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)

A Nigerian series of 890 patients with primary liver cell carcinoma, seen during the recent three years, has been examined with a view to establishing the natural history of the tumour in untreated cases. There were 60 males and the mean age of all the patients was 50 years. Hepatitis B surface antigen was positive in 70 pc of tested patients and there were higher pathologic levels of aflatoxins in these patients when compared to normal controls. Liver cirrhosis was associated with 81 pc of patients. Alcohol and smoking were unlikely to be aetiologically important in these patients. The macroscopic type of tumour was mainly diffusely nodular and the commonest microscopic pattern was the characteristic trabecular pattern. Metastases were present in 52 pc of the patients and were mainly to the lungs. Due to late presentation and underlying cirrhosis, most patients were critically ill with high incidence of ascites, jaundice and hepatic precoma. The mean survival time of all patients was six months after onset of the initial symptoms to death and only three weeks after admission to death. The major causes of death were advanced cancer in 78 pc, hepatic failure in 48 pc and rupture of tumour, 39 pc. These observations clearly show that the prognosis of liver cancer is dismal in this environment, as elsewhere. Medical education on earlier presentation in hospital and early operative removal of the tumour should be emphasised. It is suggested that an attempt through immunisation should be employed to reduce the incidence of liver cancer in the population.
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PMID:The natural history of primary liver cell carcinoma: a study of 89 untreated adult Nigerians. 132 87

The purpose of this study was to retrospectively analyse the results of 1102 primary liver cancer (PLC) patients who underwent liver resection in the past thirty years and to research some effective approaches for improving the longterm effect of PLC treatment. Ninety five percent were hepatocellular carcinoma (HCC), 85.2% with cirrhosis of hepatitis and 25.6% with tumor equal to or smaller than 5 cm in diameter. The mortality rate (MR) within 1 month after operation was 1.8%, the operative MR was 8.8% before 1977 and only 0.4% after that. The total 5-year survival rate (SR) was 28.4% while in the group of small tumor (less than or equal to 5 cm), it was 75.0%. Our experience is as follows: (1) Early diagnosis and early resection of PLC is the key point for improving the operative result of long-term survival. In 282 cases of small cancer, tumor resection rate was 90.0%. Of 48 cases with tumor equal to or smaller than 3 cm in diameter, the 5-year SR was 83.3%. (2) Rehepatectomy for recurrent liver cancer is an important approach for improving the surgical result. In our series, recurrent rate within 5 years postoperation was 72.3% in larger tumor group and 34.5% in small tumors. There were 78 cases undergoing reoperation in a total number of 170 times of rehepatectomy with 54.7% of 5-year SR, after the 1st operation and 34.6% after the 2nd one. (3) For unresectable large tumors, two-stage operation is an important development in liver surgery. We had 26 cases of such patients with 60.0% of 5-year SR. (4) Improvement of operating techniques plays an important role in reducing postoperative complications, lowering operative mortality and obtaining better operative result. (5) Postoperative comprehensive treatment is also important for solidating operative effect and preventing tumor recurrence.
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PMID:Surgical approaches for improving the operating results of primary liver cancer. 132 42

A 61-year-old male was admitted because of hemoptysis. He had a 9 year history of liver cirrhosis associated with HB viral chronic hepatitis. Physical examination revealed no abnormalities. Laboratory investigations revealed positive HBs antigen with normal alpha-fetoprotein. Chest X-ray film showed large mediastinal lymph nodes and an endobronchial polypoid mass in the distal end of the right main bronchus. The right main PA was narrowed due to compression by the mediastinal mass. Bronchoscopic examination revealed a polypoid mass in the right main bronchus. The biopsy specimen was histologically diagnosed as undifferentiated large cell carcinoma. The patient developed respiratory failure, and died 3 weeks after admission. Autopsy revealed a small liver cancer of 1.3 cm diameter within the cirrhotic liver, associated with a small abdominal lymph node metastasis and large mediastinal lymph node swellings. Thromboembolism in the bilateral main pulmonary arteries was concluded to be the cause of death. The mediastinal mass which directly invaded into the right main bronchus had a close histological similarity with the liver cancer, showing undifferentiated carcinoma cells with bizarre nuclei and abundant cytoplasm. An immunohistological study revealed cells positive for alpha-fetoprotein in the mediastinal lymph nodes. The patient was diagnosed as having small liver cancer with mediastinal lymph node metastases. A survey of the literature revealed only a few cases of advanced hepatoma associated with prominent mediastinal metastases. This is the first reported case of small liver cancer presenting with large mediastinal lymph node metastases.
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PMID:[A case of small liver cancer presenting as a huge mediastinal mass]. 132 37

Epidemiological, clinical and laboratory data point to a role of hepatitis C virus infection in hepatocellular carcinoma. The connection appears to be indirect and to be mediated by cirrhosis. Thus, geographical differences can be observed, based on the locally prevalent etiological factors for cirrhosis. In the end, prospective studies of hepatitis C virus infected persons will be needed to elucidate the role of this agent in liver cancer.
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PMID:Hepatitis C virus and hepatocellular carcinoma. 133 32

Chronic infection by hepatitis B and C viruses is frequently associated to the development of primary liver cancer. Liver cirrhosis, induced by these viral infection, plays an important role in the liver carcinogenesis. In addition, HBV has a direct role in liver cell transformation by a transactivating effect of some viral proteins as well as insertional mutagenesis. The role of hepatitis C virus is not known. The strong association, even in France, of primary liver cancer to these viral infections underline the importance of their prevention by vaccination.
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PMID:[Liver cancer and hepatitis B and C virus]. 133 32

The present paper reviews several studies performed between 1977 and 1986 in Singapore on the 10-year survival outcome of treatment for stage I and II hepatocellular carcinoma (HCC). Of 801 HCC patients evaluated, only 2 survivors (0.3%) remained in complete remission for 13 and 14 years, respectively. One had received four weekly cycles of prednisolone, Adriamycin, vincristine and 5-fluorouracil for an inoperable HCC with a 10-cm diameter, and the other had received localised synchronised hepatic irradiation and Adriamycin. As follow-up, the use of localised hepatic irradiation consisting of 131I-labeled (30 mCi) iodised oil in lipiodol infused via the hepatic artery appeared to benefit patients with small residual tumours but did not affect larger tumours measuring 2 cm in diameter. Prophylactic, intermittent long-term administration of lymphoblastoid interferon-alpha (Wellferon) was carried out in pre-cancerous, high-risk hepatitis B surface antigen (HBsAg)-positive patients with cirrhosis, in immediate male relatives of liver cancer patients, and in persons who had undergone hepatic resection. In the untreated group, 10/162 (6%) cirrhotics, 3/18 (17%) male family members, and 6/10 (60%) post-resection cases developed single or multiple HCCs within 1 year of screening done at 3-month intervals on the basis of alpha-fetoprotein (AFP) levels and real-time hepatic ultrasonography. In contrast, none of the Wellferon-treated group consisting of 518 cirrhotic patients, 82 male relatives of HCC patients and 20 post-resection cases developed HCC. Two HBsAg-positive individuals who had not been treated with interferon (IFN) developed hepatic nodules which that showed dysplasia, AFP elevation and chromosomal changes. These studies demonstrate the poor results of late diagnosis and show that early intervention and prophylaxis with Wellferon can reduce the incidence of HCC in high-risk persons. In addition, transhepatic chemoembolisation and liver resection are suitable methods for treating small HCCs (single or multiple) that are detected by screening. However, some of these early-detected HCCs remain highly malignant. Prophylactic treatment of pre-cancerous conditions appears to be a better option as a long-term programme for HCC.
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PMID:Long-term survival following treatment of hepatocellular carcinoma in Singapore: evaluation of Wellferon in the prophylaxis of high-risk pre-cancerous conditions. 133

We studied all the 70 cases of liver cancer referred to us in 1988. Sixty (85.71%) were primary hepatocellular carcinoma (HCC), the other 10 (14.29%) were metastatic liver cancer. Of the 60 HCC, 48 were males and 12 females. Peak age incidence was between 20-40 years. Forty-five (75%) had tumours in both lobes. Of the remaining 15, seven had tumours in the right lobe while eight were in the left. More detailed assessment identified eight as Child's C. Seven (11.66%) had laparotomy, and two were inoperable. Three (60%) died shortly after resection, leaving two survivors. One of the survivors lived for 24 months, and the other had recurrent tumour after 26 months. The majority had cirrhosis of the liver, were positive for markers of hepatitis B virus, and showed elevated serum alpha fetoprotein (AFP). Palliative treatment was disappointing, and all were dead within 15 months. Prognosis of HCC in our environment is poor. Considering the advances made in liver surgery in recent years, our mortality and morbidity figures can improve. Notwithstanding, preventive measures should be intensified.
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PMID:Sixty cases of primary hepatocellular carcinoma in one year. A preliminary appraisal. 133

Point-mutational activation of the c-Ki-ras proto-oncogene has been shown to be rare in human hepatocellular carcinoma, the most common primary liver cancer and one usually associated with chronic viral infection. To reveal the association of c-Ki-ras activation with cholangiocarcinogenesis under different etiological backgrounds, the incidence of point mutation at codons 12 and 13 of the c-Ki-ras proto-oncogene was examined in three groups of human liver cancers with differentiation to biliary epithelial cells: Group 1, cholangiocellular carcinoma in Japanese with normal livers; Group 2, cholangiocellular carcinoma in Thais who had lived in an area where the liver fluke Opisthorchis viverrini is endemic; and Group 3, combined hepatocellular-cholangiocellular carcinoma, a rare type showing features of both hepatocellular and biliary epithelial differentiation, in Japanese with chronic viral hepatitis with or without cirrhosis. The polymerase chain reaction and direct sequencing of its product were used to detect the mutation. Point mutation at codon 12 of the c-Ki-ras gene was detected in five (56%) of nine cases in Group 1. In contrast, the mutation was not detected in any of the cases in Groups 2 and 3. Therefore, point-mutational activation of c-Ki-ras did not seem to be involved in the development of primary liver cancers associated with apparent chronic irritation of liver cells or biliary epithelial cells caused by exogenous liver-fluke or viral infection. On the other hand, point-mutational activation of the c-Ki-ras proto-oncogene may be involved in cholangiocarcinogenesis in liver without preexisting liver-fluke or viral infection.
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PMID:Cholangiocarcinomas in Japanese and Thai patients: difference in etiology and incidence of point mutation of the c-Ki-ras proto-oncogene. 133 66

From november 1973 to June 1991, cryosurgery with liquid nitrogen was performed on 87 patients with primary liver cancer (PLC). Of these, 27 patients was of stage I (31.0%), 52 in stage II (59.8%), and 8 stage III (9.2%). There were 30 patients with PLC of < or = 5 cm (34.5%). Liver cirrhosis was found in 73 patients (83.9%). In the beginning, plate-like cryoprobes and thermocouples were used to monitor the frozen area. Later on we designed single- and multiple-needle cryoprobes for freezing tumors deeply into the hepatic parenchyma and intraoperative ultrasound was used to monitor hepatic cryolesions. The 1-year, 3-year, and 5-year survival rates were 60.5%, 32.0%, and 20.2%, respectively. Among the 30 patients with PLC of < or = 5 cm, the 1-year, 3-year, and 5-year survival rates were 92.6%, 66.6%, and 50.8%, respectively. There were no operative mortality and complications such as rupture of the tumor, delayed bleeding, and bile leakage. These results indicate that cryosurgery is a safe and effective local treatment for unresectable PLC.
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PMID:[Cryosurgery for primary hepatic cancer of 87 patients]. 133 12

This paper reports the application of Cox regression model in prognostic factors analysis of Primary Hepatocellular Carcinoma (PHC), based on the data obtained from 1618 registered of cases PHC and 432 hospitalized patients of PHC in ZhongShan City from 1980 to 1989. The result shows that there is an association between PHC and the following factors: extrahepato metastasis, therapeutic method, clinical stage, alpha-fetoprotein, gamma-glutamyl-transpeptidase, the number of tumors in the liver, the size of the tumor, icteric index and history of cirrhosis. Among these factors, clinical stage III, large liver cancer are unfavorable factors for PHC prognosis, while hepatectomy, hepatic artery catheterization chemotherapy, are favorable prognostic factors.
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PMID:[The analysis of prognostic factors of primary hepatocellular carcinoma with Cox model]. 133 14


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