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By Faiza Asghar. “Hepatocellular Carcinoma” (HCC). Cancer. Mutation Un - controlled cellular growth Tumor!! Benign. Tumors. Malignant. Cancer in Progress…. Chronic, primary liver cancer. Starts in hepatocytes. - PowerPoint PPT Presentation
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“Hepatocellular Carcinoma” (HCC)
By
Faiza Asghar
Cancer Mutation Un - controlled cellular growth
Tumor!!
BenignTumors Malignant
Cancer in Progress…
Liver Cancer
Benign Malignant
Primarye.g.
Secondary
Cholangiocarcinoma
Hepatocellular carcinoma Angiosarcoma
Etymology Chronic, primary liver cancer.
Starts in hepatocytes.
Metastatic; spreads through blood stream and lymphatic system.
More frequent in men especially, in cirrhotic patients.
Statistics Common in Asia, China, Japan, U.S., Africa, Latin
America, and Eastern European countries.
6th most common cancer in the world.
5th most common disease in men.
8th most common disease in women.
HCC rate in Pak. is2.69%/Yr.
Etiology
Disease MechanismMutation inactivation of tumor repressor genes and
cell cycle regulators activation of oncogenic pathways.
Two steps:1. Activation of specific pathways triggering
proliferation of cancer e.g. EGFR, IGF, MAP kinase, Wnt, mTOR etc.
2. Activation of generic mechanisms involved in all types of cancers e.g. VEGFR, Insensitivity of apoptosis, Inactivation of cell cycle check points, Preserving unlimited replicative potential.
Mol. Biology involved…
α1 -antitrypsin deficiency.
Lower expression of p27kip1 protein.
Integration of viral proteins (HBV, HCV).
Telomerase is active in 90% of human HCC. It appears to be necessary for the immortal proliferation capacity of HCCs.
Research still going on…
Symptoms
1.Weight loss.2.High level of AFP & ALP.3. 4. 5.
Anorexia HepatomegalyJaundice
Continued… 6.
8.9.
7.
Abdominal Fluid
(Ascites)
Nausea
Abdominal Pain
Fatigue
Diagnosis
Full physical exam. Ultrasonography. M.R.I.C.T scans etc.
M.R.I
CT Scan
Continued…Biopsy.L.F.T. A.F.P serology.
BiopsyL.F.T
Clinical Treatment Tumor ablation.i. RFAii. Ethanol injectioniii. Cryotherapy etc.
TACE. Partial hepactomy. Endoscopic palliation. Liver transplant.
Cryotherapy
Chemo-embolizatio
n
RFA
Prevention
Vaccination against HBV & HCV.
Regular screening.Balanced diet.Regular exercise.No alcohol.No food storage!
BioTech Services... Ongoing Research for Molecularly targetted drugs. e.g. Sorafenib,
Nexavar. DNA microarray to determine recurrence %age in
future. Telomerase inhibition to impair proliferation or using it
as an anticancer agent. Development of new markers to improve screening
for early lesions. Antibody treatment against HCC surface markers
have been reported to lower recurrence rates after liver transplantation.
R