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Hepatocellular Carcinoma

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Biotargets of Cancer in Current Clinical Practice

Part of the book series: Current Clinical Pathology ((CCPATH))

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Abstract

Hepatocellular carcinoma (HCC) is the sixth most common neoplasm in the world and the third most common cause of cancer-related death. The most common risk factor for HCC is cirrhosis, which is caused most often by hepatitis B or C virus infection. The HCC incidence is higher but shows a decreasing trend in developing countries, while the trend is the opposite in developed countries. Patients with cirrhosis are therefore usually included in surveillance programs. Ultrasonography (US) and a serum alpha-fetoprotein test at 6-month intervals are the current standard, aiming to achieve early detection in order to facilitate effective treatment. HCC can be diagnosed radiologically, without the need for biopsy if the typical imaging features of the presence of arterial enhancement followed by washout of the tumor in the delayed phases are present. Upon diagnosis, the patients must be staged to define tumor extent and impairment of liver function. Thereafter, the best treatment option can be indicated, and prognosis can be estimated. While surgery remains the gold standard for the treatment of HCC, new methods are emerging with greater potential response, lower risk, and lower cost. Percutaneous local ablative therapy has proved to be very effective. Chemoembolization therapy has been effective in selected patients with improved survival reported in a large cohort. Moreover, patients in a more advanced stage are candidates for sorafenib pharmacologic treatment, which has shown a good response rate. Here, we provide an overview of the current status of HCC, including risk factors, surveillance, pathology, diagnosis, treatment, and prevention.

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Abbreviations

AFP:

Alpha-fetoprotein

AFP-L3:

Alpha-fetoprotein

Lens:

Culinaris agglutinin 3

BCLC:

Barcelona Clinic Liver Cancer

CTHA/CTAP:

CT with hepatic arteriography and arterial portography

DCP:

Des-gamma-carboxypro­thrombin

Gd-DTPA:

Gadolinium diethylenetriamine pentaacetic acid

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

MDCT:

Multidetector row CT

MPR:

Multiplanar reconstruction

NASH:

Nonalcoholic steatohepatitis

PDGFR:

Platelet-derived growth factor receptors

PIVKA-II:

Prothrombin induced by vitamin K absence-II

SPIO:

Superparamagnetic iron oxide

RCT:

Randomized controlled trial

TACE:

Transcatheter arterial chemoembo­lization

VEGFR:

Vascular endothelial growth factor receptors

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Yasunori Minami M.D. & Masatoshi Kudo M.D., Ph.D.

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  1. Yasunori Minami M.D.
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Correspondence to Masatoshi Kudo M.D., Ph.D. .

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  1. Chair of General Pathology, Department of Experimental Medicine, University of L’Aquila, Via Vetoio, Coppito-2, L'Aquila, 67100, Italy

    Mauro Bologna

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Minami, Y., Kudo, M. (2012). Hepatocellular Carcinoma. In: Bologna, M. (eds) Biotargets of Cancer in Current Clinical Practice. Current Clinical Pathology. Humana Press. https://doi.org/10.1007/978-1-61779-615-9_10

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