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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hepatocellular carcinoma (HCC) is a common cancer the world over. In Pakistan it has an incidence of 8/ 100,000 per annum. To assess the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in biopsy proven cases of HCC a serological study was conducted at Screening Laboratory of Blood Transfusion Services, Jinnah Postgraduate Medical Centre. Of 54 sera of HCC tested for HBV and HCV infections, 67% showed HBV infection, and 33% HCV infection. Among them 24% were positive for both HBV and HCV infections. No HBV and HCV infection was found in 24% cases of HCC. Our findings suggest viral association for most of the HCC cases reported in the country. We suggest an immediate intervention strategy to prevent the spread of HBV and HCV infections by mandatory screening of blood for HBV and HCV infections, and the use of disposable/sterilized needles, instruments for all invasive procedures. For the prevention of vertical transmission of HBV infections all pregnant women should be screened and vaccinated and HBV vaccination should also be included in EPI (expanded programme for immunization).
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PMID:Prevalence of hepatitis B surface antigen and HCV antibodies in hepatocellular carcinoma cases in Karachi, Pakistan. 903 22

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and a public health concern in many developing countries. The main risk factor is the chronic carriage state of the hepatitis B virus which is found in about 20% of the adult population in many African and Asian countries. Other important risk factors are HCV infection, aflatoxin exposure and alcohol consumption. The Gambia Hepatitis Intervention Study was launched in 1986 with the aim of evaluating the efficacy of the hepatitis B vaccination, given in early infancy, in preventing HBV infection, its chronic carriage status, and later, HCC. For this purpose, a randomised vaccine trial was designed and carried out. Over a period of four years a total of 124.577 children were recruited, one half received the usual EPI vaccines (BCG, DTP, OPV, measles, yellow fever) and the other half the hepatitis B vaccine in addition to the EPI ones. Hepatitis B vaccination has been successfully integrated into the "Expanded Programme of Immunization" in The Gambia, since every new born baby can receive this vaccination in addition to the EPI vaccine. The first mid point evaluation showed that in four-year-old children, hepatitis B vaccine efficacy was 84% in preventing infection and 94% in preventing chronic carriage status of HBV. Other mid point evaluations are still ongoing. A nationwide Cancer Registry was set up to detect HCC cases in the cohort under study. Follow-up through the Cancer Registry is planned for the next 30 years.
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PMID:[Hepatocellular carcinoma: a preventable cancer]. 937 80

Segmental SMANCS Lipiodol TAE (Seg. SMANCS Lp-TAE) using SMANCS was used to treat HCC in 58 patients and was evaluated in comparison with Seg. Lp-TAE using Epirubicin performed in 50 patients with respect to the course of atrophy of the embolized area, recurrence rate and side effects. On serial CT (Lp-CT) performed after TAE, in cases with P type in which the tumor is present in the periphery of the embolized area and showing Type I homogeneous accumulation of Lp within the tumor, the incidence of atrophy in the embolized area including the tumor was high and the recurrence rate was low. Although no significant difference in the recurrence rate was noted between the groups in which SMANCS and EPI were used, there were more cases with marked atrophy and a lower recurrence rate in the former. No difference was found in post-procedural side effects such as fever between the two groups, while hypotension was rarely observed during the procedure in the group in which SMANCS was used and was easily managed with intravenous steroids. The present results suggest that Seg. SMANCS Lp-TAE is an effective local treatment for HCC limited to a subsegment or segment.
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PMID:[Treatment of hepatocellular carcinoma by segmental SMANCS Lipiodol-TAE]. 951 99

The imaging characteristics of two EPI-hybrid breath-hold sequences, T2-weighted fast spin-echo [FSE, effective echo time (TEeff) 138 ms] and half Fourier single shot turbo spin-echo (HASTE, TEeff 60 ms), were compared in hepatic imaging. A total of 111 patients with suspected hepatic disease were studied at 1.5 Tesla using a body phase-array coil. The signal-to-noise (S/N) and contrast-to-noise (C/N) ratios for organs and lesions were calculated and quantitatively compared. Organ delineation, visualization of anatomical structures and pathological lesions, artifacts, and total image quality were qualitatively assessed and statistically compared. The final diagnoses were metastases from colorectal, breast, and pancreatic cancer in 23/111, hepatocellular carcinoma in 15/111, cysts in 19/111, hemangiomas in 9/111, several other lesions in 7/111, and no lesions in 38/111 of the cases. A total of 139 lesion in 73% of the patients were seen while 85% of the lesions were at least 1.5 cm in size. Regarding S/Ns HASTE was significantly (P < 0.03) superior to FSE with only minor (P > 0.05) differences in C/Ns between the two sequences for anatomical and pathological structures. HASTE demonstrated in almost all (97.3%) of the cases no artifacts, while on fast SE imaging moderate to minor artifacts were present in 23.5-51.7% of the cases. The overall image quality and diagnostic confidence was rated significantly higher (good 43.2%, excellent 53.2%) for HASTE than for fast SE imaging (good 44.8%, excellent 17.6%). Providing comparable C/Ns for anatomical and pathological structures, breatheld HASTE imaging proved to be superior to fast SE in T2-weighted imaging of the upper abdomen regarding general image quality, and, with adequate technical prerequisites, may be a suitable substitute of fast T2-imaging techniques.
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PMID:T2-weighted breathold imaging of the liver: a quantitative and qualitative comparison of fast spin echo and half Fourier single shot fast spin echo imaging. 1055 72

The purpose of our study is to compare qualitatively and quantitatively the abilities of various superparamagnetic iron oxide (SPIO)-enhanced breath-hold magnetic resonance imaging (MRI) techniques to detect hepatocellular carcinoma (HCC). Eight patients with HCCs were imaged. The images were obtained with conventional T2-weighted spin-echo imaging (CSE), half-Fourier single-shot turbo spin-echo (HASTE), single-shot gradient-echo type echo planar imaging (GE-EPI), and single-shot spin-echo type echo planar imaging (SE-EPI) before and after SPIO administration. The liver signal-to-noise ratios (SNRs) in CSE and each EPI sequence were significantly decreased after SPIO administration. GE-EPI had the highest decrease ratio (DR) of liver SNR, followed by SE-EPI (TE=98), SE-EPI (TE=28), CSE, and HASTE in this order. The relative contrasts with GE-EPI and SE-EPI (TE=98) were significantly higher than that with CSE after SPIO administration. On receiver operating characteristic (ROC) analysis, diagnostic accuracy did not differ significantly among the pulse sequences after SPIO administration. GE-EPI and SE-EPI (longer TE) were useful for SPIO-enhanced breath-hold MRI performed to detect HCC.
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PMID:Comparison of various techniques of iron oxide-enhanced breath-hold MR imaging of hepatocellular carcinoma. 1148 19

About 170 million Chinese are infected chronically with HBV and 10% suffer from chronic hepatitis. Around half a million Chinese die from hepatitis B caused hepatocellular carcinoma and endstage cirrhosis each year. From 1983 to the present, a controlled clinical trial involving 80,000 children on a universal hepatitis B vaccination programme to prevent chronic hepatitis, hepatocellular carcinoma, and endstage cirrhosis was implemented in Qidong, China. A pilot study demonstrated that the HBsAg rate reached the adult level before the fifth year of age, and neonatal vaccination with either plasma-derived or recombinant hepatitis B vaccines provided a similar 75% protective efficacy against HBV infection. The high rate of follow-up and blood tests coverage of the cohorts provided data to show 75% protection at the tenth to eleventh years of age against serum HBsAg and also against prolonged hepatic dysfunction. The strategy of controlling hepatitis B nationwide was based on the universal immunisation of newborns, beginning in cities and then the rural areas. The large-scale vaccine source was provided by domestic plants through technology transfer, first providing plasma-derived vaccine replaced completely by recombinant DNA vaccine in 1997. An official survey in 1999 using a cluster sampling of 25,878 children from 31 provinces reported an average coverage rate of three dose of hepatitis B vaccination of 70.7%, being higher in urban areas. The Ministry of Public Health of China has planned to integrate hepatitis B vaccination into the nationwide EPI program with Government-provided vaccines starting January 1, 2002.
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PMID:Prevention and control of hepatitis B in China. 1211 43

Hepatocellular carcinoma (HCC) etiology and incidence in Madagascar are not well established. The work presented here is the first documented study on HCC in Madagascar. The study was undertaken at the Centre Hospitalier de Soavinandriana, Antananarivo, from October 1995 to October 1996. Hepatocellular carcinoma was reported in 19 out of 22 patients with liver tumor included in the study. In 6 cases, patients developed post alcoholic cirrhosis HCC. Hepatitis B virus markers were detected in 48% of cases (13/19). The HBs Ag was detected in 42% of cases (8/19) in association with HBe Ag in 16% of cases (3/19), and hepatitis C virus antibodies in 11% of cases (2/18). In 3 cases, the etiology remained unknown. Hepatocellular carcinoma appeared the most frequent liver cancer, mainly due to post-hepatitis B cirrhosis. The introduction of hepatitis B vaccine in EPI (Expanded Program of Immunization) is recommended in order to reduce the percentage of hepatitis B virus carriers in the malagasy population and furthermore the incidence of HCC.
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PMID:[Etiology of hepatocellular carcinomas in Madagascar: results of a study in Antananarivo from October 1995 to October 1996]. 1246 21

We report a case of advanced hepatocellular carcinoma (HCC). A 73-year-old man with positive HBV and HCV underwent a partial hepatectomy (S6 and S5) twice and transcatheter arterial (chemo) embolization (TAE) four times, thereafter. During these treatments, HCC became intractable and the patient complained of general fatigue. The liver function was Child's classification A, and serum AFP was 6,737 ng/ml. Abdominal CT scan revealed recurrent lesions in the right hepatic lobe and left adrenal gland. The catheter for hepatic arterial infusion chemotherapy was inserted from the left femoral artery. Arterial chemotherapy with 5-fluorouracil (5-FU 750 mg) and cisplatin (CDDP 10 mg) was performed every two weeks. During 6 courses of this regimen, a significant side effect did not appear. Abdominal CT revealed no change in size, but serum AFP decreased up to 794 ng/ml and the general fatigue subsided. After 2 months, serum AFP began to increase and became 1454 ng/ml. The regimen of arterial chemotherapy was changed to epirubicin (EPI 40 mg every two weeks) and UFT-E (300 mg/day for four weeks), followed by a week off. An appetite loss (grade 2) appeared, but it could be well controlled. Serum AFP decreased again, up to 54 ng/ml. A good QOL was kept for about one year after the initiation of hepatic arterial infusion chemotherapy.
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PMID:[Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma providing a good QOL]. 1721 49

Further studies on the roots of Goniothalamus donnaiensis Finet et Gagnap (Annonaceae) led to the isolation of two pairs of Annonaceous acetogenins, donnaienin C ( 1) and 34- EPI-donnaienin C ( 1'), donnaienin D ( 2) and 34- EPI-donnaienin D ( 2'), containing a rare gamma-hydroxymethyl-gamma-lactone moiety and a C-4-acetoxy group. Their structures were elucidated by spectral data and chemical derivatization. Preliminary pharmacological tests showed that the mixture of donnaienin C( 1) and 34- EPI-donnaienin C ( 1') inhibited human hepatoma (Bel) cell lines in vitro (IC (50), 7.1 microg/ml).
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PMID:Two epimeric pairs of C-4-acetyl annonaceous acetogenins from Goniothalamus donnaiensis. 1725 51

Hepatitis B vaccine is one of the best human vaccines ever developed; it is safe, cheap, and highly immunogenic, stimulates long lasting protective efficacy, and is the first human cancer vaccine. Remarkably, HBV vaccine works even when administered to newborns, timing which is necessary because of mother to infant transmission. Countrywide HBV immunization programs were initiated in Taiwan and Thailand in the 1980s. HBV vaccine has been part of the WHO global immunization since 199x and with at-birth immunization programs in xxx countries resulting in major declines in acute sequelae of HBV infection. Of far greater significance, HBV vaccination prevents hepatocellular carcinoma (HCC) and its use is reducing mother to infant transmission, the driving force behind the HBV carrier state worldwide. These benefits are just being realized since decades elapse between perinatal transmission at birth and the onset of HCC decades later. Studies in Taiwan and Thailand are showing declines in HCC incidence as a result of country wide at-birth HBV immunization programs initiated in the 1980s. Many investigators from many countries have contributed to the understanding of HBV and its role as the major cause of HCC. This article briefly summarizes the work of my University of Washington laboratory in Taipei, Taiwan where I lived and worked from 1972 and 1986 because of the very high HBV carrier rates of HBV in Taiwan. During those 14 years we discovered vertical transmission, its timing and mechanism, and the predictive value of HBeAg. We went on to establish the efficacy of HBIG for prevention of vertical transmission. In later studies we established the efficacy and timing of HBV vaccine and HBIG and HBV vaccine in combination for optimum preventive efficacy. Of greatest significance, our studies showed that chronic HBV infection is the commonest cause of HCC. Worldwide, mothers are the driving force behind the infections that lead to HCC because the HBV carrier state is inversely proportional to the age of the infant when infected. We were able persuade WHO to adopt HBV as the 7th immunogen in the EPI, its global infant immunization program. In some ways enormous progress has been made but measured against its potential, progress in most countries, including the United States has been far too slow.
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PMID:Rocks along the road to the control of HBV and HCC. 1934 59


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