title: [The incidence and clinical significance of paraneoplastic syndromes in patients with hepatocellular carcinoma].
abstract: OBJECTIVE
  Patients with hepatocellular carcinoma (HCC) may manifest paraneoplastic syndromes such as hypercholesterolemia, hypoglycemia, hypercalcemia and erythrocytosis. This study was aimed at evaluating the incidence and clinical significance of paraneoplastic syndromes in Korean HCC patients.
  
  
  METHODS
  The medical records of 165 HCC patients who were diagnosed and died in the Kyung Hee University Hospital, were reviewed retrospectively. The following variables were analyzed: age, gender, hepatitis markers, platelet, liver function test, alpha-fetoprotein (AFP), Child-Pugh score, tumor features, and the duration of their survival.
  
  
  RESULTS
  In total, paraneoplastic syndromes were presented in 43.6% of the HCC patients during the course of their disease. Hypercholesterolemia was solely presented in 14.5%, hypoglycemia in 12.7% and hypercalcemia in 7.8%. The patients who presented with more than 2 syndromes were 8.5%. While 80% of erythrocytosis (4/5) and 51.6% of hypercholesterolemia (16/31) was presented at the time of HCC diagnosis, hypoglycemia and hypercalcemia mainly occurred as terminal events. The patients with paraneoplastic syndromes were younger and had higher rates of portal vein thrombosis, bi-lobar tumor involvement and tumor more of more than 10 cm in diameter, compared to those patients without them. The proportion of patients with a serum AFP more than 400 ng/mL tended to be higher in the patients with paraneoplastic syndromes. The HCC patients with paraneoplastic syndromes, except for erythrocytosis, had a shorter survival than those patients without them.
  
  
  CONCLUSIONS
  Paraneoplastic syndromes are not infrequently presented in HCC patients, especially at an advanced stage, and the survival of these patients is relatively shorter.
authors.affiliation: Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Uh Young
authors.initials: UY
authors.lastname: Huh
authors.forename: Jin Hyuk
authors.initials: JH
authors.lastname: Kim
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Kim
authors.forename: Ki Deuk
authors.initials: KD
authors.lastname: Nam
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Nam Hoon
authors.initials: NH
authors.lastname: Kim
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
authors.forename: Kwang Ro
authors.initials: KR
authors.lastname: Joo
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Dong
authors.forename: Hyo Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Young Woon
authors.initials: YW
authors.lastname: Chang
authors.forename: Joung Il
authors.initials: JI
authors.lastname: Lee
authors.forename: Rin
authors.initials: R
authors.lastname: Chang
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000150:complications / Q000175:diagnosis