So sánh đặc điểm lâm sàng, cận lâm sàng và mô bệnh học của ung thư biểu mô tế bào gan ở bệnh nhân xơ gan và không xơ gan

Hepatocellular carcinoma (HCC) stands as a formidable global health challenge, frequently associated with underlying liver cirrhosis. However, a significant subset of HCC cases arises in non-cirrhotic livers, presenting with distinct clinical and pathological characteristics that profoundly impact prognosis and therapeutic approaches. In Vietnam, a region with a high burden of HCC and often late diagnoses, a comprehensive understanding of these differences is crucial for optimizing patient management. This study aims to delineate and compare the clinical, paraclinical, and histopathological features of HCC in patients with and without cirrhosis, thereby informing more targeted screening, diagnosis, and treatment strategies within resource-limited settings.

Medical professionals, researchers, and public health practitioners in hepatology, oncology, gastroenterology, and pathology, especially those focused on liver diseases and cancer in Southeast Asia.

This cross-sectional study investigated 108 patients who underwent surgical resection for hepatocellular carcinoma at the University Medical Center Ho Chi Minh City in 2018, aiming to compare features between those with and without liver cirrhosis. Clinical, paraclinical, and histopathological data were collected, with cirrhosis defined by Ishak-Knodell fibrosis scores F5-F6. The results revealed that 80 (74.1%) patients had cirrhosis, while 28 (25.9%) did not. Significantly, the non-cirrhotic group presented with larger tumor sizes, higher alpha-fetoprotein (AFP) levels, better-preserved liver function (evidenced by a higher proportion of ALBI score ≤ -2.6), and a remarkably lower prevalence of Hepatitis C virus infection compared to the cirrhotic group. Conversely, a platelet count below 225 G/L was more common in cirrhotic patients. While some histopathological aspects like tumor differentiation showed no significant differences, the distinction in tumor size and liver function is notable. These findings underscore that hepatocellular carcinoma in non-cirrhotic Vietnamese patients exhibits specific characteristics, which can inform tailored clinical management. The study's implications suggest the need for differentiated screening protocols and therapeutic interventions, potentially allowing for more aggressive curative treatments like wide liver resection in non-cirrhotic patients due to their better liver function. Furthermore, these results pave the way for future research into the molecular mechanisms differentiating these two forms of hepatocellular carcinoma, enhancing personalized medicine approaches.