Hepatocellular carcinoma

Abstract

Male sex, age, cirrhosis, and HBsAg are the major risk factors for hepatocellular carcinoma (HCC). The geographic distribution of HCC is highly uneven, such that three distinct incidence areas are recognized. To clarify the reason(s) for this geographic variability of HCC, the risk factors in each incidence area were assessed. In parallel with the geographic distribution of HCC, HBsAg prevalence was highest in both HCC patients and in general population in Africa and Asia, where mothers of HCC patients are frequently HBsAg-positive, suggesting that hepatitis B virus hyperendemicity and perinatal infection account for the high HCC incidence in these areas. Cirrhosis, which is found on autopsy in 80% of the cases of HCC patients worldwide, is the most prevalent risk factor for HCC in areas where hepatitis B virus infection is less common. However, HBsAg carriage adds to the HCC risk carried by cirrhosis and explains the higher incidence of HCC in cirrhotics from Africa and Asia as well as elsewhere. Available data suggest that chronic HCV infection is a risk factor for cirrhosis and HCC. HBV vaccination should decrease HCC incidence rates worldwide; however, HCC prevention in regions where HBsAg carriage is infrequent may also require prevention of the other causes of cirrhosis in order for HCC rates to decline.

Cloning and characterization of a novel 90 kDa ‘companion’ auto-antigen of p62 overexpressed in cancer

“…Primary hepatocellular carcinoma (HCC) frequently occurs in certain regions of Asia and sub-Saharan Africa at a rate of one in 200 new cases a year (Simonetti et al, 1991). Acute and chronic liver diseases such as an unremitting infection with HBV or HCV followed by cirrhosis places patients at increased risk of developing HCC (Kiyosawa et al, 1990).…”

Hepatocellular carcinoma in Asia: Prevention strategy and planning

“…The increased HCC risk associated with HBV. Thus, the HCC's incidence increases with the prevalence of hepatitis B surface antigen (HBsAg) in all areas, particularly in endemic HBV region [31,32] . Similar to the world distribution of HBV, Asian countries also divided in to the low (< 2%), intermediate (2%-8%) and high endemic areas (> 8%) of HBV [33] .…”

A Historical Review of the Benefits and Hypothetical Risks of Disinfecting Drinking Water by Chlorination

“…Chloroform does not appear to induce chromosome breakage or sister-chromatid exchanges in human lymphocytes and failed to produce mutagenic changes in cultures of Chinese hamster lung fibroblast cells [73]." Simonetti et al (1991) cited the male gender, age, cirrhosis and the presence of the Hepatitis B Surface Antigen (i.e., the coat protein for which the gene has been isolated and abbreviated to HBsAg in literature) as the "major risk factors" for primary liver cancer (hepatocellular carcinoma), [109]. This cancer is now discussed in some detail.…”