Screening, clinical features and prognostic analysis of liver cirrhosis-related hepatocellular carcinoma

Abstract

Objective

To explore the impact of the screening interval and methods on cirrhosis-related hepatocellular carcinoma (HCC) detection and to analyse the clinical features and prognosis of HCC.

Materials and methods

We recruited 3000 patients diagnosed with liver cirrhosis, who had been treated at the First Affiliated Hospital of Anhui Medical University from January 2016 to January 2020. The time of admission was divided into 3- (group A, 539 cases), 6- (group B, 1012 cases), and 12-month screening groups (group C, 1449 cases). We compared the detection rate of small HCCs in each group and analysed the clinical characteristics and prognosis of the patients with HCC.

Results

We detected a total of 124 HCC cases, including 41 cases of small HCC: 21, 14, and 6 cases in groups A, B, and C, respectively. The detection rate was 3.9% (21/539) in group A, which was significantly higher than that in groups B and C (χ² = 31.186, p < .001). Single small, right liver lobe, and alpha-fetoprotein-negative HCCs accounted for 90.2%, 73.2%, and 68.3%, respectively. We detected vascular invasion and lymph node metastasis in one and three cases, respectively. The average survival time of patients in the small HCC group was significantly higher than that in the non-small-HCC group (35.68 ± 12.95 vs. 22.87 ± 11.42 months) (t = 5.623, p < .001).

Conclusions

Screening patients with a history of liver cirrhosis at intervals of 3 months can increase the detection rate of small HCCs. Early detection can provide more patients with an opportunity for radical treatment and prolong their survival.

Keywords:

• Liver cirrhosis
• hepatocellular carcinoma
• screening
• clinical features
• prognosis
• detection rate

Ethical approval

The study was approved by the Clinical Research Ethics Committee of the First Affiliated Hospital of Anhui Medical University. All patients provided their informed consent before participating in this study.

Author contributions

Zhengwei Zha, Wenyue Wu, and Derun Kong conceived and designed the study. Zhengwei Zha, Wenyue Wu, Qianqian Zhang, Xi Wang, Xuecan Mei, and Yi Xiang contributed to the data acquisition. Zhengwei Zha, Wenyue Wu, and Xi Wang contributed to the data analysis and interpretation. Zhengwei Zha and Wenyue Wu drafted and reviewed the manuscript. All authors have read and approved the final manuscript. We thank our colleagues from the Pathology Department for providing the pathology results.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used in this study are available on reasonable request from the corresponding author.

Additional information

Funding

This work was supported by the Research Fund Project of Anhui Institute of Translational Medicine, China [2017zhyx18]; The 2018 Key Research and Development Project of the Department of Science and Technology of Anhui Province, China [1804h08020260].