Luis Fernando Sandoval GarcÃa
Internal Medicine Msc, Instituto Guatemalteco de Seguridad Social (IGSS), Guatemala
Title: Hepatocarcinoma in Guatemala Functional Three Phase CT as Diagnosis Tool
Biography
Biography: Luis Fernando Sandoval GarcÃa
Abstract
Statement of the Problem: Guatemala has the highest incidence and mortality of hepatocarcinoma (HCC) in Latin America and the Caribbean (Cancer Today, 2012). HCC is associated with chronic liver disease and cirrhosis regardless of the etiology. Only about 10% of HCCs develop in non-cirrhotic livers. HCC can be diagnosed in cirrhotic patients non-invasively on the basis of radiologic findings (Tiffany Hennedige, 2012). Biopsy is only performed when there is a low probability of HCC (doesn´t have cirrhosis, chronic hepatitis B nor current or prior hepatitis C) (NCCN, 2018). IGSS previous data base have showed more than expected HCC in non-cirrhotic (71%), so we have to evaluate our diagnostic protocol with the use of functional three phase CT. Methodology & Theoretical Orientation: Observational, retrospective and analytic study. All the liver masses seen by functional three phase CT were included and compared with the pathology result during 2015 – 2017 in IGSS. Statistical analysis was performed with PSPP 2007. Categorical variables were presented with frequency and percentages, and analyzed by chi squared of homogeneity. Normality was tested with Kolmogorov-Smirnov. Numerical data were evaluated with t-student of independent samples. At relational level a bivariate study was made, then elevated to multivariate level. NPV and PPV was calculated. Findings: Total of 76 liver masses evaluated by functional three phase CT were analyzed, with 53.85% of HCC confirmed by biopsy; 84% of HCC diagnosis were non-cirrhotic livers. Taking all the samples, our functional CT has a PPV of 0.54 and NPV of 0.69 for HCC diagnosis. After stratification, in cirrhotic samples a PPV of 0.25 and NPV of 0.83, vs. non-cirrhotic a PPV of 0.67 and NPV of 0.62 were obtained. These findings are opposite to the global epidemiology, our main HCC source are the non-cirrhotic livers, and that´s why we have different experiences in functional imaging.