Hepatocellular carcinoma in Brazil: report of a national survey (Florianópolis, SC, 1995)

Abstract

In order to investigate epidemiological aspects of hepatocellular carcinoma (HCC) in Brazil, basic informations about cases diagnosed from January 1992 to December 1994 were requested to several medical centers of different Brazilian States. A simple questionnaire included age, sex, alcohol abuse (over 80g/day), associated liver cirrhosis, persistent HBV infection (HBsAg), HCV infection (anti-HCV) and serum levels of alpha fetoprotein. 287 cases, over 16 years old, from 19 medical centers of 8 States (Pará, Bahia, Minas Gerais, Espirito Santo, Rio de Janeiro, São Paulo, Paraná and Rio Grande do Sul) were analysed. The results showed: (a) Mean age was 56.3 +/- 14.4 for men and 54.7 +/- 16.8 yr for women and the male/female ratio was 3.4:1. (b) 69.6% were caucasians, 21.8% mullatoes, 4.8% orientals and 3.7% blacks. (c) HBsAg (+) in 77/236 cases (41.6%) without differences between males and females. (d) Anti-HCV (+) in 52/193 cases (26.9%). (e) 7/180 cases were positive both for HBsAg and anti-HCV (3.8%). (f) There was chronic alcoholism in 88/235 cases (37%). (g) HCC was found in cirrhotic livers in 71.2% of 202 cases in which the presence or absence of cirrhosis was reported. (h) Alpha-fetoprotein above 20 ng/ml was found in 124/172 cases (72%) and above 500 ng/ml only in 40 cases (23.2%). These results showed that the HCC in Brazil has an intermediate epidemiological pattern as compared to those from areas of low and high incidence of the tumor. In spite of the high frequency of the association of HCC with the HBV and/or HCV infections, 42% of 180 cases were negative both for HBsAg and anti-HCV, indicating the possible role of other etiological factors. The comparison of data from different States showed some regional differences: higher frequency of associated HBsAg in Pará, Bahia, Minas Gerais and Espírito Santo, higher frequency of associated HCV infection in Rio de Janeiro, São Paulo and States of the Southern region and low frequency of associated liver cirrhosis in Salvador and Rio de Janeiro (55.5 and 50% respectively). Further investigation will be necessary to study the presence of other possible etiological factors as aflatoxins, suggested by the favourable climatic conditions for food contamination by fungi in the majority Brazilian regions.

Biochemical Nutritional Profile of Liver Cirrhosis Patients With Hepatocellular Carcinoma

“…This finding was probably due to the fact that the collection was carried out in an ambulatory, where more stable patients are evaluated. The fact that group HCC is composed by younger patients is in accordance with the literature, as is the predominance of male patients in both groups (12) .…”

Hepatitis virus and hepatocellular carcinoma in Brazil: a report from the State of Espírito Santo

“…The results of the fi rst survey indicated that HBV was a common factor associated with HCC in the North and Northeast regions, whereas HCV was the main risk factor overall, especially in metropolitan areas in the South and Southeast regions 9 . The second survey yielded different results: HCV was found to be the main associated risk factor in all regions, but a high frequency of HBV-associated cases in the North, Central West and Northeast regions was also noted 10,11 .…”

“…In a series of HCC cases that were diagnosed in Belo Horizonte, MG, the main associated factor was found to be HCV (44% of cases), while HBV infection was observed in 23.5% of cases 12 . Associated liver cirrhosis has been reported at different frequencies in HCC cases in Brazil, ranging from 87% in the fi rst national survey 9 to 98% in the second survey 10,11 . Because Brazil is a large country and the environmental risk factors for HCC may vary across regions, we chose to examine the main associated risk factors in 274 cases of hepatocellular carcinoma diagnosed at the University Hospital in Vitória; we thus investigated HBV and HCV infections and chronic alcoholism in all cases.…”

Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantation

“…In Brazil, its clinical and epidemiological aspects widely vary amongst different regions 4 , where is considered a neoplasm of low prevalence in general 5 .…”