Thesis Abstract

Hepatocellular carcinoma (HCC) is a primary malignancy of the liver and is one of the leading causes of cancer-related deaths worldwide. Chronic hepatitis B and C infections are major risk factors for the development of HCC. Alpha-fetoprotein (AFP) is a well-known biomarker that has been used for HCC screening and surveillance. However, its role in predicting the progression of hepatitis to HCC remains controversial. This study aimed to analyze the alpha-fetoprotein (AFP) levels in hepatitis patients as an aid in assessing the degree to which it correlates with the development of hepatocellular carcinoma (HCC). A total of 200 hepatitis patients were included in the study, with a mean age of 55 years. The patients were followed up for a period of 5 years to monitor the progression to HCC. The results showed that 30% of the hepatitis patients developed HCC during the follow-up period. The mean AFP level in the HCC group was significantly higher compared to the non-HCC group (P < 0.001). Furthermore, there was a positive correlation between AFP levels and the stage of HCC, with higher AFP levels observed in advanced stages of the disease. In addition, the study found that hepatitis patients with AFP levels above 200 ng/mL had a significantly higher risk of developing HCC compared to those with lower AFP levels (P = 0.003). The sensitivity and specificity of AFP in predicting HCC development were 70% and 85%, respectively. Overall, the findings suggest that AFP levels can serve as a useful marker in assessing the degree to which hepatitis patients may progress to HCC. Regular monitoring of AFP levels in hepatitis patients, especially those with levels above 200 ng/mL, may help in early detection and management of HCC. However, further studies are needed to validate these findings and to explore the potential of combining AFP with other biomarkers for improved prediction of HCC development in hepatitis patients.

Thesis Overview

1.0 INTRODUCTION

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. It accounts for 60% of all cancer world wide (Melissa 2004). The most significance cause is the presence of cirrhosis. HCC has unique geographic sex, age distribution that are likely determined by specific actiology factor. It’s distribution also varies among ethnic group within the same country (Munoz 1989). A high incidence of hepatitis B and C may have been an important factor contributing to the development of liver disease (HCC and Cirrhosis) in south eastern Nigeria. However, a recent trend which reveals an increase in cases of liver cirrhosis and hepatitis in our environment suggest that there could be other contributory factors peculiar to our environment besides hepatitis B and C which could be possible explanation to the recent trend. In so doing, it would be necessary to look into the various predisposing/causative factors of chronic hepatitis which could lead to increased cases of liver cirrhosis and HCC in our environment. The risk of developing HCC differs depending on the cause of cirrhosis. For example, cirrhosis due to hepatitis B has a high risk of leading to HCC while the risk of HCC in people with primary biliary cirrhosis, although present is very low. All these human hepatitis viruses are RNA viruses except for hepatitis B virus, which is a DNA virus. Although these viruses can be distinguished by their molecular and antigenic properties, all types of viral hepatitis produce clinically similar illnesses. These range from asymptomatic and unapparent to fulminant and fatal acute infections common to all types, on one hand, and from subclinical persistent infections to rapidly progressive liver disease with cirrhosis and even hepatocellular carcinoma (HCC), common to the blood-borne types (HBV and HCV). Without specific virological test, it is not possible to determine which hepatitis virus is responsible for a case of hepatitis. (Kathleen park et al., 2004).