Early Detection and prediction of survival of patients with Hepatocellular Carcinoma Using Transient Elastography

Hashem, Mohamed B.; Shousha, Hend Ibrahim; Abou Hia Allah, Mohammed N.; Abdelaziz, Ashraf Omar; Al-Nadry, Mohammed H.; Gomaa, Walid M.; Abdel-Halim, Mohamed M.; Nabeel, Mohamed Mahmoud; Elbaz, Tamer Mahmoud; Abdelmaksoud, Ahmed Hosni; Badary, Hedy A.

doi:10.21608/ajgh.2023.245244.1039

Early Detection and prediction of survival of patients with Hepatocellular Carcinoma Using Transient Elastography

Document Type : Original Clinical

Authors

¹ Endemic medicine department, Faculty of Medicine, Cairo University

² Endemic Medicine Department, Faculty of Medicine, Cairo University

³ Hepatogastroenterology and Infectious diseases department, Faculty of Medicine, Al-Azhar University

⁴ Diagnostic and interventional radiology department, Faculty of Medicine, Cairo University

10.21608/ajgh.2023.245244.1039

Abstract

Background:
Detection of early cases of HCC allows for offering curative interventions that may positively impact the survival of patients. Screening depends on the use of ultrasound with or without alpha-fetoprotein. However, some cases might need to be noticed, so alternatives are needed. Transient elastography can be studied as an effective alternative.
Methods:
Patients were divided into groups with liver cirrhosis and HCC and another group without HCC. Demographic criteria and laboratory profiles were compared. Transient elastography was then performed, and values of Controlled Attenuation Parameters (CAP) and liver stiffness were compared between both groups.
Results:
One hundred thirty-three patients with liver cirrhosis and HCC and 133 patients without HCC were studied. Our study showed that patients with HCC had significantly lower steatosis as measured by CAP using transient elastography (p-value < 0.001). However, they had substantially higher fibrosis (p-value < 0.001). A cutoff level of >24.3 Kpa showed a 90.5% sensitivity, 85.7% specificity, 86.4% PPV and 90% NPV for predicting the occurrence of HCC. By using univariate analysis, smoking was a significant predictor for mortality of HCC patients. In contrast, the multivariate analysis showed that gender was an independent predictor for mortality in patients with HCC. Liver stiffness measurement was not shown to predict survival in patients with HCC.
Conclusion:
Detection of early HCC is essential to gain the utmost benefit from the available therapeutic options. Transient elastography may provide a tool for diagnosing patients in the early stages. However, it might not be a good predictor of overall survival.

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