WITH CHRONIC INFECTION FROM

HEPATITIS B VIRAL AND HEPATITIS C VIRAL -> LIVER CIRRHOSIS

EUROPEAN STUDY -> EVER FOUND HEPATITIS B VIRAL INFECTION -> HEPATOMA ->50X

LABORATORY

ALKALIN FOSFATASE ALFA FETO PROTEIN ABNORMAL RESULT OF LFT ABNORMAL RESULT OF RFT

DIAGNOSTIC AND FOLLOW UP USG CT SCAN MRI LAPAROSCOPY/MINILAPAROSCOPY LIVER BIOPSY

METHOD

RETROSPECTIVE HEPATOMA PATIENTS THAT HOSPITALIZED IN ADAM MALIK HOSPITAL FROM JAN. 2001- DEC. 2002 HEPATOMA CLINICAL FINDING NOTED : PATIENT IDENTITY, LABORATORIUM, USG, ENDOSCOPY, FINAL ANALYSIS -> DESCRIPTIVE

AGE

GENDER TOTAL

MALE FEMALE n %

21 – 30 3 0 3 5,4

31 – 40 5 2 7 12,5

41 – 50 16 3 19 33,9

51 – 60 9 3 12 21,4

61 – 70 7 2 9 16,1

> 70 6 0 6 10,7

TOTAL 46(82,1%) 10 (17,9%) 56 100

TABEL.1 DISTRIBUTION PATIENT BASED ON GENDER AND AGE

56 PATIENT WITH HEPATOMA MALE : FEMALE = 82,1%(46) : 17,9%(10) MOST POPULATED GROUP : 41-50 YEAR (18-95)

RESULT

 LABORATORY

NORMAL ABNORMAL

n MEAN SD n MEAN SD

HB 9 13.021.32 21 9.51.39BIL.TOTAL 12 1.050.32 23 5.854.45SGOT 4 19.256.60 32 322315SGPT 4 14.54.50 31 144.84116.3

1AP 0 - 28 610.46570.8

3UREUM 18 28.16.88 11 66.7324.15KREATININ 26 0.970.43 2 3.420.53HBSAG 12 (-) 32 (+)ALFA FETO 4 (-) 22 (+)

TABEL 2. DISTRIBUTION OF LABORATORY RESULTS

GRAPH.1. LABORATORY RESULTS

30.0%

42.9%

11.1%11.4%

0.0%

20.0%

62.1%

92.9%

70.0%

57.1%

88.9% 88.6%

100.0%

80.0%

37.9%

7.1%

0%

20%

40%

60%

80%

100%

120%

NORMAL

ABNORMAL

HB BIL.TOTALSGOT SGPT AP ALBUMINUREA CREATININ

0%10%20%30%40%50%60%70%80%90%

Splenomegaly Icteric Anemia

100%

42,835,7

39,2

Ascites

33,9

17,8

HE

14,2

Dyspepsia Upper GI Tract Bleeding

0,01

GRAPH 2. CLINICAL FEATURES

0%10%20%30%

40%50%60%70%80%90%

8,33%

50%

16,66%

33,33%

Normal Varicess Gastritis GastropatyPeptic Ulcer

16,66% 16,66%

Malignancy

GRAPH 3. ENDOSCOPY RESULTS

0%10%20%30%

40%50%60%70%80%90%

48,27%55,17%

Hepatoma with Splenomegaly

Hepatoma with Ascites

Hepatoma with Liver Cirrhosis

48,27%

GRAPH 4. ABDOMINAL USG

DISCUSSIONHEPATOMA INFLUENCED ALL AGE

41-50 YEAR OLD ( HIGHEST PREVALENCY ) MALE >> FEMALE

YOUNGEST : 18, OLDEST : 95 CLINICAL FEATURES: ASCITES, ICTERIC,

ANEMIA GASTROSCOPY: 50% VARICES;

33%GASTROPATY USG : ASCITES , LC FORM

LAB : MOSTLY FOUND ANEMIA, INCREASE LIVER FUNCTION TEST, DECREASE ALBUMIN

LEVEL AND MOSTLY WITH HBSAG (+).

CONCLUSION

THE MOST PROMINENT LABORATORYASPECTS OF HEPATOMA ARE ALFA FETO

PROTEIN AND ALKALINE POSPATASE AND WITH SEVERAL POSITIVE HBSAG THE MOST COMMONLY FOUND OF CLINICAL FORM OF THE PATIENT IS LIVER CIRRHOSIS CONDITION.