title: Paraneoplastic syndromes in patients with hepatocellular carcinoma in Taiwan.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is the most common malignancy in Taiwan. Some patients may manifest paraneoplastic syndromes during the clinical course of the disease. In this study, the authors evaluated the clinical significance of these paraneoplastic syndromes, compared the prevalence of these syndromes between cases of hepatitis B virus (HBV)-related and hepatitis C virus (HCV)-related HCC, and estimated significant predictors associated with the syndromes.
  
  
  METHODS
  Clinical data on 1197 HCC patients, including age, gender, Child-Pugh score, survival time, laboratory data (including liver biochemistry, hepatitis markers, and serum alpha-fetoprotein [AFP]), and tumor features (including tumor size, portal vein thrombosis, and histologic pictures), were retrospectively reviewed.
  
  
  RESULTS
  A total of 232 of 1197 patients (19.4%) had paraneoplastic syndromes. HCC patients with paraneoplastic syndromes had significantly higher serum AFP; higher rates of initial main portal vein thrombosis, metastasis, and bilobal tumor involvement; larger tumor volume; and shorter survival than those without these syndromes. Patients with HBV-related HCC had a significantly higher prevalence of paraneoplastic syndromes than patients with HCV-related HCC (20.1% vs. 11.2%, P = 0.005). In a stepwise multivariate logistic regression analysis, AFP >50,000 ng/mL and tumor volume >30% were significant predictive variables associated with the presence of paraneoplastic syndromes in HCC patients.
  
  
  CONCLUSIONS
  HCC patients with paraneoplastic syndromes usually had higher levels of serum AFP and larger tumor volumes than those without. Patients with HBV-related HCC had a significantly higher prevalence of paraneoplastic syndromes than those with HCV-related HCC.
authors.affiliation: Division of Gastroenterology, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: J C
authors.initials: JC
authors.lastname: Luo
authors.forename: S J
authors.initials: SJ
authors.lastname: Hwang
authors.forename: J C
authors.initials: JC
authors.lastname: Wu
authors.forename: C P
authors.initials: CP
authors.lastname: Li
authors.forename: L T
authors.initials: LT
authors.lastname: Hsiao
authors.forename: C R
authors.initials: CR
authors.lastname: Lai
authors.forename: J H
authors.initials: JH
authors.lastname: Chiang
authors.forename: W Y
authors.initials: WY
authors.lastname: Lui
authors.forename: F Y
authors.initials: FY
authors.lastname: Chang
authors.forename: S D
authors.initials: SD
authors.lastname: Lee
mesh_terms: D000368:Aged; D015415:Biomarkers; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000378:metabolism / Q000821:virology; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000453:epidemiology* / Q000378:metabolism / Q000821:virology; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D015415:Biomarkers; D000509:alpha-Fetoproteins