Case-Control Study on Environmental, Metabolic and Nutritional Factors of Hepatocellular Carcinoma in Cirrhotic Patients

{"level_sex_clusion_I":[{"value":"Male","concept":{"vocab":"MeSH","vocabURI":"D008297"}},{"value":"Female","concept":{"vocab":"MeSH","vocabURI":"D005260"}}],"level_age_clusion_I":[{"value":"Adult (25 to 44 years)","concept":{"vocab":"MeSH","vocabURI":"D000328"}},{"value":"Middle Aged (45 to 64 years)","concept":{"vocab":"MeSH","vocabURI":"D008875"}},{"value":"Aged (65 to 79 years)","concept":{"vocab":"MeSH","vocabURI":"D000368"}}],"level_type_clusion_I":"Patients population","level_type_clusion_other":"","clusion_I":"Aged 35 or over; - Informed consent. Cirrhotic cases: - Patients with hepatocellular carcinoma cases from liver cirrhosis, regardless of the cause of the cirrhosis. - Criteria for hepatocellular carcinoma diagnosis: European Association for Study of the Liver (EASL); Focal hepatic lesions greater or equal to 2 cm in diameter: - Alpha-fetoprotein (AFP) below 400 ng/ml: nodules must be identified by at least two morphological examinations (abdominal ultrasound, angiography, CT or MRI); - AFP over 400 ng/ml: lesion seen in a single imaging procedure; Focal hepatic lesions less 2 cm in diameter: - Lesions 1 to 2 cm in diameter: use of fine-needle aspiration with biopsy; - Lesions less than 1 cm: serial abdominal ultrasound every 3 months until the lesion exceeds 1 cm in size so that biopsy becomes possible. These cases will be included at time of diagnosis. Cirrhotic control patients: - Histological confirmation by liver biopsy or in the absence of biopsy: - In patients with no portal thrombosis at Doppler imaging, on the presence of portal hypertension confirmed by biological, morphological, hepatic venous pressure measurements or upper endoscopy. - In patients with portal thrombosis, on the presence of portal hypertension associated with clinical or morphological signs of cirrhosis. - Biological signs of hepatocellular failure. - Lack of HCC at baseline through imaging examinations. ","clusion_E":"Other cancer; - HIV infection; - Major somatic or psychiatric illness not compatible for inclusion in the study.1,179 cirrhotic patients with (436 cases) or without (743 controls) HCC were enrolled in the CiRCE study."}