Profile of hepatocellular carcinoma in the Republic of Moldova: first-hand information on the presentation, distribution and etiologies

Abstract

Introduction. Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital. Methods. A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation. Results. The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases. Conclusions. The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.

Drastic sex-dependent etiological distribution in severe liver diseases from Gabon

“…This situation indicates that despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, these infections still remain the main causes of HCC and LC burden in Gabon and will continue until the maturity of generations born before 2004 who did not benefit from the universal immunization against HBV at birth ( 24 ). In contrast with the situations observed in East European countries as Moldova or in Mongolia, dual infections were infrequent in our study (3.1%) ( 25 , 26 ). This observation is in keeping with the fact that in Sub-Saharan Africa, HBV and HCV are generally transmitted through different routes and not predominantly together as when intravenous drug use is widespread ( 27 , 28 ).…”

Diagnostic Value of Multislice Spiral Computed Tomography Combined with Serum AFP, TSGF, and GP73 Assay in the Diagnosis of Primary Liver Cancer

“…The main blood supply source of healthy liver tissue is the portal vein, while that of PLC patients is the hepatic artery [ 23 ]. With blood circulation, the liver cancer lesions of patients gradually disperse, and the diffusion rate of cancer cells rapidly increases through blood metastasis.…”

The changing context of hepatitis D

“…16 In Europe, HDV remains endemic in Romania 17 and Moldova. 18 Hot spots sustained by immigrants and intravenous drug users (IVDUs) have been reported in Russia. 19,20 IVDUs are the group at highest risk of hepatitis D. 21 However, the HDV scenario is also changing in IVDUs in Europe, reflecting the impact of HBV vaccination and the success of harm reduction programmes.…”