Thesis Abstract

Abstract
Hepatocellular carcinoma (HCC) is one of the most prevalent types of liver cancer worldwide, often arising in the context of chronic liver disease, such as hepatitis B or C infection. Alpha-fetoprotein (AFP) is a well-known biomarker that has been used for decades in the surveillance and diagnosis of HCC. However, its role in predicting the degree to which hepatitis progresses to HCC remains controversial. This study aimed to analyze the levels of AFP in hepatitis patients and assess its utility in predicting the development of HCC. A total of 200 patients with chronic hepatitis were included in the study, with a mean age of 55 years and a male-to-female ratio of 32. Blood samples were collected from each patient, and AFP levels were measured using enzyme-linked immunosorbent assay (ELISA). Patients were followed up for a period of 5 years to monitor for the development of HCC. The results showed that 30% of the patients had elevated AFP levels at the time of diagnosis with chronic hepatitis. Among these patients, 15% went on to develop HCC during the follow-up period. In contrast, only 5% of patients with normal AFP levels developed HCC. Statistical analysis revealed a significant correlation between elevated AFP levels and the development of HCC (p < 0.05). Furthermore, subgroup analysis based on hepatitis B and C infection status showed that patients with hepatitis B had higher baseline AFP levels compared to those with hepatitis C. Interestingly, the rate of progression to HCC was also higher in the hepatitis B group, particularly in patients with elevated AFP levels. In conclusion, our findings suggest that analysis of AFP levels in hepatitis patients can aid in assessing the degree to which hepatitis progresses to HCC. Patients with elevated AFP levels at the time of hepatitis diagnosis should be closely monitored for the development of HCC. Future studies should focus on elucidating the underlying mechanisms by which AFP contributes to hepatocarcinogenesis and explore the potential of AFP as a therapeutic target for HCC.

Thesis Overview

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).