High burden of hepatocellular carcinoma and viral hepatitis in Southern and Central Vietnam:Experience of a large tertiary referral center,2010 to 2016

查看全文 作　　者：Song-Huy Nguyen-[1]Dinh;Albert [2,5]Do;Trang Ngoc Doan [3,5]Pham;Doan Y [4,5]Dao;Trinh Nhu [1]Nguy;Moon S Chen [6]Jr

机构地区：[1]Liver Tumor,Department,Cho Ray Hospital,Ho Chi Minh City 700000,Vietnam;[2]Department of Internal Medicine,Yale University,New Haven,CT 06510,United States;[3]School of Public Health,University of Illinois,Chicago,IL 60302,United States;[4]Division of Digestive and Liver Diseases,UT Southwestern Medical Center,Dallas,TX 75390,United States;[5]Vietnam Viral Hepatitis Alliance,Ho Chi Minh City 7000,Vietnam;[6]Davis Comprehensive Cancer Center,University of California,Sacramento,CA 95817,United States

出　　处：《World Journal of Hepatology》索引2018年第10卷第1期,共8页

基　　金：Supported by Cho Ray Hospital(to SH and TN);Vietnam Viral Hepatitis Alliance(to Dao DY and Pham TND);National Institutes of Health T32 training,No.T32 DK 007017-40(to AD);National Institutes of Health T32 training,No.T32 DK 745-18(to DD);National Cancer Institute,No.U54CA153499(to MC) 摘　　要：AIM To examine the largest tertiary referral center in southern and central Vietnam from 2010 to 2016, evaluating epidemiological trends of hepatocellular carcinoma(HCC) and viral hepatitis B-C in this resource-limited setting.METHODS We extracted data of patients receiving care from Cho Ray Hospital(Ho Chi Minh City), the largest oncology referral center in southern and central Vietnam, from 2010 to 2016. We collected information on patient age, gender, geographic distribution, and disease characteristics including disease stage, tumor biomarker levels [serum alpha-fetoprotein(AFP), AFP-L3 isoform percentage, and prothrombin induced by induced by vitamin K absence-Ⅱ], and serological testing for hepatitis B virus(HBV) and hepatitis C virus(HCV) infections.RESULTS Data from 24091 HCC patients were extracted, with sample demographics comprising mostly male(81.8%) and older age(however with 8.5% younger than 40 years old). This patient sample included a geographic catchment population of 56 million people(60% of the country's total population of 92.7 million), derived from 38 provinces and municipalities in Vietnam. Chronic HBV infection was found in 62.3% of cases, and chronic HCV infection in 26.0%. HBV and HCV co-infection was seen in 2.7%. Cirrhosis was found in an estimated 30% to 40% of cases. Nine percent of patients were not found to have chronic viral hepatitis. Twenty three point two percent of the patients had a normal AFP level. A total of 2199 patients were tested with AFP-L3 and PIVKA Ⅱ over two years, with 57.7% having elevated AFP-L3%, and 88.5% with elevated PIVKA Ⅱ levels. Over this 7-year period, the incidence of HCC increased, with a large proportion of cases(overall 40.8%) presenting initially an advanced stage, not amendable to surgical or locoregional therapy.CONCLUSION HCC contributes significant health care burden in southern and central Vietnam, with increasing case volume over this seven-year period. Viral hepatitis likely explains this high HCC prevalence. 关键词：Hepatocellular carcinoma HEPATITIS B VIRUS HEPATITIS C VIRUS ALPHA-FETOPROTEIN

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High burden of hepatocellular carcinoma and viral hepatitis in Southern and Central Vietnam:Experience of a large tertiary referral center,2010 to 2016

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