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[Hepatocellular carcinoma]
C S Gonçalves1, F E Pereira, M da P Zago
1Departamento da Clínica Médica e de Patologia do Centro Biomédico da Universidade Federal do Espírito Santo e Serviços de Gastroenterologia e de Patologia do Hospital Universitário Cassiano Antonio de Moraes, Vitória, ES.
Insights
Hepatocellular carcinoma (HCC), a global health concern, is strongly linked to the hepatitis B virus (HBV). Early diagnosis and HBV vaccination are key to reducing the incidence of this common liver cancer.
Area of Science:
- Hepatology
- Oncology
- Virology
Context:
- Hepatocellular carcinoma (HCC) is a significant global public health issue, particularly in high-incidence regions like Africa and Southeast Asia.
- The World Health Organization recognizes HCC as a major health concern.
- HCC is frequently associated with liver cirrhosis.
Purpose:
- To review the multifaceted aspects of Hepatocellular Carcinoma (HCC).
- To explore the etiology, geographic distribution, morphology, clinical presentation, and diagnosis of HCC.
- To discuss therapeutic strategies and prevention through Hepatitis B Virus (HBV) vaccination.
Summary:
- HCC is closely linked to the hepatitis B virus (HBV), though other carcinogens also contribute to its development.
- The review covers geographic variations in HCC incidence, morphological classifications, and clinical/biochemical diagnostic methods, including alpha-fetoprotein and ultrasonography.
- Early diagnosis in high-risk patients and the role of HBV vaccination in reducing HCC incidence are emphasized.
Impact:
- Highlights the critical role of HBV in HCC pathogenesis and the importance of vaccination for prevention.
- Emphasizes the need for improved early diagnostic methods, such as ultrasonography, for HCC.
- Provides insights into HCC classification and management, relevant for clinicians and public health officials.
Abstract:
Hepatocellular carcinoma (HCC), one of the most frequent tumors in the world, is included by the World Health Organization as a relevant public health problem in areas of high incidence as Africa and Southeast of Asia. In this review it will be discussed: a) the close relationship between HCC and hepatitis B virus (HBV), the more universal but not the single etiologic factor having other carcinogens and co-carcinogens involved with the origen of the tumor; b) the great variation in geographic distribution of this tumor, including that of Brazil where the incidence of HCC, including the new macroscopic classification according to the pattern of growth and general with liver cirrhosis in all countries where the tumor is diagnosed; d) some morphological aspects of HCC, including the new macroscopic classification according to the pattern of growth and general characteristics of small HCC; e) the clinical and biochemical aspects, calling attention to the evaluation of serum levels of alpha-fetoprotein, not always increased in patients with HCC, and the immage processing methods, specially ultrassonography, as methods for early diagnosis of HCC, being relevant in the follow-up of high risk patients (cirrhotics HBsAg (+]. Finally some comments are done about the therapeutic methods and perspectives of reduction in the incidence of the tumor with the use of vaccination against HBV infection.