title: Hepatocellular carcinoma and its early detection by AFP testing in Mongolia.
abstract: Liver cancer is one of the leading causes of cancer death in Mongolia. Since 1982-1986 , when HCC became the most frequent cancer among the Mongolian population, the rate has been increasing continuously. In the period 2000-2005 years 35.3%of all newly registered cancer cases were liver cancers, with an incidence rate of 51.3 per 100,000 population. Compared to the previous 5 year period, the rate increased by 11%. The objective here was to analyze hepatitis B (HBV) and C virus (HCV)-related HCC cases and to evaluate the possibility of tumor marker (AFP) testing for early detection in Mongolia. Sera from a total of 513 patients with chronic liver diseases, liver cirrhosis and HCC were analyzed for liver function (ALAT, ASAT) and hepatitis virus markers (HBsAg, anti-HCV). Sera from 316 patients were also examined for alpha-fetoprotein (AFP) levels. The overall incidence of HBsAg or anti-HCV were very high ( 95.3%) among all patients. Some 33.5% (66/197) of patients with HCC were positive for HBsAg and 45.2% (89/197) for anti-HCV. Moreover, 17.3% ( 34/197) of HCC patients demonstrated co-infection with HBV and HCV. AFP levels were elevated in 4.6% (11/238) and 29.5% (23/78) of chronic hepatitis and cirrhosis patients, respectively. In HCC cases, 84.3% (166) of patients had increased level of AFP ranging from 32 ng/ml to more than 400 ng/ml. We conclude that HBV/HCV infection is the main factor related to development of HCC in Mongolia and that testing for AFP serum levels is a useful tool for early detection and diagnosis.
authors.affiliation: Laboratory of Molecular Biology, Center for Biotechnology, Mongolian Academy of Sciences, Health Sciences University, Ulaanbaatar, Mongolia. tsosuren@yahoo.com
authors.forename: Tsendsuren
authors.initials: T
authors.lastname: Oyunsuren
authors.forename: Ruvjir
authors.initials: R
authors.lastname: Sanduijav
authors.forename: Duger
authors.initials: D
authors.lastname: Davaadorj
authors.forename: Dorj
authors.initials: D
authors.lastname: Nansalmaa
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000209:etiology; D042241:Early Diagnosis; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D006509:Hepatitis B / Q000097:blood / Q000150:complications; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification; D006526:Hepatitis C / Q000097:blood / Q000150:complications; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008986:Mongolia / Q000453:epidemiology; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D006514:Hepatitis B Surface Antigens; D000509:alpha-Fetoproteins