Study of hepatoma from all provincial hospitals in Kenya

ABSTRACT

Hepatocellular carcinoma is common in Kenya occurring at an earlier age than in Europe. It is the third commonest solid tumour among males at the Kenyatta National Hospital. Hepatitis B virus seems to be playing a very important role in the causation of HCC. A study done at the KNH in 1985 showed that hepatitis B surface antigen (HBsAg) was positive in 85of HCC patients. Some of these cases had integrated HBV-DNA in the liver; whereas others had free HBV-DNA. We undertook to screen patients with possible HCC clinically and ultrasonographically in all teh provincial hospitals in Kenya and taat KHN. These patients had blodded samples taken for HBV markers; hepatitis C virus (HCV)) antibodies and allllphafetopreotein (AFP). A few of teh patients had histological confirmation of the HCC. A total of 137 cases of HCC were screened; with a mean age of 45.7 years (range 7-86 years). The prevalence of HBsAg in HCC was found to be 39.4 per cent and the prevalence of anti-HCV Ab was found to be 2.9 per cent. AFP was positive in 51.8 per cent of HCC cases with 38 per cent of cases having levels greater than 200 ng/ml. Most of the HCC cases were diffuse (48 per cent) or multiple (32.7 per cent) and only solitary in 9.2 per cent of the cases. Even the solitary tumours were large with an average size of 41.3 pmm. HBV plays an important role in the causation of HCC in our setup whereas HCV does not seem to be as important. AFP is an important indicator of HCC and combined with ultrasound; it can be used for early diagnosis of HCC in high risk groups; that is; HBsAg positive individuals