Biochemical nutiitional profile of liver cirrhosis patients with hepatocellular carcinoma / Perfil nutricional bioquímico de pacientes portadores de cirrose com carcinoma hepatocelular

ABSTRACT

Context Liver cirrhosis patients with hepatocellular carcinoma present nutritional alterations and metabolic disorders that negatively impact the prognosis. Objective The objective is to identify alterations in the metabolism of macro and micronutrients among liver cirrhosis patients with and without hepatocellular carcinoma and their relation to the Child-Turcote-Pugh score and Barcelona Clinic Liver Cancer staging. Methods Analytical transversal study, with 31 hepatocellular carcinoma patients and 48 liver cirrhosis patients. Laboratorial exams were carried out. The existence of an association between the biochemical parameters and the disease severity as well as the presence of hepatocellular carcinoma was assessed. Results The metabolic-nutritional profile of liver cirrhosis patients caused by the hepatitis C virus and hepatocellular carcinoma showed alterations, specifically the lipid (total cholesterol, HDL and triglycerides), protein (albumin, creatinine and uric acid), iron (transferrin, iron and ferritin saturation), hematocrit and hemoglobin, zinc and B12 vitamin profiles. There is a relation between nutritional biochemical markers and the Child-Turcote-Pugh, as well as Barcelona Clinic Liver Cancer staging. Conclusions Considering the existence of alterations in the metabolism of nutrients in liver cirrhosis patients with and without hepatocellular carcinoma, and also that conventional nutritional assessment methods present limitations for this population, the biochemical laboratorial exams are valid to complement the diagnosis of the nutritional state in a quick and practical manner. .

RESUMO

Contexto Pacientes cirróticos portadores de carcinoma hepatocelular apresentam alterações nutricionais e metabólicas, com impacto negativo no prognóstico. Objetivos Observar o perfil dos macro e micronutrientes em pacientes cirróticos com e sem carcinoma hepatocelular e sua relação com escore de Child-Turcot-Pugh e estadiamento através do escore do grupo Barcelona Clinic Liver Cancer. Métodos Estudo transversal analítico. Avaliados exames laboratoriais de 31 pacientes com carcinoma hepatocelular e 48 com pacientes cirróticos pelo vírus da hepaite C (CI-HCV). Resultados A avaliação metabólico-nutricional de portadores de cirrose-HCV e carcinoma hepatocelular mostrou-se alterada em relação ao perfil lipídico (colesterol total, HDL e triglicerídeos), proteico (albumina, creatinina e ácido úrico), ferro (saturação da transferrina, ferro e ferritina), hematócrito e hemoglobina, zinco e vitamina B12. O diagnóstico de carcinoma hepatocelular foi relacionado com piores resultados de colesterol HDL, hematócrito e aumento de ferro e ferritina. Houve correlação entre marcadores bioquímicos nutricionais e a classificação de Child-Turcot-Pugh e com o estadiamento Barcelona Clinic Liver Cancer. Conclusão Considerando a existência de alterações no metabolismo dos macro e micronutrientes nos pacientes cirróticos com e sem carcinoma hepatocelular e sua relação com o prognóstico das doenças, a avaliação bioquímica é válida para complementar o diagnóstico do estado nutricional de maneira rápida e prática. .