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“Hepatocellular Carcinoma” (HCC)

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.

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“Hepatocellular Carcinoma” (HCC)

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  1. By Faiza Asghar “Hepatocellular Carcinoma” (HCC)

  2. Cancer Mutation  Un - controlled cellular growth  Tumor!! Benign Tumors Malignant

  3. Cancer in Progress…

  4. Chronic, primary liver cancer. Starts in hepatocytes. Metastatic; spreads through blood stream and lymphatic system. More frequent in men especially, in cirrhotic patients. Etymology

  5. 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. is 2.69%/Yr.

  6. Etiology

  7. Disease Mechanism Mutation  inactivation of tumor repressor genes and cell cycle regulators  activation of oncogenic pathways. Two steps: • Activation of specificpathways triggering proliferation of cancer e.g. EGFR, IGF, MAP kinase, Wnt, mTOR etc. • Activation of genericmechanisms involved in all types of cancers e.g. VEGFR, Insensitivity of apoptosis, Inactivation of cell cycle check points, Preserving unlimited replicative potential.

  8. Mol. Biology involved… • α1 -antitrypsin deficiency. • Lower expression ofp27kip1 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…

  9. Symptoms • Weight loss. • High level of AFP & ALP. 3. 4. 5. Jaundice Anorexia Hepatomegaly

  10. Continued… 6. Fatigue 8. 9. 7. Abdominal Pain Nausea Abdominal Fluid (Ascites)

  11. Diagnosis M.R.I • Full physical exam. • Ultrasonography. • M.R.I. • C.T scans etc. CT Scan

  12. Continued… • Biopsy. • L.F.T. • A.F.P serology. L.F.T Biopsy

  13. Clinical Treatment • Tumor ablation. • RFA • Ethanol injection • Cryotherapy etc. • TACE. • Partial hepactomy. • Endoscopic palliation. • Liver transplant.

  14. Cryotherapy RFA Chemo-embolization

  15. Prevention • Vaccination against HBV & HCV. • Regular screening. • Balanced diet. • Regular exercise. • No alcohol. • No food storage!

  16. 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. BioTech Services... R

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