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Hepatocellular carcinoma (HCC) (Asian and African countries(> 85% …
Hepatocellular carcinoma
(HCC)
Asian and African
countries(> 85%
of HCC)
Aflatoxin from Aspergillus flavus
increases the risk. mutation in p53
In 50% of cases, HCC occur
without
cirrhosis
Chronic HBV infection
M:F 8:1, 20 - 40 years
Western countries:
In 90% of cases tumors develop
in persons
with
cirrhosis
M:F 3:1, rarely before 60 years
Incidence increases
rapidly due to HCV &
chronic alcoholism
cirrhosis is an important contributor but not a requisite (direct cause)
The tumors may arise from both mature hepatocytes and progenitor cells (oval cells)
50% of patients have very high levels of serum α-fetoprotein
The overall prognosis of HCC is grim (depends mainly on stage)
The median survival is 7 months
The most effective therapy Surgical resection of smaller tumors
Tumor recurrence rate is > 60% at 5 years
in the two countries we wrote the Etiologies and here is more : Hemochromatosis , Tyrosinemia abnormal accumulation of tyrosine
HCC in HCV occurs almost exclusively in the setting of cirrhosis
Precancerous lesions
high-grade dysplastic nodules
in cirrhotic liver have high risk of
developing HCC
Small-cell
distinguishing dysplastic nodule from HCC , look at the nodule
vascularization
by radiological imaging