Hepatocellular carcinoma

OBJECTIVE: To establish the most common pathological criteria to diagnose hepatocellular carcinoma, and to identify the high-risk patients for further investigation in order to detect hepatocellular carcinoma in its early stages.

METHODS: A retrospective study was carried out at King Khalid National Guard Hospital including 60 cases diagnosed as hepatocellular carcinoma cytologically and histopathologically. Further investigations were performed by special staining and immunohistochemical staining on 42 blocks including Periodic acid-schiff, PAS-D, Reticulin, Iron and Alpha Fetoprotein, hepatitis B surface antigen, hepatitis B core antigen and p53 antibodies.

RESULTS: It was found that pleomorphism, followed by presence of prominent nucleoli and nuclear pseudoinclusion were the most frequent finding in hepatocellular carcinoma. While considering other studies, reticulin framework, glycogen and iron content of the hepatocellular carcinoma were markedly diminished as compared to non-malignant liver tissue. Antibodies against tumor suppressor gene was applied on paraffin section (p53), it was positive in 52% of cases and 53% of them were having anti hepatitis B surface antigen positivity, detected in their serum and 23% were having hepatitis C antibodies positive.

CONCLUSION: Hepatocellular carcinoma is a common malignancy that can be detected by certain defined pathological parameters and should be suspected in high-risk patient.