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Original Article

J Liaquat Uni Med Health Sci. 2012; 11(1): 29-33

Prevalence of Hepatocellular Carcinoma in Cirrhotic Patients of Northern Sindh Attending Liver Clinics at Ghulam Mohammad Mahar Medical College Hospitals Sukkur and Khairpur

Javed Ahmed Phulpoto, Iftikhar Ali Shah, Zulfiqar Bhatti.


Despite bearing the main burden of Hepatocellular carcinoma, prospective studies from
developing countries particularly Pakistan are lacking. This prospective observational study
was designed to estimate the prevalence of HCC among Northern Sindh patients with hepatic
OBJECTIVE: To assess the prevalence of hepatocellular carcinoma in cirrhotic patients of
Northern Sindh attending liver clinics at Ghulam Mohammad Mahar Medical College Hospitals
Sukkur and Khairpur
STUDY DESIGN: Prospective observational study
PLACE & DURATION OF STUDY: Liver clinic Ghulam Mohammad Mahar Medical College Hospitals
Sukkur and Khairpur, between April 2008 and November 2010
METHODOLOGY: Between April 2008 and November 2010, we enrolled 301 patients with liver
cirrhosis. Patients found to be free of hepatocellular carcinoma (HCC) using baseline abdominal
ultrasound, computed tomography (CT) Scan of abdomen in selected cases and serum alphafetoprotein
(AFP) levels. Patients were followed up prospectively for detection of HCC using
ultrasound and AFP every 6 months, liver biopsy and CT scan of abdomen in selected cases
when required.
RESULTS: Among the 194 patients (mean age [SD] 45.1+13.1 years; male: female 6.1:1.0) followed
up, 154 had Child’s A and 40 had Child’s B disease. The causes of cirrhosis were: hepatitis
B in 71 (36.6%), hepatitis C in 54 (27.8%), dual infection with hepatitis B and C in 12 (6.2%)
and others including autoimmune, alcoholic and cryptogenic cirrhosis in 57 (29.4%) cases. During
a cumulative follow up period of 563.4 person-years, 9 cases of HCC were detected, with an
incidence rate of 1.60 per 100 person-years.
CONCLUSION: In our study, the prevalence of HCC among patients with liver cirrhosis was intermediate,
being lower than that in Japan but higher than that reported from Europe.

Key words: Hepatocellular Carcinoma, Cirrhosis, Incidence, Northern Sindh.

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