Bioclinical Performance of Liver Cirrhosis and Hepatocarcinoma Diagnosis versus Abdominal Ultrasound-Hepatic Histopathology at Kinshasa University Clinics between 1990 and 2004

Author(s): Malenga Mpaka Serge, Longo-Mbenza Benjamin, Lelo Tshikwela Miche, Pakasa Muyulu Nestor, Tshimpi Wola Yaba Antoine, Mbendi Nlombi Charles, Kisoka Lusunsi Christian, Mawalala Malengele Héritier

Introduction: Hepatic cirrhosis is the final stage in the natural history of chronic liver diseases. Hepatocarcinoma is a form of cancer that develops from the cellular anarchy of the liver. The objective of this study was to measure the diagnostic performance of bioclinical and abdominal ultrasound information suspecting liver cirrhosis and hepatocarcinoma in front of liver biopsy as a reference test for the diagnosis of liver cirrhosis and hepatocarcinoma.

Materials and Methods: The Departments of Gastroenterology, Radiology, and Pathological Anatomy, Faculty of Medicine of Kinshasa, served as a framework for this work which adopted a secondary analysis of clinical, biological and ultrasound information. Sensitivity, specificity, concordance, predictive values, ROC curves and statistical analyzes specified the levels of diagnostic performance of the bioclinical workup of liver cirrhosis and hepatocellular carcinoma.

Results: Among 200 patients, including 142 men and 58 women with a mean age of 47 ± 15 years, 67% (n=) and 43.5% (n=) had cirrhosis and hepatocarcinoma respectively on histopathology. The increase in transaminases, but anemia, hypoalbuminemia and abdominal ultrasound had better diagnostic performance of liver cirrhosis histopathology. Only abdominal ultrasound had an excellent sensitivity for histopathological diagnosis while clinical hepatomegaly, sensitive liver and transaminases had poor diagnostic performances of histopathological hepatocarcinoma.

Conclusion: Abdominal ultrasound is becoming an essential non-invasive examination in the histopathological diagnosis of liver cirrhosis and hepatocellular carcinoma at the University Clinics of Kinshasa, DR Congo.