title: Characteristics of hepatocellular carcinoma in Egyptian patients with primary Budd-Chiari syndrome.
abstract: Budd-Chiari syndrome (BCS) is caused by hepatic venous outflow obstruction. This work aimed at analyzing characteristics and factors associated with development of hepatocellular carcinoma (HCC) in patients with primary BCS.
  
  
  
  A total of 348 Egyptian BCS patients were included. They were presented to the Budd-Chiari Study Group of Ain Shams University Hospital. BCS was confirmed using abdominal Doppler US. Abdominal magnetic resonance imaging (MRI), MR venography and/or multislice computed tomography (CT) were performed to confirm all diagnoses and to assess vascular anatomy. Hepatic focal lesions detected during the study period (2005-2011) were evaluated using serum alpha foetoprotein (AFP) level, imaging features and histopathological examination.
  
  
  
  Diagnosis of HCC was confirmed in 15/348 patients (4.3%). Imaging studies showed that 60% had multiple hepatic focal lesions ranging from 2 to 6.3 cm in size. The median level of serum AFP in BCS with HCC was 300 ng/mL vs 11 ng/mL in those without HCC (P<.001). A cut-off level >24.5 ng/mL for serum AFP showed sensitivity 80%, specificity 97.9%, positive predictive value 93.18% and negative predictive value 99.1% for detection of HCC in BCS patients. Male gender, older age, cigarette smoking, serum AFP (>24.5 ng/mL) and shrunken liver by ultrasonography were independent factors associated with HCC development.
  
  
  
  Male gender, older age and cigarette smoking are independent risk factors for development of HCC in BCS. Serum AFP is a good screening test in BCS.
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Mohammad
authors: M
authors: Sakr
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Sara M
authors: SM
authors: Abdelhakam
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Hany
authors: H
authors: Dabbous
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Amr
authors: A
authors: Hamed
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Zeinab
authors: Z
authors: Hefny
authors: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Waleed
authors: W
authors: Abdelmoaty
authors: Department of Radiodiagnosis and Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Mohamed
authors: M
authors: Shaker
authors: Department of Radiodiagnosis and Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Mohamed
authors: M
authors: El-Gharib
authors: Department of Radiodiagnosis and Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Ahmed
authors: A
authors: Eldorry
mesh_terms: D000328:Adult; D006502:Budd-Chiari Syndrome / Q000097:blood* / Q000150:complications*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology*; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins
keywords: alpha foetoprotein; hepatocellular carcinoma; primary Budd-Chiari syndrome; thrombophilia