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)

Prognostically relevant factors and treatment were analysed in 103 patients suffering from primary epithelial liver tumors (88 HCC, 15 CCC). Ninety of them underwent operations: 14 liver transplantations, 32 resections, 44 explorative laparotomies. The resection rate was 38%, the 30-day mortality in transplantation 14%, in resection 22%. The 5-year survival after resection was about 25%. Liver transplantation resulted in 50% 1-year and 40% 2-year survival. Long-term prognosis was positively influenced by cirrhosis and formation of a tumor capsule. Indications for operative management depend only on extension of tumor growth and concomiting liver cirrhosis as biology of epithelial liver tumors is poorly understood.
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PMID:[Prognosis and therapy of primary epithelial liver tumors. Evaluating a personal patient sample]. 217 93

Several clinical observations suggest that hepatocellular carcinoma (HCC or "hepatoma") may be a hormone-dependent tumour; the apparent relation to anabolic steroids and oral contraceptive preparations, and the striking male predominance particularly among patients with cirrhosis. In many animal models thyroid hormones, prolactin and testosterone stimulate tumour growth, and the latter may enhance the progression of chemically-induced hyperplastic nodules to frank malignancy. In animals and humans, both oestrogen and androgen receptors have been reported in normal and malignant liver tissue though some of the evidence is conflicting and the amounts detected vary widely. From a therapeutic standpoint, we failed to show any advantage from the addition of tamoxifen to adriamycin, in a controlled trial although other workers have, more recently, reported prolonged survival using tamoxifen alone. About 20% of HCC patients receiving the antiandrogen cyproterone acetate showed a clinical response.
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PMID:Growth factors, endocrine aspects and hormonal treatment in hepatocellular carcinoma--an overview. 217 61

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

The presence and distribution of AFP, AAT and HBsAg in peritumoral non-neoplastic hepatocytes (NNH) of 27 cases and, at the same time, in the neoplastic tissue of 37 liver cell carcinoma (HCC) were studied; AFP and HBsAg were more frequently found in NNH than in HCC cells; no differences were found for AAT. The presence of HBsAg also in normal liver without cirrhosis is probably best explained by its possible role in neoplastic transformation and by the inhibition of replication of the viruses AFP, considered to be expression of dedifferentiated cells, may possible be taken up by NNH for catabolic purposes.
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PMID:Immunohistochemical study of the appearance of some markers in liver adjoining hepatocellular carcinoma. 242 60

In 94 patients liver transplantations for malignant tumors of the liver have been performed in this institution from 1972 to 1987. The long-term overall results in hepatic transplantation for irresectable tumors are disappointing in spite of good short-term palliation in most of the patients. Tumor recurrence is the rule. But individual long-living patients demonstrate the potentials of this treatment. Thus the crucial question will be a proper selection of patients. The relative suitability (in descending order of favorableness) of the kinds of tumors may range from HCC without cirrhosis, to central bile duct tumors, to HCC in cirrhosis, to CCC, and finally to secondaries. But this range can only give some probability for the success rate. More important is the tumor stage. Survival in lymph node-positive stages is by far worse than in lymph node-negative stages. The 6-month, 1-year, and 2-year actuarial survival data in our experience for lymph node-negative (lymph node-positive) HCC without cirrhosis are 83%, 75%, 75% (33%, 11%, 11%); in bile duct carcinomas in lymph node-negative stages (lymph node-positive) they are 6 months, 100% (40%); 1 year, 100% (13%); and 2 years, 83% (0%). Hepatic transplantation for selected tumor patients furthermore seems justified and is essential for a detailed analysis of the chance of different tumor types for success with this method of treatment.
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PMID:Is there a place for liver grafting for malignancy? 245 Apr 17

The actual interest of immunoscintigraphy for the detection of liver tumours was investigated by both visual examination and quantitative analysis in 41 patients with hepatoma (HCC, 21 cases, 13 AFP-secreting), other primary or secondary liver cancer (9 cases), testicular cancer (2 cases) and cancer free cirrhosis (9 cases). All patients were injected with 123I-anti-alphafetoprotein (AFP) monoclonal antibodies (MAbs) and scans were performed after 28 +/- 2 h. In the hepatoma-bearing patients, 11 positive anti AFP scans were found; 9 of them had an enhanced serum; besides, 3 non HCC tumours were also detected. With respect to hepatoma diagnosis, sensitivity was 52.5% and specificity 66.5%. For all hepatomas, it was striking that the positivity rate was 2/10 and 9/11, respectively, when HCC was and was not associated with cirrhosis. Among 6 patients with a positive anti AFP scan who were also injected with control anti hCG 123I-MAb, 5 positive anti hCG scans were surprisingly found, with specificity indices ranging between 1.00 and 1.75. The quantitative study also highlighted the importance for hepatoma detection of specific and non specific factors such as serum AFP, tumoural vascularization, non tumoural liver uptake and intrahepatic distribution of HCC. Anti AFP immunoscintigraphy appears as a poorly sensitive and moderately specific method for hepatoma diagnosis. In contrast, non tumoural liver uptake level could be more useful for discriminating HCC from liver metastases and perhaps to detect the early extension of HCC.
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PMID:Is anti-alphafetoprotein immunoscintigraphy a promising approach for the diagnosis of hepatoma? Implications of a quantitative study in 41 patients. 246 95

Two hundred and eighty-two patients with HCC including 89 with tumors 2 cm or smaller in size and 193 of 2-5 cm were studied on clinical and pathological findings and correlated with the value of various diagnostic imaging modalities. There were apparent differences in histological findings of HCC between 2 cm or smaller in size and larger ones; the former had much less invasion of malignant cells to the extracapsule and portal vein neighbouring the HCC than the latter. In 83 patients with HCCs 2 cm or less in diameter AFP level was normal (less than 20 ng/ml) in 39.8%, 20-200 ng/ml in 44.6% and more than 200 ng/ml in only 15.6%. Detectability of HCC measuring 2 cm or less by various imaging modalities was as follows: 97.8% by US, 54% by X-ray computed tomography (CT), 61.6% by magnetic resonance imaging (MR) and 75.4% by angiography. There was considerable limitation of imaging modalities in making a definitive diagnosis of the smaller HCCs, particularly in the differentiation from regenerative nodules of liver cirrhosis. Tissue biopsy under ultrasound control provided a correct diagnosis in 36 out of 41 patients (87.8%) with HCCs 2 cm or less in size, a better ratio than for aspiration biopsy.
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PMID:Strategy for early diagnosis of hepatocellular carcinoma (HCC). 246 79

We have examined a population of 1099 patients, suffering of HCC and chronic hepatitis of different nature, to determine the frequency and significance of alpha-fetoprotein elevation. Moreover we have followed up a group of 206 patients with liver cirrhosis referred to our department of hepatology in Turin, from January 1981 through April 1989. The AFP test with a cut-off of 50 ng/ml, is positive in 67.2% of tumor patients and in 12.9% of chronic hepatitis. No differences exist in patients carriers of hepatitis B virus versus alcoholic or criptogenetic subjects. Twenty-one out of 206 cirrhotic patients followed-up have developed HCC during the observation period (36.5 +/- 22.4 months). Fifteen out 21 patients (71%) showed an increase of AFP values. In 14 patients the HCC was graded as small (less than 4 cm of diameter at US) and in other 7 as advanced or multifocal. The underlying cirrhosis was alcoholic in 11 (53.3%), cryptogenic in 5 (23.8%), and hepatitis B chronic infection related in 5 (23.8%). Serological surveillance has led, to the identification of 71% of the tumors developing during this study. Using the time-course of AFP as the diagnostic parameter of the risk of HCC, we obtained the best performance in term of sensitivity, specificity and diagnostic accuracy. Screening patients at risk of HCC, using abdominal US and AFP testing, is an effective way of determinating small lesions, but how much early determination of HCC in a cirrhotic patient will improve the prognosis remain to be defined.
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PMID:Alpha-fetoprotein in hepatic pathology and hepatocarcinoma. 248 Apr 19

During the last eighteen years (1970-1987) at the Infectious Diseases Clinic of the University of Pavia, Ospedale Policlinico S. Matteo, IRCCS, Pavia (referral Center for hepatitis in our district: 502534 inhabitants) we observed 4238 patients (2706 M = 63.8%; 1532 F = 36.2%) admitted with presumptive diagnosis of hepatitis. The male to female sex ratio was 1.78 and average age was 38 (1-90) years. Acute viral hepatitis was diagnosed in 3238 patients (76.4%), 1960 of which were males (60.5%) and 1278 (39.5%) females, with an average age of 35 (1-88) years. The possible route of transmission was: drug addition in 487 patients (15%), blood transfusion in 464 (14.3%), other (sexual, professional, familiar) in 332 (10.3%), unknown in 1955 (60.4%). Chronic hepatitis (CH) was diagnosed according to the European Association for the Study of the Liver (EASL) and to the International Association for the Study of the Liver (IASL) in 848 patients (20%), 704 M(83%) and 144 F (17%) with an average age of 48 (2-90) years. 463 patients (54.5%) were biopsied during admission, 385 (45.5%) received definitive diagnosis by clinical and previous histologic records. CAH was found in 268 (57.9%), CPH in 161 (34.8%) and CLH in 20 (4.3%) patients. Other liver diseases (steatosis, cirrhosis, HCC) were identified in 152 subjects (3%). The prevalence of A, B, NANB and Delta hepatitis virus and HI virus in the acute disease was respectively of 5.4%, 54.8%, 33.9%, 0.28% and 0.77%. In CH the HBV aetiology accounted for 49.1%, NANB virus for 44.5%, co/super infection with HDV for 15%. Among factors involved in pathogenesis of chronic hepatitis we focused attention on drug addition which was found in 129 (28.7%) patients, blood transfusion in 70 (15.6%), HIV infection in 35 of 166 (21.1%). The data still demonstrate the high prevalence of HBV aetiology of CH and existence of co-factors in the pathogenesis of chronicity. The lack of markers for NANB infection persists as the main problem in the diagnosis of liver disease. This work was supported by grant 40% from M.P.I.: "Epatiti virali acute e croniche"....
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PMID:The spectrum of chronic hepatitis in the last two decades in a university hospital for infectious diseases. 249 35

Choice of treatment for HCC depends mainly on the size of tumor and patient's liver function because more than 80% of HCC patients are associated with liver cirrhosis. Percutaneous ethanol injection therapy (PEIT), transcatheter arterial embolization (TAE) and intraarterial infusion chemotherapy are, at present, commonly used treatments for HCC in Japan. PEIT is a safe and reliable treatment, in which absolute ethanol is injected to the tumor through a fine needle under US guide. PEIT is indicated for tumors of small size, which can not be removed surgically. The survival rate of PEIT for small liver cancer, less than 2 cm in diameter, is similar with the one of surgically removed cases. TAE is indicated for advanced HCC. Chemoembolization with Lipiodol is commonly used with good result. After TAE has been often performed, the survival rate of HCC patients was dramatically increased. In future, TAE combined with percutaneous transhepatic portal embolization or PEIT would be applied more often to obtain complete destruction of the lesion for advanced HCC. Intraarterial infusion chemotherapy is indicated for advanced HCC, in which TAE can not be performed. MMC, ADM and CDDP are commonly used anti-cancer drugs. Recently frequent infusion of these drugs has become possible by using implantable reservoir with good result. We have performed chemosensitivity test by SRCA for HCC specimens obtained by biopsy using a fine needle.
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PMID:[Non-surgical (medical) treatment of hepatocellular carcinoma (HCC)]. 253 69


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