Search

The authors report the clinical and biological features in 197 patients with hepatocellular carcinoma seen in two French hospitals. Mean age was 63 +/- 12 years. Eighty-nine per cent were men. Cirrhosis was present in 88 p. 100. Alcoholic liver disease was associated with hepatocellular carcinoma in 71.5 p. 100. At the time of diagnosis, ascites was present in 62 p. 100 of the patients, jaundice in 49 p. 100, encephalopathy in 20 p. 100 and gastrointestinal bleeding in 12.5 p. 100. Twenty patients (10 p. 100) did not have any of these complications. An increase in serum gammaglutamyl transpeptidase and ASAT was the most frequent biological abnormality observed in 96 and 94 p. 100 of patients respectively. Hypercalcemia and a high hematocrit were present in 5 and 6 p. 100 of patients respectively. Serum HBs Ag (RIA) was present in 17.5 p. 100 of patients, anti-HBc in 50 p. 100 and anti-HBs in 33.5 p. 100; 38.5 p. 100 of patients had no serum HBV marker. Serum alphafetoprotein levels were higher than 20 ng/ml, 250 ng/ml and 1,000 ng/ml in 76.5 p. 100, 43.5 p. 100 and 33 p. 100 of patients respectively. There were no relationships between the presence of serum markers of HBV or high alphafetoprotein levels and clinical and biological data. These results confirm that the clinical, biological and virological aspects of hepatocellular carcinoma in France are similar to those reported in other western countries.

Prevalences of serum markers of hepatitis B virus and alphafetoprotein levels were investigated in 96 patients with hepatocellular carcinoma. Serum HBs Ag was present in 17 patients (17.5 p. 100), anti-HBc antibody alone in 10 patients (10.5 p. 100), and anti-HBs antibody with or without associated anti-HBc antibody in 32 patients (33.5 p. 100). Serum alphafetoprotein levels were increased (greater than 20 ng/ml) in 71 patients (74 p. 100). Serum alphafetoprotein levels were significantly higher in patients with than in patients without serum HBs Ag. Serum alphafetoprotein levels above 1,000 ng/ml were more frequently found in patients with serum HBs Ag or anti-HBc antibody than in other patients. These results suggest the presence of a link between HBs Ag and alphafetoprotein in hepatocellular carcinoma.

Alcoholic hepatitis (AH) seems to be less frequent and to play a lesser role in the death of cirrhotic patients than previously acknowledged. The purpose of this work was: 1) to study the cause of death of cirrhotic patients 2) to determine the prevalence of AH among these patients and 3) to describe the clinical and laboratory features of cirrhotic patients with AH. The data were collected from a series of 107 necropsies in cirrhotic patients without hepatocellular carcinoma. The statistical analyses were carried out with an IRIS 80 computer. Severe liver failure with jaundice and encephalopathy, hemorrhage and uncontrolled infection with septic shock represented 84 p. 100 of the causes of death in patients with cirrhosis. Seventy-nine out of 107 patients (74 p. 100) had no AH (group 1), and 28 (26 p. 100) had AH (group 2): AH was mild in 15 cases and severe in 13 cases. All patients with AH died from a complication directly related to their liver disease while 21.5 p. 100 of patients without AH died from a complication not related to cirrhosis. The clinical and laboratory features of the patients without AH and cirrhosis differed from those of patients without AH by: a more frequent presence of fever (p less than 0.01), the absence of important weight loss (p less than 0.001), the total absence of abstinence (p less than 0.05), a higher value of ASAT/ALAT ratio, of serum levels of total bilirubin (p less than 0.01) and conjugated bilirubin (p less than 0.05), gamma glutamyl transpeptidase (p less than 0.001) and total cholesterol (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)