Thyroid Dysfunction in Patients with Hepatocellular Carcinoma: A 60-Case Study at BSMMU, Dhaka, Bangladesh

Abstract

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with increasing incidence in Bangladesh. Thyroid hormones play a key role in hepatic metabolism, and altered thyroid function has been reported in patients with chronic liver disease. However, data on the prevalence and impact of thyroid dysfunction in HCC patients are limited. Objectives: This study aimed to evaluate thyroid hormone abnormalities in patients with HCC and explore correlations with liver function parameters and tumor characteristics. Methods: This prospective observational study included 60 adult HCC patients attending the Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2021 to December 2021. Clinical, laboratory, and imaging data were collected. Thyroid function tests (TSH, free T4, free T3) were performed at diagnosis. HCC was diagnosed according to AASLD criteria. Thyroid dysfunction was classified as hypothyroidism, hyperthyroidism, or subclinical forms. Statistical analysis was conducted using SPSS v25. Results: Among 60 patients (mean age 56.8 ± 11.2 years; 45 males, 15 females), 26 patients (43.3%) exhibited thyroid dysfunction. Hypothyroidism was the most common (21.7%), followed by subclinical hypothyroidism (11.7%) and hyperthyroidism (10%). Patients with thyroid dysfunction had significantly higher serum bilirubin (3.1 ± 1.2 vs 2.2 ± 1.0 mg/dL, p<0.05) and lower albumin levels (3.1 ± 0.5 vs 3.5 ± 0.4 g/dL, p<0.05). Tumor size and Child-Pugh score were positively correlated with TSH levels (r=0.42, p=0.002). Conclusion: Thyroid dysfunction is prevalent in HCC patients and correlates with liver function impairment and tumor burden. Routine thyroid function assessment in HCC patients may help optimize clinical management and prognostication. Further studies are needed to clarify the underlying mechanisms and therapeutic implications.