title: [Analysis of risk factors for spontaneous rupture of hepatocellular carcinoma].
abstract: OBJECTIVE
  To assess the risk factors for spontaneous rupture of hepatocellular carcinoma (SRHC).
  
  
  METHODS
  A retrospective analysis of 34 consecutive patients with SRHC treated by emergency interventional embolization in our hospital from July 2003 to July 2011 was conducted. General condition, laboratory examination and imaging data were analyzed, and compared with the data of 34 patients with primary hepatocellular carcinoma but without rupture, randomly selected from 215 concurrent patients. The patients with SRHC were selected for risk factor analysis, and the non-SRHC patients were taken as control group.
  
  
  RESULTS
  No significant difference between the SRHC group and control group was found in age, sex, Child-Turcotte-Pugh (CTP) grade, Barcelona clinic liver cancer (BCLC) stage, HBsAg, HBsAb, HBeAg, HBeAb, HBcAb, prothrombin time (PT), thrombin time (TT), international normalized ratio (INR), glucose (GLU), cirrhosis, portal tumor thrombus, the maximum diameter of tumor, location, and cholecystitis or cholelithiasis. The univariate analysis showed that activated partial thromboplastin time (APTT), lower or normal plasma fibrinogen (FIB) level, alpha fetoprotein (AFP), tumor protrusion > 1 cm above the liver surface were all associated with increased risk of SRHC (P < 0.05). Multivariate analysis only showed that lower or normal level of FIB (P = 0.033) and tumor protrusion > 1 cm above the liver surface (P = 0.041) were significant independent risk factors for SRHC.
  
  
  CONCLUSIONS
  Lower or normal level of FIB and tumor protrusion > 1 cm above the liver surface are significant independent risk factors for spontaneous rupture of hepatocellular carcinoma.
authors.affiliation: Department of Interventional Radiology, Third Affiliated Hospital of Wenzhou Medical College, Wenzhou 325200, China.
authors.forename: Meng-xing
authors.initials: MX
authors.lastname: You
authors.forename: Xi-xiang
authors.initials: XX
authors.lastname: Yu
authors.forename: Kuan
authors.initials: K
authors.lastname: Wu
authors.forename: Yong-sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Guo-qing
authors.initials: GQ
authors.lastname: Zhu
authors.forename: Chang-sheng
authors.initials: CS
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D012189:Retrospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000509:alpha-Fetoproteins; D005340:Fibrinogen