Incidence and Histopathology of Hepatocellular Carcinoma in Iraqi Patients

Dhafer  Jawad

Dhafer Jawad Al-Muthanna University , College of Medicine , Department of Pathology, PhD Molecular Pathology

Keywords: HCC, male, female, age, histopathology

Abstract

This study aimed to Know the Incidence and Histopathology of hepatocellular carcinoma in Iraqi patients. A study was conducted on 41 patients diagnosed with hepatocellular carcinoma (HCC) between February 2022 and March 2023. The study cohort consisted of 32 male and 9 female patients with different ages. The study participants were obtained from medical and surgical units across multiple hospitals and subsequently referred to a specialized pathological laboratory located in the Baghdad Province. Liver biopsy can be performed through various methods such as Trucut needle biopsy, Chiba needle biopsy directly on liver tissue or under ultrasound guidance, or open liver biopsy through diagnostic laparoscopy or explorative laparotomy. Histological slides were done and stained with H&E stain. The findings of the present study or data analysis indicate a discrepancy in disease rates between genders, with males exhibiting higher rates compared to females. The current findings exhibited that age group (51-60 years) were highly diseased than other groups. On histopathology, the growth patterns of tumoral hepatocytes can be classified into three distinct types: trabecular, acinar or pseudoglandular, and compact or solid. The trabecular pattern is distinguished by the disposition of hepatocytes in plates of diverse thickness, which are demarcated by vascular spaces known as sinusoids. The acinar or pseudoglandular configuration is distinguished by the expansion of canaliculi between neoplastic cells, resembling glandular structures, with luminal spaces that may harbour bile, or the central deterioration of trabeculae, with luminal spaces predominantly occupied by fibrin. The compact or solid pattern comprises of dense trabeculae that are compressed into a compact entity. In conclusion, males were more diseased than females especially at age 50-61 years and histopathology can aid in diagnosis and differentiate HCC from other liver diseases.

References

1. Carr, B.I., Lotze, M.T. and Flicking, T.C.: Hepatobilliary cancers, Devita, V., Hellman, S. and Rosenberg, S.A. Principles and practice of Oncology, Lippincott 1997: 1087-128.
2. Scott Howard , M.D. , M.S. , Memphis TN . : Review provided by veri Med. Health care Net work. Review Date 2002 .
3. Sabiston, D.C.: Textbook of surgery: The biological basis of modern surgical practice . 15th ed. WB. Saunders , Philadelphia. 1997 .
4. Yuen M , Hou J and Chutaputti A . HCC in the Asia pacific region . J Gastroenterol Hepatol 2009;24: 346-53.
5. Ferlay J , Autier P , Boniol M , Heanue M , Colombet M and Boyle P . Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 2007;18:581-92 .
6. Hardell L. , Bengtsson No. Jonsson U.etal. : Etiological aspects of primary liver cancer with special regard to alcohol , organic solvents and acute itermitant porphyria : An epidemiological study. Br. J. Cancer 1984; 50 : 389– 92 .
7. Eriksson S., Carlson J. , and velez : Risk of cirrhosis and primary liver cancer in alpha -1 antitrypsin deficiency . N.Engl. J. Med. 1986; 314 :736 – 39 .
8. Van damme P. , Kane M. , Meheus A. : for the viral hepatitis , prevention board integration of hepatitis B vaccination into national immunization programs BMJ. 1997;314:1033 – 6 .
9. Sherlock S. : Hepatic tumors in Disease of the liver and biliary system 8th ed. , London : Blackwell scientific , 1989:558.
10. Akriviadis EA. , liovet JM. , Efremidis SC. et al : HCC. Brit J. Surgery 1998;85: 1319 – 31 .
11. Niederani C. , Fischer R. , Sonneberg A. et al : Survival and causes of death in cirrhotic and in non cirrhotic patients with primary hemochromatosis N. Eng J. Med . 1995;313 : 1256 – 62 .
12. Purtillo DT. : chlonorchiasis and hepatic tumors. Geop. Med. 1976;28:21-27 .
13. Jay, H.S.: Internal Medicine, little Brown and company Boston, Toronto, 6th ed . 1997:1804 .
14. Abou – shady – M . :Molecular aspects of HCC , department of visceral & transplantation surgery, University of Bern . Inselspital switzerland . Swiss Surg. 1995;5 : 102 – 6.
15. Zuhair Alkassir , Ziad M . Juredini : HCC. in Iraq . J- Fac. Medicine Baghdad – 1986 ;28.
16. Flickinger JC . , Carr BI . , Lotz MT. : cancer of the liver . In Devita Vt. , Hellman S., Rosenberg SA. , eds cancer : principles and practice of oncology . 5th ed . Philadelphia : Lippincott – Raven , 1997:1087–97 .
17. Shomura, M., Kagawa, T., Okabe, H., Shiraishi, K., Hirose, S., Arase, Y., Tsuruya, K., Takahira, S. and Mine, T., 2016. Longitudinal alterations in health-related quality of life and its impact on the clinical course of patients with advanced hepatocellular carcinoma receiving sorafenib treatment.BMC cancer,16(1), 1-9.
18. Brunocilla, P.R., Brunello, F., Carucci, P., Gaia, S., Rolle, E., Cantamessa, A., Castiglione, A., Ciccone, G. and Rizzetto, M. (2013). Sorafenib in hepatocellular carcinoma: prospective study on adverse events, quality of life, and related feasibility under daily conditions.Medical Oncology,30(1), 1-8.
19. Balogh, J., Victor III, D., Asham, E.H., Burroughs, S.G., Boktour, M., Saharia, A., Li, X., Ghobrial, R.M. and Monsour Jr, H.P. (2016). Hepatocellular carcinoma: a review.Journal of hepatocellular carcinoma,3, 41.
20. Omata M, Peters RL, Tatter D (1981) Sclerosing hepatic carcinoma: relationship to hypercalcemia. Liver 1:33–49.
21. Kojiro M, Sugihara S, Kakizoe S et al (1989) Hepatocellular carcinoma with sarcomatous change: a special reference to the relationship with anticancer therapy. Cancer Chemother Pharmacol 23:4–8.