Hepatocellular etiology

In Greece, a case-control study was conducted to investigate the incidence of liver cancer by estimating the consumption of six types of flavonoids with a semiquantitative questionnaire on the frequency of foods. The intake of flavones was inversely associated with hepatocellular carcinoma, irrespective of its etiology (viral or nonviral). With respect to cholangiocarcinoma, an inverse association with the consumption of flavan-3-ols, anthocyanidins, and total flavonoids studied was found. However, this last result should be viewed with caution because of the small sample size, due to the fact that this is a rare type of cancer (Lagiou and others 2008). 

The etiology of bilirubinemia can be loosely classified into three types hemolytic, obstructive, and hepatocellular. 

Hepatitis C virus (HCV) is an RNA virus that is a common cause of parenterally acquired viral hepatitis chronic infection follows acute infection in 80% to 85% of cases. Although liver disease resulting from chronic HCV infection is only slowly progressive, HCV is the most common cause of chronic liver disease in the United States, the most common etiology for hepatocellular carcinoma, and the leading indication for liver transplantation [34-36]. 

Colombo, M. and Sangiovanni, A., 2003, Etiology, natural history and treatment of hepatocellular carcinoma. Antiviral Res 60, 145-50. 

Wild CP, Kleihues P Etiology of cancer in human and animals. Exp Toxic Pathol 1996 48 95-100. Wogan GN Aflatoxins as risk factors for hepatocellular carcinoma in humans. Cancer Res 1992 52(suppl) 2114s-2118s. 

Lee, H.-S., Han, C.J., Kim, C.Y. Predominant etiologic association of hepatitis C virus with hepatocellular carcinoma compared with hepatitis B virus in elderly patients in a hepatitis B-endemic area. Cancer 1993 72 2564-2567... 

Gelatti, U., Donato, F., Tagger, A., Fantonl, C., Portolani, N., Ribero, M.L., Martelll, C., Trevisi, R, Covolo, L., Simonati, C., Nardi, G. Etiology of hepatocellular carcinoma influences clinical and pathologic features but not patient survival. Amer. X Gastroenterol. 2003 98 907-914... 

Stanford JL, Thomas DB. Reproductive factors in the etiology of hepatocellular carcinoma. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. Cancer Causes Control 1992 3(1) 37 2. 

The aminotransferases, AST and ALT, are enzymes located in the cytoplasm of hepatocytes and their levels will be elevated with hepatocellular injury. The degree of elevation of the aminotransferases is helpful in suggesting possible etiologies. The highest levels (>20-fold increase above normal) are typically seen in acute viral, drug-induced, or ischemic events associated with circulatory catastrophes. Alcoholic liver disease rarely presents with ALT values >500 units/L, and higher values should alert the clinician to complicating problems... 

As with many polymorphisms, epidemiology studies have been done to explore risks to diseases in the absence of information about etiology, substrates, etc. Some of the reports include suggestion of more hepatocellular cancer in PMs " and lack of association of leukemia with polymor-phism505. Other possible relationships have been explored but evidence for any associations is limited at this time . ... 

Summary Primary hepatocellular carcinoma is one of the most common cancers in the world and is prevalent on the continents of Africa and Asia. A number of classical epidemiological studies have determined that the exposure status of people to aflatoxin B1 is an important risk factor in the etiology of liver cancer. However, these studies have only relied upon the criteria of presumptive intake data, rather than information obtained from quantitative analyses of food samples, biological fluids and from people exposed to aflatoxin. Information obtained by monitoring exposed individuals for specific DNA adducts and metabolites will define the pharmacokinetics of aflatoxin B1 in people, thereby facilitating risk assessments. Preliminary data, reported here, support the concept that measurement of the major, rapidly excised AFB-N7-Gua adduct in urine and quantification of the more persistent aflatoxin albumin adduct are appropriate dosimeters for estimating exposure status and possibly risk in individuals consuming this mycotoxin. 

Hepatocellular cancer (HCC) is a common cause of cancer death worldwide with a striking geographical variation in incidence. In the People s Republic of China, HCC has an incidence rate of 150 cases per 100,000 per year in some regions and accounts for over 250,000 deaths annually. Major etiological factors associated with development of HCC include iufection with hepatitis B or C viruses and exposure to dietaryaflatoxin Bi (AFBi) [26 27]. 

Extrahepatic biliary obstruction occurs due to a myriad of benign and malignant etiologies. The resulting cholestasis may lead to malabsorption, coagulopathy, pruritus, hepatocellular failure, renal dysfunction. 

Beasley, R.R, Hepatitis B virus. The major etiology of hepatocellular carcinoma. Cancer, 61, 1942-1956 (1988). 

Fasani P, Sangiovanni A, De Fazio C, et al (1999) High prevalence of multinodular hepatocellular carcinoma in patients with cirrhosis due to multiple etiological factors. Hepatology 29 1704-1707... 

Smalley SR, Moertel CG, Hilton JF, et al (1988) Hepatoma in the noncirrhotic liver. Cancer 62 1414-1424 Trevisani F, D Intino PE, Caraceni P, et al (1995) Etiologic factors and clinical presentation of hepatocellular carcinoma. Differences between cirrhotic and noncirrhotic Italian patients. Cancer 75 2220-2232... 

Hussain, S.R, Schwank, J., Staib, R, Wang, X.W., Harris, C.C. (2007). TR53 mutations and hepatocellular carcinoma insights into the etiology and pathogenesis of liver cancer. Oncogene. 26, 2166-2176. 

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