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)

In every patient, in particular males of all ages presenting with chronically progressive diseases or cirrhosis of the liver, ultrasonography and an AFP test should be performed at intervals of six months. If hepatocellular carcinoma of the liver (HCC) is suspected (i.e. by increase of AFP or a positive result in ultrasonography), diagnosis should be confirmed by further investigations such as fine-needle biopsy guided by sonography, angiography and CT-scan. Adequate therapeutical measures such as resection of the tumor, chemotherapy, injection of alcohol or liver transplantation can thus be initiated in time. Besides efforts for early diagnosis of carcinoma of the liver, preventive measures (vaccination for hepatitis B, restrictive use of blood transfusion, reduction of alcoholism, thorough therapy of hemochromatosis, etc.) may contribute to the reduction of chronic diseases of the liver and of associated HCC.
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PMID:[Early diagnosis of hepatocellular carcinoma]. 137 85

Twenty-eight patients with hepatocellular carcinoma (HCC) of not larger than 5 cm diameter were surgically treated during the 12 years from 1977 to 1988, twenty-five of them since 1983. Half of the patients were admitted for check up because of elevated serum AFP and were high risk subjects. Serum HBsAg were positive in 24 (85.7%). Serum AFP was less than 10 ng/ml in 2 (7.1%) and greater than or equal to 200 ng/ml in 14 (50%). Coexistent liver cirrhosis was found in 21 (75%). Local resection or partial hepatectomy played a major surgical role in small HCC, especially in the presence of cirrhosis and tumor in right liver. The cumulative survival rates for the 28 patients treated by hepatic resection at 1, 2 and 5 years were 60.6, 42.5 and 42.5 percent. The survival rate of patients with tumor size not larger than 3 cm diameter is not better than those with tumor size between 3 cm and 5 cm. The small HCC patients with AFP less than or equal to 200 ng/ml had better survival than those with AFP greater than 200 ng/ml.
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PMID:Hepatic resection for 28 patients with small hepatocellular carcinoma. 137 75

This is a case report of a 69-year-old woman with sarcomatoid hepatocellular carcinoma (HCC), which was diagnosed clinically as hemangioma. She was first admitted to our university hospital, complaining of general fatigue in December, 1988, and cholelithiasis and liver cirrhosis with hepatic tumor in Segment 8 were diagnosed. The serum AFP level was within normal range, and the tumor was diagnosed as hemangioma radiologically. She underwent only cholecystectomy and was well without any therapy for the liver tumor up until March in 1991 when she was readmitted to our university hospital due to rapidly progressive liver dysfunction. The size of the liver tumor was unchanged. Despite intensive care, she died of hepatic failure due to cirrhosis in a decompensation state. At autopsy, a well defined yellowish white tumor of 3 cm in maximum diameter was seen in the cirrhotic liver. Although the largest part of the tumor revealed necrosis and hyalinization, a sarcomatoid part composed of spindle-shaped cells was noted in the peripheral portion. In addition, some necrotic ghost cells, probably hepatocellular carcinoma, were also noted. Low molecular cytokeratin, which is always found in HCCs, was seen in spindle-shaped sarcomatoid cells. The liver tumor was diagnosed as sarcomatoid HCC from these pathological findings. We report this histologically unusual HCC with an immunohistochemical study.
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PMID:[Sarcomatoid liver carcinoma diagnosed clinically as hemangioma]. 147 Jul 79

It has been reported that hepatoma (HCC) cells produce abnormal proteins such as erytropietin, fibrinogen, prothrombin, and, recently, antithrombin III (AT III). In a preliminary report, we reported increased AT III levels in patients bearing HCC independent of their clinical liver status. The present study was performed to assess antithrombin III levels and other serological data present in patients with cirrhosis and in patients with cirrhosis and clinical findings of neoplastic disease. In 70 well-matched patients (47 with cirrhosis and 23 with cirrhosis and proven HCC) serum total cholesterol, albumin, prothrombin, alkaline phosphatase, AFP, aminotransferases, and AT III were determined. Together with AFP and alkaline phosphatase, patients with HCC had higher values of AT III (88 +/- 7%) and total cholesterol (184 +/- 17 mg/100 ml), as compared with cirrhotic patients (AT III 56 +/- 3.6%; total cholesterol 113 +/- 5 mg/100 ml) (P less than 0.001). No difference was observed between these two groups for albumin, prothrombin, and aminotransferases. In HCC patients, AT III levels were related to the total cholesterol level (R2 = 0.317), whereas in the cirrhotic patients it correlated with the prothrombin level (R2 = 0.274). These data suggest that in HCC patients a greater rate of synthesis of AT III occurs, whereas in cirrhotic patients lower levels of AT III occur due to impaired synthesis or increased catabolism of the protein. The serial determination of AT III in cirrhotic patients as a means of detecting neoplastic transformation is suggested.
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PMID:Hepatocarcinoma in cirrhosis. Is antithrombin III a neoplastic marker? 164 42

99mTc-PMT delayed hepatobiliary imaging was performed preoperatively in 62 patients with small hepatocellular carcinoma. All patients received operation and had pathological proof. All these tumors were smaller than 5 cm in size. Liver scan was done 5 min, 2 and 5 hr after administration of radiopharmaceutics. The sensitivity was 33.3% (2/6), 41.2% (7/17), 60.0% (9/15) and 54.2% (13/24) in tumors with sizes of less than or equal to 2 cm, 2-3 cm, 3-4 cm and 4-5 cm groups, respectively. The positive rates in the first two groups were lower than in the last two groups but much higher than those by conventional imaging. The total positive rate was 50.0%. The difference was not significant in comparison with the group of tumor size greater than 5 cm. The smallest mass detectable was only 1.2 cm in diameter. The uptake of radiopharmaceutic was not related to serum AFP level and hepatic cirrhosis (P greater than 0.05). These results show that 99mTc-PMT delayed hepatobiliary imaging may be useful in the diagnosis, particularly in the pathognomonic diagnosis, of small hepatocellular carcinoma.
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PMID:[Diagnostic value of 99mTc-PMT delayed hepatobiliary imaging in small hepatocellular carcinoma--an analysis of 62 cases]. 165 87

Serum complement C3, C4, and C3 proactivator (C3PA) have been evaluated for their diagnostic power in detecting a hepatocellular carcinoma (HCC) in patients with liver cirrhosis (LC). It was found that serum complement levels were lower in LC patients than in HCC patients and that difference of the serum C4 and C3PA levels between LC patients and HCC patients were statistically significant. In addition, serum C3 PA levels were found to correlate significantly with the serum gamma-GTP levels in HCC patients. Thus, using the cutoff values of C4 and C3PA as the mean values for HCC patients, examination of serum complement levels enabled the detection of 38% of the HCC patients with low AFP levels. These findings suggest that the examination of the serum complements may be a useful a tool for the detection of HCCs in LC patients.
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PMID:[A clinical study of complements as a marker of a hepatocellular carcinoma]. 170 Jan 67

To elucidate the cell biological significance of ras oncogene, the expression of ras-p21 was analyzed in 53 cases of liver tissues including 34 cases of hepatocellular carcinoma (HCC), by using immunohistochemical method. In result, 22 (65%) cases of 34 HCC and 34 (79%) cases of 43 liver cirrhosis were positive for p21, whereas all of chronic hepatitis and normal livers were negative. Especially, comparative study between the expression of p21 and clinicopathological background of HCC revealed that p21 was prominently expressed in well differentiated form, nodular type, small liver cancer, and the cases showing AFP levels below 400 ng/ml. From these results, it was indicated that ras oncogene might play an important role in malignant transformation of hepatocytes or differentiation of HCC.
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PMID:[The expression of ras p21 product in hepatocellular carcinoma]. 170 Jan 76

The clinical usefulness of serum 5'-nucleotide phosphodiesterase isozyme-V (5'-NPD-V) assay as a serological marker for hepatocellular carcinoma was evaluated. Serum levels of 5'-NPD-V were measured by polyacrylamide gel electrophoresis in 536 Japanese patients with various diseases, including 120 patients with hepatocellular carcinoma. Icteric serum was not an indicator for the measurement of this isozyme, because jaundice gave a non-specific false-positive reaction. In 99 cases of hepatocellular carcinoma without jaundice, 73 (74%) had positive 5'-NPD-V and 24 (24%) showed levels greater than (+ +). The diagnostic value of this isozyme for hepatocellular carcinoma was relatively high, especially in patients with low or negative AFP levels. Diagnostic application for serum 5'-NPD-V assay to small liver tumors was limited. 5'-NPD-V showed false-positive results even in certain cases of benign liver diseases such as chronic hepatitis and liver cirrhosis, but cases with positivities stronger than (+ +) were few. Moreover, the test might be useful for the prediction of liver metastasis in cancer patients, since positive rates were significantly higher in cases with liver metastasis than in those in the non-liver metastasis group.
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PMID:5'-Nucleotide phosphodiesterase isozyme-V in hepatocellular carcinoma and other liver diseases. 170 10

The present study is based on the assay of four markers (AFP, CEA, TPA, Ca 19-9) using IRMA methods in 36 normal subjects, 44 cirrhosis and 66 HCC patients. Parametric and non parametric tests were used to test differences and correlations. ROC curves and discriminant functions were also elaborated. Normal 95% "cut-off" was determined by the "boostrap" method yielding: CEA 3.4 ng/ml; Ca 19-9 55 U/ml; TPA 58U/l and AFP 5.2 ng/ml. In HCC patients the values of the four markers were, on average, significantly different from those of normal subjects. However, only AFP and TPA exhibited high diagnostic accuracy (90%) for detection of the tumor. Higher than normal mean values for all markers were, also observed in cirrhotic patients. Only AFP yielded effective discrimination between HCC and cirrhosis. The positive prediction for the presence of the tumor on cirrhotic ground was 95% for AFP values higher than 18.5 ng/ml, with a 78% negative predictive value with a 6 ng/ml threshold. Association of AFP with TPA showed only a marginal diagnostic improvement. Results were not improved at all by combining CEA and Ca 19-9 with AFP and/or TPA. In conclusion, AFP is and remains the best marker for HCC and the only one effective in discriminating of HCC from cirrhosis. TPA may be considered a valid alternative if cirrhosis is not present. CEA and Ca19-9 are of no use.
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PMID:AFP, CEA, CA 19-9 and TPA in hepatocellular carcinoma. 170 5

Markers for hepatocellular cancer include the best and worst of cancer detection. Although hepatocellular cancer is relatively infrequent compared to other cancers in the western world, HCC has a very high incidence in parts of Asia and Africa. It is estimated to be one of the most common cancer worldwide. High risk factors for HCC include previous hepatitis B infection, heavy alcohol consumption, cirrhosis, and aflatoxin exposure. Alpha fetoprotein may be the best human cancer marker that appears in the serum, but levels of this marker are often not elevated until the tumor is beyond surgical treatment. No other serum or tissue marker is particularly useful. Screening of high-risk populations in China has detected previously undiagnosed HCC in 1,000 of 5 million individuals tested and has led to an increase in survival from 5.5 to 61.6% with surgical resection over those who are later diagnosed with HCC without screening. Elevations of AFP due to yolk sac tumors may be differentiated from those due to HCC on the basis of Concanavalin A reactivity. Immunodetection using radiolabeled anti-AFP and immunoscintigraphy have given inconsistent results that are not as sensitive as ultrasonography in detecting HCC in the liver. Various enzymes, isoenzymes, and other markers may be useful as adjuncts to diagnosis in selected cases, but are not generally as good as AFP alone. If a patient has an AFP-producing tumor, the serum levels of AFP provide an excellent means of monitoring its progression. If the serum AFP levels drop to normal and stay there, cure is almost certain. If, however, the serum AFP level does not fall at the normal catabolic rate after therapy, or subsequently rises, regrowth of metastases are indicated. Immunotherapy using anti-AFP has not been shown to induce remission, but experimental studies indicate that drug-conjugated anti-AFP is effective in inhibiting growth of AFP-producing tumors. Clinical trials using drug-conjugated anti-AFP are now underway. Monoclonal antibodies have not yet identified the "antigens" useful for the diagnosis or treatment of HCC, but epitopes identified by monoclonal antibodies have been studied experimentally in rats which indicate multiple cellular lineages to HCC in cases of experimental chemically induced hepatocarcinoma.
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PMID:Markers for hepatocellular carcinoma. 171 67


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