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Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
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Related Experiment Video

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Hepatocellular carcinoma: Where are we?

Roberto Mazzanti1, Umberto Arena1, Renato Tassi1

  • 1Roberto Mazzanti, Umberto Arena, Renato Tassi, Department of Experimental and Clinical Medicine, School of Sciences of Human Health, University of Florence, 50134 Firenze, Italy.

World Journal of Experimental Medicine
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PubMed
Summary

Hepatocellular carcinoma (HCC), a leading cause of cancer death, has known risk factors including viral hepatitis and diabetes. Treatment advances offer improved survival and quality of life for patients.

Keywords:
ChemoembolizationChemotherapyEpidemiologyHepatocellular carcinomaLiver cancerLiver transplantationPercutaneous ethanol injectionRadiofrequency ablationTreatment

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Area of Science:

  • Hepatology
  • Oncology
  • Gastroenterology

Background:

  • Hepatocellular carcinoma (HCC) is a major global malignancy, ranking second in cancer-related deaths worldwide.
  • Key risk factors include chronic hepatitis B/C virus infections, alcoholism, aflatoxin B1, liver cirrhosis, genetic factors, and increasingly, type II diabetes, obesity, and metabolic syndrome.
  • Despite known risk factors and early detection capabilities (tumors <1 cm), HCC often presents late, complicating treatment and prognosis.

Purpose of the Study:

  • To review current understanding of hepatocellular carcinoma (HCC) risk factors and treatment modalities.
  • To discuss advancements in HCC management beyond established criteria, including novel markers and systemic therapies.
  • To emphasize the importance of multidisciplinary approaches for optimizing patient outcomes in HCC treatment.

Main Methods:

  • Literature review of risk factors, diagnostic criteria, and therapeutic interventions for HCC.
  • Analysis of treatment outcomes for liver transplantation, resection, ablation, embolization, chemotherapy, and targeted therapies like sorafenib.
  • Evaluation of emerging criteria (e.g., Milan criteria, up-to-seven criteria) and biomarkers (e.g., cytokeratine 19) for patient stratification and prognosis.

Main Results:

  • Liver transplantation, guided by Milan criteria, offers a 5-year survival rate of approximately 70% for HCC.
  • Expanding criteria beyond Milan, incorporating markers like cytokeratine 19 and the 'up-to-seven criteria,' improves patient risk stratification.
  • Sorafenib represents a significant advancement in systemic therapy for advanced HCC, enhancing survival rates.

Conclusions:

  • Multidisciplinary management integrating diverse therapeutic strategies is crucial for improving survival and quality of life in HCC patients.
  • Ongoing research aims to refine treatment selection and improve outcomes for both early-stage and advanced hepatocellular carcinoma.
  • Personalized treatment approaches, considering individual patient factors and disease stage, are key to managing HCC effectively.