Hepatocellular carcinoma; different child-pugh classes based on alpha-fetoprotein level

ABSTRACT

To determine the frequency of hepatocellular carcinoma in different Child-Pugh classes based on Alfa fetoprotein level. Case series study. Six months. Medical Unit-I of Liaquat University Hospital, Hyderabad Sindh Pakistan. A total of 100 patients admitted [inpatients] in Medical Unit I with the diagnosis of cirrhosis were enrolled in the study. Patients with cirrhosis of liver [more than six month duration] of either gender were included. If patients had metastatic lesion of the liver, liver abscess, or acute liver failure then they were excluded. Child-Pugh score was calculated which included ascites, encephalopathy, prothrombin time, albumin and serum bilirubin. The levels of alpha-fetoprotein were measured and HCC was diagnosed. The primary outcome variable was presence of HCC in cirrhotic patients. The proportion of males [53%] was higher as compared to females [47%]. The mean age of the study patients was 40.47 years with a standard deviation of 11.5. At the beginning patients were categorized according to Child Pugh Classes [A= up to 6, B=7-9 and C=10-11], age groups [15-30 years, 31-50 years and 51- 70 years respectively]. The mean Child Pugh score was 6.83 with +/- 1.8 S.D. The majority of the cases of HCC [75.61%] occurred in the Child Class A, whereas 21.95% occurred in Child Class B and finally only one case of HCC [2.44%] was present in Child Class C. This study comprehensively demonstrated that hepatocellular carcinoma [HCC] is far more common in compensated cirrhosis [Child Pugh Class A] vs. decompensated cirrhosis [Child Pugh Class B and C]