title: Clinico-cytopathological spectrum of hepatocellular carcinoma, its correlation with serum alpha-fetoprotein level, and hepatitis B and C viral markers.
abstract: Fine-needle aspirationbiopsy (FNAB) is now widely accepted as a diagnostic modality for the treatment of hepatocellular carcinoma (HCC). The most common diagnostic problem in HCC is distinguishing it from a metastatic carcinoma. The literature from India on HCC is scanty. Hence, we studied the cytomorphological features of HCC and metastatic carcinoma. The study included 37 cases of space-occupying lesions (SOLs) of the liver as demonstrated by ultrasound or computed tomography (CT) scan. Cytomorphological features of these SOLs were analyzed in all subsequent to FNAB. Hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibody (anti-HCV) and alpha-fetoprotein (AFP) were determined in all the cases by enzyme-linked immunosorbent assay (ELISA). The cytopathological diagnosis was HCC in 22 and metastatic carcinoma of the liver in 15. The individual cytomorphological features and which helped to make a definite diagnosis of HCC were: a high nuclear cytoplasmic ratio (81.8%), predominantly trabecular pattern (63.6%) and atypical naked nuclei (100%). Other features were prominent multiple nucleoli (63.3%), hyperchromasia (100%) and moderate anisonucleosis (59%). AFP was elevated in 81.8% of the cases with a mean of 634.8+812.7 ng/ml. HBsAg by ELISA was found to be positive in 72.7% of cases while only 1 case (4.5%) was positive for anti-HCV. In 1 case (4.5%), there was dual infection due to hepatitis B virus (HBV) and HCV. No viral cause was found in 18.3% of cases.
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh.
authors.forename: Nitin Shriniwas
authors.initials: NS
authors.lastname: Radhika
authors.forename: Ajay
authors.initials: A
authors.lastname: Duseja
authors.forename: Arwind
authors.initials: A
authors.lastname: Rajwanshi
authors.forename: Subhash Kumari
authors.initials: SK
authors.lastname: Gupta
authors.forename: Shobha
authors.initials: S
authors.lastname: Sehgal
authors.forename: Sudha
authors.initials: S
authors.lastname: Suri
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Chawla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D044963:Biopsy, Fine-Needle; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D018937:Hepatitis C Antibodies / Q000032:analysis*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D000509:alpha-Fetoproteins