OUTCOME OF ELEVATED ALPHA-FETOPROTEIN LEVELS ON MORTALITY IN PATIENTS WITH HCV RELATED HCC AT LIAQUAT UNIVERSITY HOSPITAL, HYDERABAD / JAMSHORO

OBJECTIVES: To determine the frequency of death due to elevated serum alpha-fetoprotein (AFP ≥20 IU/ml) in HCV patients suffering from HCC in Liaquat University Hospital, Hyderabad/Jamshoro MATERIAL & METHODS: This case series study was conducted in the department of department of Medicine Liaquat University Hospital, Hyderabad/Jamshoro, with six months from 4TH October 2014 to April 2014. All the patients with hepatocellular carcinoma due to hepatitis C virus, raised alpha fetoprotein levels (20IU/ml), HCC newly or recent diagnosed i.e. diagnosed within last 6m, tumour size more than or equal to 3cm, adult population (if they are having underlying HCV related HCC) either gender were included in the study. RESULTS: A total of 165 HCC patients were enrolled in this study with average age + SD 55.8+10.112 years.152(92.1%) were male and 13(7.87%) were female. 92(55.7%) were middle class, 51(30.9%) patients were from rich families and 22(13.3%) consisted to poor class of socio-economic status. Mean duration + SD (range) of HCC was 12.53 + 7.23 (1 to 48 years). 29(17.5%) patients had tumor size < 3 cm, 66(40.0%) had tumor size 3 to 5 cm whereas 70(42.4%) patients had tumor size > 5 cm. 32(19.3%) patients had normal serum alpha fetoprotein level (< 20 IU/ml), 38(23.0%) moderately elevated alpha fetoprotein level (20 to 399 IU/ml) while 95(57.5%) patients had markedly elevated serum alpha fetoprotein level(≥400 IU/ml). Overall mortality was seen in 68(41.1%). Tumor size > 5 cm and markedly elevated AFP (≥400 IU/ml), duration of HCC were found to be significant causes and biomarkers of mortality in HCC patients respectively (p value 0.01, < 0.0001). CONCLUSION: HCC patients with elevated AFP levels determine a higher mortality rate, which appears to be attributable to the growth promoting properties of AFP. Key words: Hepatocellular carcinoma, Alpha feto-protein, HCV