Pulmonary Impairment Tests Study in Cirrhotic Patients with and without Hepatocellular Carcinoma: A Prospective Case-Control Study

Background: Cirrhotic patients frequently develop pulmonary complications, and hepatocellular carcinoma (HCC) is among the most hypoxic malignancies. Objective: This study evaluated pulmonary function in cirrhotic patients with and without HCC. Patients and Methods: A prospective case-control study was conducted on 120 participants (50 cirrhotic without HCC, 50 cirrhotic with HCC, and 20 healthy controls). All underwent history, clinical examination, laboratory investigations including arterial blood gases (ABG), and pulmonary function testing (spirometry). Results: Patients with HCC had significantly higher partial pressure of carbon dioxide (PaCO₂) and serum bicarbonate compared to cirrhotic patients without HCC (p=0.037, p=0.004 respectively) and to controls (both p=0.001). Forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC ratio were significantly lower in cirrhotic patients with HCC compared to those without HCC (p=0.008, p=0.029, p=0.004). These values were also significantly lower in cirrhotic patients without HCC compared to controls (all p=0.001). Conclusion: Cirrhosis impairs pulmonary function, and this impairment is more pronounced with the development of HCC. Monitoring pulmonary function in cirrhotic patients may have prognostic and management implications.