Published in:
01-09-2014 | Original Research
New Insights on Non-B non-C Hepatocellular Carcinoma in Mid Delta Region, Egypt
Published in: Journal of Gastrointestinal Cancer | Issue 3/2014
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Purpose
The rate of hepatocellular carcinoma (HCC) is increasing worldwide, including in Egypt. Hepatitis B (HBV) and C (HCV) viruses are major risks. Non-B non-C HCC was reported in some countries. We investigated non-B non-C HCC-independent risk factors and associated profiles in viral hepatitis endemic region.
Methods
In a consecutive series, 281 patients were diagnosed with HCC and received for management, at Tanta University Hospitals, within the past 3 years. Demographic variables and environmental exposures were recorded by direct application of a modified questionnaire. Sera were tested for HCV (antibodies by ELISA and RNA by RT-PCR) and HBV (HBs Ag by ELISA and HBV DNA). Antinuclear antibody, serum copper, and iron were assessed in non-viral HCC. Liver biopsy was performed for HCC diagnosis and grading and liver tissue in all patients by histopathological and immunohistochemical methods to assess HBV and/or HCV etiology.
Results
Non-B non-C HCC patients were 13.87 % of the total and were associated with multiple risks, predominantly pesticides (100 %, p < 0.001) and super phosphate and ammonium sulfate fertilizers (94.87 %, p < 0.001) with significant exposure in industry, farming, and residence. Their tumors were mainly solitary, smaller sizes, and of lower alpha-fetoprotein titers. The study showed insignificant increase in prevalence of non-B non-C HCC and had special characters. Multivariate analysis showed significance of pesticides and smoking as independent risks for non-B non-C HCC.
Conclusions
Pesticides and smoking heavy exposure can be considered as primary risks for non-B non-C HCC. Phosphate and ammonium sulfate fertilizers were associations. The study will increase awareness for better prevention and management.