Characterisation of Hepatocellular Carcinoma and other Hepatic Tumours diagnosed at the University Teaching Hospital

Abstract

Introduction: Hepatic tumour is a joint term for a diverse group of liver tumours which are caused by a variety of agents and fall into primary or secondary hepatic tumours. A tumour is an abnormal benign or malignant new growth of tissue that may or may not possess physiological functions and arises from uncontrolled usually rapid cellular proliferation. There is little information on the distribution of hepatic tumours in Zambia. Histopathology and immunohistochemistry is cardinal in the classification of hepatic tumours. Aim: To determine the phenotypic distribution and prevalence of hepatic tumours at the University Teaching Hospital, Lusaka. Materials/Methods: This was a retrospective cross-sectional study that was conducted at the University Teaching Hospital (UTH) from February 2016 to July 2016. Archival formalin-fixed paraffin embedded 34 liver biopsy specimen blocks were obtained, sectioned, re-stained and examined histologically. These tissues were diagnosed as hepatic tumours from 2012 to 2015. Tissues were cut for histological analysis using a microtome. Haematoxylin and Eosin staining were done on the slides to confirm hepatic tumor status. Immunohistochemical staining was done to detect HBV using hepatitis surface antigen (HBsAg). Data was analyzed using IBM SPSS version 20.0 for windows. Chi-square and Fisher’s exact test with a p-value of less than 0.05 was used to indicate statistical significance of the results. Results: From the examined 34 cases, patient age distribution of hepatic tumours was as follows; <10 years (8.8%), 10-20 years (8.8%), 21-30 years (20.6%), 31-40 years (14.7%), 41-50 years (14.7%), 51-60 years (17.6%), 61-70 years (11.8%), and >70 years (2.9%). Hepatic tumours affected males 19/34 (55.88%) and females 15/34 (44.12%) with a p-value of 0.03 as statistical significant. The male to female ratio of patients diagnosed with hepatic tumors was found to be 1.3:1. The phenotypes of hepatic tumours included 17/34 (50%) hepatocellular carcinomas (HCC), 6/34 (17.6%) metastatic adenocarcinomas, 4/34 (11.8%) intrahepatic cholangiocarcinomas (ICC), 3/34 (8.8%) hepatoblastomas, 2/34 (5.9%) metastatic small cell carcinomas, and 2/34 (5.9 %) hepatic adenomas. The histological subtypes of HCC diagnosed included trabecular pattern 9/17 (52.9%), pseudoglandular pattern 4/17 (23.5%), solid pattern 2/17 (11.8%), diffuse pattern 1/17 (5.9%), and fibrolamellar pattern 1/17 (5.9%). HCC was graded into well-differentiated 7/17 (41.2%), moderately differentiated 8/17 (47.0%), and poorly differentiated 2/17 (8.8%). Conclusion: Hepatic tumours affect patients mostly in the age range of 21-30 years and more males than females. HCC is the most common histologically diagnosed hepatic tumour at UTH followed by metastatic adenocarcinomas. The most diagnosed grade of HCC is moderately differentiated followed by well differentiated grade.

Key words: Hepatic tumour, hepatocellular carcinoma, histological subtype, Zambia.