Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After reviewing collection techniques and the cytology of normal and reactive hepatocytes, a systematic approach to the evaluation of fine-needle aspiration biopsy smears of hepatic mass lesions is presented. One of the main problems facing the cytopathologist is the differentiation of cirrhosis from well-differentiated hepatocellular carcinoma. Smears from patients with cirrhosis often contain clusters of bile duct epithelial cells and chronic inflammatory cells, while properly sampled hepatocellular carcinoma smears should contain no bile duct epithelial cells and few inflammatory cells. Key criteria which favor the diagnosis of hepatocellular carcinoma over cirrhosis are: increased nuclear to cytoplasmic ratio, trabecular pattern, and atypical naked hepatocytic nuclei. Key criteria which favor the diagnosis of primary hepatocellular carcinoma over metastatic disease include polygonal cells with centrally placed nuclei, cells separated by sinusoidal capillaries, and bile. This systematic approach to the evaluation of hepatic fine-needle aspiration biopsies must be used with the realization that other uncommon mass lesions of the liver do exist (focal nodular hyperplasia, adenoma, hepatoblastoma, bile duct carcinoma, vascular tumors, mesenchymal tumors, and lymphomas).
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PMID:An approach to fine-needle aspiration biopsy diagnosis of hepatic masses. 206 78

In the U.S. oral cancer accounts for 2.1% of all cancers and 1% of cancer deaths. Two to three times as many males as females are affected. Blacks have more intra-oral cancer than whites, and their incidence and mortality rates have increased in recent years. The etiologic process very likely involves several factors. The major etiologic agents are tobacco (all types) and alcoholic beverages. Herpes simplex virus, human papilloma virus, and Candida have been implicated. Host factors include poor state of dentition, nutritional aberrations, cirrhosis of liver, lichen planus, and immunologic impairmant. Cellular changes include amplification of some oncogenes, alterations in antigen expression, production of gamma-glutamyl transpeptidase, and disturbance of keratin and involucrin production. Experimentally, cancer is readily produced on the hamster cheek pouch and rat oral mucosa. Unlike oral cancer in humans, most experimental lesions are exophytic, and they rarely metastasize.
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PMID:Oral cancer. 212 24

Serum CA 19-9 was determined in 83 control subjects, 99 patients with pancreatic cancer, 104 with chronic pancreatitis and 137 with extra-pancreatic diseases mainly of gastrointestinal origin in order to evaluate whether hepatic factors can influence circulating CA 19-9 in pancreatic cancer. Sensitivity, specificity and accuracy of this test in determining pancreatic malignancy were: 74%, 83% and 57%. We divided patients into two groups: group A (159 cases) and group B (181 cases) with and without anatomical liver damage (presence of primary or metastatic cancer, cirrhosis, hepatitis, steatofibrosis, cholangitis). Group A presented higher CA 19-9 values as compared to group B. Significant correlations were found in group B but not in group A between CA 19-9 and ALT, ALP and total bilirubin. Multiple regression analysis (CA 19-9 dependent and ALT, ALP and total bilirubin predictor variables) was significant only in group B. The standardized partial regression coefficients found to be significant were those of ALP and total bilirubin. We can conclude that CA 19-9 is an index of pancreatic cancer with satisfactory sensitivity and specificity. The presence of anatomical liver damage seems to increase the value of this index, probably releasing CA 19-9 into the bloodstream. Extra-hepatic cholestasis may also be an important factor in elevating CA 19-9 probably by reducing the hepatic catabolism of this glycoprotein.
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PMID:How does liver dysfunction influence serum CA 19-9 in pancreatic cancer? 213 20

A rare case of a colon cancer with a hepatomatous metastasis is reported. A 79 year old female was admitted hospital in April, 1988 with liver cirrhosis. On death in November, 1988, an autopsy revealed a primary, linitis plastica type diffuse adenocarcinoma of the total colon with an extensive metastases into lungs, kidneys, liver, small intestine, bladder, spleen, the bone marrow, and the lymph nodes. In the cirrhotic liver two hepatomatous nodules were found. As a focus of one of these nodules, there was a metastatic linitis plastica lesion of the colon.
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PMID:[A case of Borrmann type 4 colon cancer with a metastasis into hepatoma]. 216 72

Ultrasound investigation of the abdominal vessels was conducted in 41 patients with liver tumors (17 patients with liver hemangiomas, 9 with primary liver cancer, and 15 with cancer metastases to the liver) and 100 controls. Shifting, compression, occlusion of the intrahepatic portal and hepatic veins as well as of the inferior vena cava and right renal vessels were observed in patients with malignant and benign liver tumors. Malignant tumors were accountable for shifting and compression of the extrahepatic segment of the portal vein and the upper mesenteric artery as a result of metastatic involvement of the lymph nodes. Statistically significant dilatation of the total hepatic artery was noted in patients with malignant and benign liver tumors, determined, probably, by an increase in the arterial inflow in the liver. A decrease in a degree of change of calibers of the portal and hepatic veins in malignant liver tumors was noted in patients with hepatocellular cancer, developing against a background of cirrhosis with portal hypertension as well as in patients with secondary malignant tumors without clinical signs of portal hypertension that might result from an obstacle posed by tumor nodes in the liver parenchyma to venous wall dilatation.
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PMID:[The ultrasonic picture of the abdominal vessels in focal lesions of the liver]. 219 20

MCA serum levels were determined in 27 healthy subjects, 136 with benign pathology (42 breast) and in 289 patients with cancer (247 active). The last group includes 223 patients with breast cancer (96 without metastases, 89 with metastases and 38 no-evidence of disease). CEA and CA15-3 serum levels were determined in all the patients with breast diseases. The mean levels of MCA were 4.7 + 2.4 U/ml in the control group, considering less than 11 U/ml as normal. MCA values were abnormal in 15.4% of patients with benign pathology, mainly in those with liver cirrhosis (8/20) and lung diseases (4/20). In the majority of these cases, the rise was only moderate, lower than 15 U/ml in 97.5% of patients. In malignant diseases, important increments were found in breast cancer (19.8% Mo, 77.5% M1) and ovarian cancer stages III-IV (44.4%). When we compared MCA serum levels with CA15-3 and CEA in breast pathology, a similar specificity was observed: 92.3%, 92.3% and 100% in cases with benign pathology and 92.1%, 94.7%, and 97.4% in NED patients, respectively. MCA and CA15-3 sensitivity was similar in breast cancer without metastases (19.8%) and lower for CEA (16.7%). In patients with breast cancer without metastases, we found a relation between positivity of these tumor markers and prognostic factors (tumor size, nodal involvement). The disease free interval in patients with locoregional breast cancer was shorter in cases with abnormal presurgical levels of some of the tumor markers, but only the difference from MCA was significant (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:MCA in patients with breast cancer: correlation with CEA and CA15-3. 223 Mar 47

Sonography has become widely used in the diagnosis of liver diseases. Fatty infiltration of the liver (adiposis hepatica), hepatic cirrhosis, cysts, metastases and tumors can be reliably diagnosed. A valid differentiation between benign and malignant new growths, however, can only be obtained by cytologic and histologic techniques. The lowest sensitivity can be expected in chronical benign diffuse diseases. Our results were compared with those in literature. Furthermore, other diagnostic approaches and procedures, e.g. fine needle biopsy and sclerotherapy in cysts, are recorded.
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PMID:[Ultrasonic diagnosis of liver diseases]. 223 33

Data from dynamic radiocolloid liver scintigraphy (DLS) have been analysed to calculate three indices of relative arterial to total hepatic perfusion. Ninety subjects have been studied, comprising 21 normals, 62 patients with metastatic liver disease and 7 patients with cirrhosis. Correlation coefficients above 0.81 were found in all patient groups between an index based on rates of liver uptake (the hepatic perfusion index, HPI) and a method based on quantitative liver uptake (the mesenteric fraction, MF). A further method employing the spleen to model arterial inflow (hepatic arterial ratio, HAR) had less agreement with both HPI and MF, with correlation coefficients below 0.76. Posterior images have previously been used to calculate HAR, and greater errors are expected in HAR from the anterior images acquired in this study. Receiver operating characteristic analysis showed that the diagnostic performance of HPI and MF indices in metastatic disease were not significantly different. For anterior image data analysis both HPI and MF were superior to HAR.
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PMID:A comparison of three indices of relative hepatic perfusion derived from dynamic liver scintigraphy. 232 73

Tissue Polypeptide Antigen (TPA) and alpha 1-fetoprotein (AFP) were determined in sera of 21 patients with hepatocellular carcinomas, in 20 patients with extrahepatic carcinomas and metastases of the liver, as well as in 26 patients with cirrhosis of the liver. TPA was increased (greater than 85 U/L) in all patients with malignant hepatomas, in 80% of patients with metastatic liver cancer and in 35% of patients with cirrhosis of the liver. The critical serum TPA level, above which only malignant liver tumours lay, was statistically evaluated and found to be 187 U/L. All patients with benign liver disease and half of the patients with metastatic liver disease showed TPA values lower than 187 U/L. All of the patients with hepatocellular carcinoma and half of the patients with metastatic liver cancer had TPA values greater than 187 U/L; all of our patients with cirrhosis of the liver, as well as half of the patients with metastatic liver cancer had lower TPA values. 86% out of all hepatoma patients showed increased AFP levels (greater than 9 ng/ml), whereby the AFP concentrations were in the range which is highly suggestive of hepatoma (greater than 174 ng/ml) in 67% of all patients with malignant hepatomas. Patients with metastatic liver cancer and cirrhosis of the liver had AFP levels lower than 174 ng/ml AFP. TPA is an unspecific tumour marker, which can be used together with AFP in the diagnosis of unclear defects in liver parenchyma, in supervision of cirrhosis, as well as in control assessment during chemotherapy or after tumour resection.
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PMID:[Serum concentrations of tissue polypeptide antigen and alpha 1-fetoprotein in patients with primary liver cancer, liver metastasis and liver cirrhosis]. 240 89

HCC occurs infrequently in Western countries, with recent increases being reported in California and parts of Europe. Southeast Asia, Japan, and South Africa continue to have a high incidence of this tumor with HBV, cirrhosis, and the ingestion of aflatoxins being identified as probable risk factors. Although the majority of patients present with abdominal pain or mass indicative of extensive tumor, asymptomatic, small HCCs are being detected with increasing frequency. Early detection in high-risk individuals is best accomplished by screening with serum AFP determinations and liver ultrasonography. CT and arteriography are valuable preoperatively in defining anatomy and determining resectability. Five-year survival following resection for cure of HCC ranges from 20 to 40 per cent, with improved survival reported for small asymptomatic tumors. Resection of metastatic liver tumors from colorectal primaries results in 48 per cent 2-year and 24 per cent 5-year survivals, with an additional 5 per cent dying of recurrent cancer after 5 years. Although patients with simultaneous and metachronous metastases do equally well after resection, the presence of four or more individual deposits adversely affects survival. Hepatic artery ligation or embolization can produce a significant palliative reduction in total tumor mass in patients with unresectable liver metastases. Regional chemotherapy using implantable hepatic artery drug infusion pumps is promising, with reports of prolonged survival compared with historical controls. Regional hyperthermia, laser vaporization of tumor, and cryosurgical techniques may prove to have useful roles in the selective treatment of liver cancer in the future. Orthotopic liver transplantation has been successful primarily in those in whom the malignancy is found incidentally in the chronically diseased liver.
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PMID:Malignant tumors of the liver. 242 9


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