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Volume 8 Journal of Gastrointestinal & Digestive System Gastroenterology Congress 2018
August 06-07, 2018
August 06-07, 2018 Osaka, Japan
14th Annual Congress on
Gastroenterology & Hepatology
Luis Fernando Sandoval Garcia et al., J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C4-073
Hepatocarcinoma in Guatemala functional three phase CT as diagnosis tool
Luis Fernando Sandoval Garcia, Yolanda Patricia Tolaque Aldana, Manuel Antonio Gatica and Jorge Luis Ranero
Instituto Guatemalteco de Seguridad Social, Guatemala
Guatemala has the highest incidence and mortality of Hepatocarcinoma (HCC) in Latin America and the Caribbean. 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 based on radiologic findings. 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).
IGSS previous data base have showed more than expected HCC in non-cirrhotic (71%), so we must evaluate our diagnostic
protocol with the use of functional three-phase CT. 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 were calculated. 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 is the non-cirrhotic livers and that is why we have
different experiences in functional imaging.
Biography
Luis Fernando Sandoval Garcia has graduated in General Medicine from Universidad de San Carlos de Guatemala with a Master’s degree and Chief of Residents
in Internal Medicine at IGSS. He works as an Internal Medicine Attending Physician in the same institute and as Professor in Universidad Francisco Marroquin.
Locally he has published researches about gastric cancer, esophageal varices, cirrhosis and HCC. He has showed the first epidemiological formal evidence of the
non-cirrhotic HCC at IGSS, Guatemala.