The effect of ethanol intake on the development of hepatocellular carcinoma in HBsAg carriers.

To study the effect of alcohol intake on the latency period for the development of hepatocellular carcinoma in a country where this tumor occurs earlier in life than in Southeast of Asia, Europe or North America, 83 male patients with hepatocellular carcinoma aged over 30 years, in which the HBsAg status and ethanol intake were prospectively investigated, were analyzed with respect to age at the time of diagnosis. Only male patients were used because in Vitória, State of Espírito Santo, the age at the time of diagnosis of hepatocellular carcinoma in females is significantly lower than in males. Only patients aged over 30 years were used because the tumor occurs in young people and children, in which habitual alcohol intake is not common. Forty-six patients with hepatocellular carcinoma HBsAg positive and 36 HBsAg negative were separated in alcohol abusers (daily ingestion above 80 g for a period of 10 years or more) or nonalcoholics. The occurrence of associated liver cirrhosis was determined for each group. For comparison of the average age of the four groups the Student t test and the Kruskall-Wallis test for two groups were used. The results showed that the average age of patients with hepatocellular carcinoma HBsAg positive with habitual alcohol intake was significantly lower than those without drinking habit (44.3 +/- 9.7 and 52.3 +/- 15.7 years; P = 0.011 and 0.028 respectively for Student t test and Kruskall-Wallis test). The average age of patients with hepatocellular carcinoma HBsAg (-) with or without habitual ethanol intake showed no significative differences (56.7 +/- 11.3 and 57.3 +/- 12.4 P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Hepatocellular carcinoma]. / Carcinoma hepatocelular.

Hepatocellular carcinoma (HCC), one of the most frequent tumors in the world, is included by the World Health Organization as a relevant public health problem in areas of high incidence as Africa and Southeast of Asia. In this review it will be discussed: a) the close relationship between HCC and hepatitis B virus (HBV), the more universal but not the single etiologic factor having other carcinogens and co-carcinogens involved with the origen of the tumor; b) the great variation in geographic distribution of this tumor, including that of Brazil where the incidence of HCC, including the new macroscopic classification according to the pattern of growth and general with liver cirrhosis in all countries where the tumor is diagnosed; d) some morphological aspects of HCC, including the new macroscopic classification according to the pattern of growth and general characteristics of small HCC; e) the clinical and biochemical aspects, calling attention to the evaluation of serum levels of alpha-fetoprotein, not always increased in patients with HCC, and the immage processing methods, specially ultrassonography, as methods for early diagnosis of HCC, being relevant in the follow-up of high risk patients (cirrhotics HBsAg (+]. Finally some comments are done about the therapeutic methods and perspectives of reduction in the incidence of the tumor with the use of vaccination against HBV infection.