HISTOLOGICAL SUBTYPES OF HEPATOCELLULAR CARCINOMA DIAGNOSED AT THE UNIVERSITY TEACHING HOSPITAL, LUSAKA, ZAMBIA
Abstract

Author(s): Steward Mudenda, Trevor Kaile, Marah Simakando, Zifa Ngwira, Julius Peter, Clemence Marimo, Derick Munkombwe, Webrod Mufwambi, Chichonyi Aubrey Kalungia, Fred Fredrick Bangara, Christopher Newton Phiri.

Hepatocellular carcinoma (HCC) is the most common form of primary hepatic tumour which develops from hepatocytes and is the 5th most common cancer worldwide. A greater burden of HCC occurs due to hep atitis B virus (HBV) and hepatitis C viruses (HCV) which are endemic in regions that are mostly resource constrained sub-Saharan Africa. HCC may also occur due to exposure to aflatoxin B1 and chronic alcoholism. This study was carried out to determine the distribution of HCC subtypes at the University Teaching Hospital in Lusaka, Zambia. Aim: To determine the distribution of the histological subtypes of hepatocellular carcinoma across all ages and sex groups 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.These were tissues diagnosed as HCC from January 2012 to December 2015. Seventeenarchival formalin-fixed paraffin embedded (FFPE) liver biopsy specimen blocks were obtained, sectioned, re-stained and examined histologically. Tissues were cut for histological analysis using a microtome. Haematoxylin and Eosin staining was done on the slides to confirm HCC status. Classification of HCC was done according to standard World Health Organization criteria. The results were matched for age and sex to detect any similarities and differences. Data was analyzed using IBM SPSS version 20.0 for windows. Fisher’s exact test with a p-value of less than 0.05 was used to indicate statistical significance of the results. Results: Out of the 17 cases of HCC examined, 9/17 (52.9%) of the cases occurred in people below the age of 50 years and was commonly diagnosed in men 12/17 (70.6%) than in women5/17 (29.4%). The histological subtypes of HCC reported in this study were trabecular pattern 9/17 (52.9%), pseudo glandular pattern 4/17 (23.5%), solid pattern 2/17 (11.8%), diffuse pattern 1/17 (5.9%), and fibro lamellar pattern 1/17 (5.9%). Conclusion: HCC was found to occur more commonly in males between the ages of 21-40 years old. The trabecular histological subtype was the predominant pattern of HCC in our patients at the University Teaching Hospital in Zambia.