PATTERN OF LIVER CANCER ADMISSIONS AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN - A 4-YEAR REVIEW.

BACKGROUND: Liver Cancer (LC) is a common malignancy globally, and it exacts an enormous toll on the health care system. Therefore, it is imperative to have an epidemiological profile for effective planning. METHODS: This study examined the basic demographic, admission profile and outcome of this category of patients through a retrospective cross-sectional study. The study was carried out using data of clinical diagnoses of LC admitted into the Gastro-intestinal Unit (GLU), Department of Medicine, University College Hospital, Ibadan between 1st January 2011 and 31st December 2014. RESULTS: Two hundred and six patients (16.8%) had diagnoses of LC out of the 1228 total cases admitted by the GLU. The total male patients were 147(71.4%) and female 59 (28.6%) while the most prominent age group for both genders and males were 41-50 years in the male group and 51-60 years among females. The mean ± SD and median hospital stay was 10.6±11.6 days and eight days for LC patients, respectively. The intrahospital fatality rate was 37.9% and occurred mainly within five days of admission. CONCLUSION: Liver Cancer is an important disorder in gastrointestinal practice and had high fatality within a few days of admission; hence, efforts should be made to improve the care of the patients.

Tumour markers and hepatitis C virus infection in Nigerian patients with liver diseases.

BACKGROUND: Early diagnosis of hepatocellular carcinoma (HCC) is very important and determination of serum levels of tumour markers in patients with chronic liver diseases could be of immense contribution to their management. METHOD: Forty-two adult Nigerian subjects consisting of 14 healthy subjects (Controls) and 28 patients with primary liver mass (es) and histological diagnoses of liver cirrhosis (LC) +/- chronic active hepatitis (CAH) and hepatocellular carcinoma +/- LC were studied. Their blood samples were assayed for Hepatitis B Surface Antigen (HBsAg), antibodies to HCV (anti-HCV), alkaline phosphatase (AP), Aphafeotoprotein (AFP) and Ferritin. RESULTS: The patients had HCC (10) HCC+LC(4), LC+CAH (2) and LC (12). Serum ferritin> 700ng/ml, AP> 375IU/ml and AFP>200IU/ml were detected in 32%, 11% and 32% of the patients respectively with corresponding specificities of 100%, 86% and 100%. Elevated serum levels of AFP and ferritin were found in patients with HCC +/- LC while raised serum AP occurred in those having PHCC without LC. Only combination of either AFP or ferritin to AP gave significant increase in the diagnostic yield of HCC among the patients than the use of only AR Elevated levels of serum AFP correlated with both HBV and HCV while raised serum levels of ferritin were associated with only with HBV CONCLUSION: Although combination of the tumour markers gave a higher diagnostic yield for HCC among Nigerian patients, serum AFP > 200IU/ml seems the best tumour marker in the diagnosis of PHCC among the patients.

Clinical feminisation and sex hormone concentrations in Nigerian men with cirrhosis with and without hepatocellular carcinoma.

The study explored the incidence of clinical feminisation and the sex hormone levels of 18 Nigerian patients with liver cirrhosis (LC) alone and 18 patients with LC and hepatocellular carcinoma (HCC). The incidence (11%) of clinical feminisation in Nigerian patients was lower than values reported from other countries and there was no association between feminising signs and the sex hormone levels of the patients. Plasma oestradiol and sex hormone-binding globulin (SHBG) levels were significantly higher and testosterone lower in patients with liver diseases than in 18 age-matched normal controls. Serum concentrations of oestradiol were also found to be significantly higher in patients with LC alone than in those with LC and HCC. A possible promotive role for oestrogens in the development of HCC from the cirrhotic liver is discussed.