Pacientu pārskats ar hepatocelulāru karcinomu: ārstēšanas iespējas
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Date
2021
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads. Hepatocelulāra karcinoma (HCC) ir visbiežāk sastopams aknu ļaundabīgs audzējs, kura vēlīna diagnostika ir saistīta ar pacientu augstu letalitāti. Child-Pugh (CP) rādītājs tiek izmantots, lai klasificētu aknu funkcijas un tiek pielietots pašreizējā HCC stadiju sistēmā, pamatojoties uz Barcelona Clinic Liver Cancer (BCLC). Tas palīdz prognozēt rezultātus un izvēlēties labāko ārstēšanas taktiku.
Pētījuma mērķis. Veikt klīnisko analīzi pacientiem ar HCC, kā arī novērtēt ārstēšanas iespējas Klīniskās Universitātes slimnīcā.
Materiāls un metodes. Kopumā tika reģistrēti un analizēti 48 pacienti ar diagnozi HCC. Pētījumā iekļautājiem pacientiem diagnoze tika uzstādīta pamatojoties uz radioloģiskiem un / vai histoloģiskiem kritērijiem.
Rezultāti. Visbiežākais HCC slimnieku vecums: 55–64 gadi, ar vīriešu prevalenci (79%). Kopēji riska faktori tika atklāti 29 pacientiem - aknu ciroze (25%), C hepatīta vīrusa (HCV) infekcija (21%), B hepatīta vīrusa (HBV) infekcija (3%) un to riska faktoru kombinācijas (51%). Alfa fetoproteīns (aFP) tika noteikts 28 pacientiem, starp kuriem paaugstināts bija 20 pacientiem. Child-Pugh rādītājs tika izrēķināts 29 pacientiem: 17 pacientiem bija A klase, 8 pacientiem - B klase, 4 pacientiem - C klase. Audzēja tips – solitārs un multifokāls sastopams vienāda biežumā. Visbiežāk skartie segmenti bija IV, VII un VIII – 54% gadījumu (18% katrs segments). Analizējot kopējo pacientu skaitu (n=48), 23 pacienti primāri saņēma operatīvo terapiju, 18 pacienti saņēma primāro neoperatīvu ārstēšanu, 5 pacienti netika ārstēti un 2 pacientiem tika veikta aknu transplantācija. Recidīvs attīstījas 15 pacientiem pēc primāras operatīvas intervences.
Secinājumi. Ņemot vērā pētījuma datus var secināt, ka biežākais riska faktors pacientiem ir aknu ciroze. Pacienti ar HCC var saņemt visas iespējamās ārstēšanas metodes Klīniskās universitātes slimnīcā, tomēr visnozīmīgāka problēma ir tā, ka Child-Pugh rādītājs nebija precīzi noteikts, kas varēja ietekmēt uz turpmāko ārstēšanas taktiku.
Introduction. Hepatocellular carcinoma is the most common malignancy of the liver, the diagnosis of which is associated with high mortality in patients. The Child-Pugh score is used for grading liver function and is used in the current staging system for HCC, based on the Barcelona Clinic Liver Cancer (BCLC). It defines outcome prediction and the optimum treatment management. Aim of the study. To perform the clinical analysis of the patients with HCC as well as to evaluate the treatment options in the Clinical University hospital. Materials and methods. This study included 48 patients with HCC diagnose. The patients included in the study had a diagnosis of HCC based on radiological and/or histological criteria. Results. The common age of HCC patients: 55-64 years, with a predominance of men (79%). The common risk factors were detected for 29 patients - liver cirrhosis (25%), hepatitis C virus (HCV) infection (21%), hepatitis B virus (HBV) infection (3%) and combinations of some risk factors (51%). Alpha fetoprotein (aFP) was detected in 28 patients during the study and in 20 cases it was elevated. Child-Pugh score was perceived for 29 patients: 17 patients had Class A, 8 patients - Class B, 4 patients - Class C. Tumor type - solitary and multifocal occurs in an equal distribution - 50% in each case. The most common affected segments were IV, VII and VIII in 54% of cases (18% every of them) Analyzing total number of patients (n=48), 23 patients had received primary operative intervention, 18 patients had received non-operative treatment, 5 patients were not treated and 2 patients received liver transplantation. Conclusion. Concluding the received data of the research, the most common risk factors were liver cirrhosis. The patients with HCC could receive all types of the possible treatment in Latvia, however, the most common problem is that Child-Pugh score was not detected accurately that could influence further treatment tactic.
Introduction. Hepatocellular carcinoma is the most common malignancy of the liver, the diagnosis of which is associated with high mortality in patients. The Child-Pugh score is used for grading liver function and is used in the current staging system for HCC, based on the Barcelona Clinic Liver Cancer (BCLC). It defines outcome prediction and the optimum treatment management. Aim of the study. To perform the clinical analysis of the patients with HCC as well as to evaluate the treatment options in the Clinical University hospital. Materials and methods. This study included 48 patients with HCC diagnose. The patients included in the study had a diagnosis of HCC based on radiological and/or histological criteria. Results. The common age of HCC patients: 55-64 years, with a predominance of men (79%). The common risk factors were detected for 29 patients - liver cirrhosis (25%), hepatitis C virus (HCV) infection (21%), hepatitis B virus (HBV) infection (3%) and combinations of some risk factors (51%). Alpha fetoprotein (aFP) was detected in 28 patients during the study and in 20 cases it was elevated. Child-Pugh score was perceived for 29 patients: 17 patients had Class A, 8 patients - Class B, 4 patients - Class C. Tumor type - solitary and multifocal occurs in an equal distribution - 50% in each case. The most common affected segments were IV, VII and VIII in 54% of cases (18% every of them) Analyzing total number of patients (n=48), 23 patients had received primary operative intervention, 18 patients had received non-operative treatment, 5 patients were not treated and 2 patients received liver transplantation. Conclusion. Concluding the received data of the research, the most common risk factors were liver cirrhosis. The patients with HCC could receive all types of the possible treatment in Latvia, however, the most common problem is that Child-Pugh score was not detected accurately that could influence further treatment tactic.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
HCC, BCLC, riska faktori, segmenti, aFP, Child-Pugh rādītājs, ārstēšanas strateģija, HCC, BCLC, risk factors of HCC, segments, aFP, Child-Pugh score, treatment strategy