Thesis Abstract

Abstract
Hepatocellular carcinoma (HCC) is a primary liver cancer that often develops in patients with chronic hepatitis. Alpha-fetoprotein (AFP) is a well-known biomarker that is frequently used in the diagnosis and monitoring of HCC. However, the role of AFP in predicting the development of HCC in patients with hepatitis remains a topic of debate. This study aimed to analyze the alpha-fetoprotein (AFP) levels in hepatitis patients and assess its utility as an aid in predicting the progression to hepatocellular carcinoma (HCC). A systematic review and meta-analysis were conducted to evaluate the existing literature on this topic. The results of the meta-analysis revealed that elevated AFP levels in hepatitis patients were significantly associated with an increased risk of developing HCC. The pooled data showed a strong positive correlation between AFP levels and the progression to HCC, indicating that AFP can serve as a valuable biomarker in identifying patients at higher risk for developing liver cancer. Furthermore, subgroup analyses were performed to investigate the impact of different factors on the relationship between AFP levels and HCC development. The analyses indicated that factors such as age, gender, hepatitis B or C infection, and liver cirrhosis may influence the predictive value of AFP in assessing the risk of HCC. Overall, this study highlights the importance of monitoring AFP levels in hepatitis patients as a potential indicator of HCC development. Early detection of HCC is crucial for improving patient outcomes, and AFP can play a significant role in identifying high-risk individuals who may benefit from closer surveillance and timely intervention. In conclusion, the findings of this study support the use of alpha-fetoprotein as a valuable tool in assessing the degree to which hepatitis patients may progress to hepatocellular carcinoma. Further research is warranted to validate these results and explore additional biomarkers or diagnostic tools that can enhance the early detection and management of HCC in high-risk populations.

Thesis Overview

1.0 INTRODUCTION

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 perculiar 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 hepatocullular 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).