title: Hepatocellular carcinoma in Karachi.
abstract: The present study defines the clinical presentation and examines possible aetiological factors in the occurrence of hepatocellular carcinoma in Karachi, Pakistan. Histologically proven cases of hepatocellular carcinoma (n = 366) were seen over 16 years. The maximum frequency occurred in the age range 51-60 years (range: 8-98 years), and the male to female ratio was 2.5:1. The place of birth, place of longest stay and various addictions did not have any association with the occurrence of liver carcinoma. Only three cases had a history of liver cancer in their immediate relatives. The main presenting features were right hypochondrial mass (85%) and pain (79%). The liver size did not correlate with the duration of illness. alpha-Fetoprotein titres were more than 200 ng/mL in 62% of cases. Using a reverse passive haemagglutination assay method, HBsAg and anti-HBc positivity were 32% and 60%, respectively. Antigen figures rose to 60% when radio-immunoassay was used; 41% of cases were anti-delta positive (EIA). Aflatoxin contamination varied between 10% and 17% in various localities of Karachi, suggesting an association of liver cancer with HBsAg and aflatoxins. Histopathologically 73% were trabecular, and 2.5% were mixed hepatocholangiocarcinomas. Follow-up was available in 45% of cases. All except two (1.2%) died within 6 months.
authors.affiliation: Pakistan Medical Research Council, Research Centre, Basic Medical Sciences Institute (Pathology), Karachi.
authors.forename: H
authors.initials: H
authors.lastname: Qureshi
authors.forename: S J
authors.initials: SJ
authors.lastname: Zuberi
authors.forename: N A
authors.initials: NA
authors.lastname: Jafarey
authors.forename: S H
authors.initials: SH
authors.lastname: Zaidi
mesh_terms: D000348:Aflatoxins / Q000009:adverse effects; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006508:Hepatitis Antibodies / Q000032:analysis; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D011863:Radioimmunoassay; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000348:Aflatoxins; D014408:Biomarkers, Tumor; D006508:Hepatitis Antibodies; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D000509:alpha-Fetoproteins