http://www.cnr.it/ontology/cnr/individuo/prodotto/ID11920
Epidemiology, risk factors, and natural history of hepatocellular carcinoma (Articolo in rivista)
- Type
- Label
- Epidemiology, risk factors, and natural history of hepatocellular carcinoma (Articolo in rivista) (literal)
- Anno
- 2002-01-01T00:00:00+01:00 (literal)
- Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
- 10.1111/j.1749-6632.2002.tb04090.x (literal)
- Alternative label
Montalto G., Cervello M., Giannitrapani L., Dantona F., Terranova A., Castagnetta La. (2002)
Epidemiology, risk factors, and natural history of hepatocellular carcinoma
in Annals of the New York Academy of Sciences
(literal)
- Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
- Montalto G., Cervello M., Giannitrapani L., Dantona F., Terranova A., Castagnetta La. (literal)
- Pagina inizio
- Pagina fine
- Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroVolume
- Rivista
- Note
- ISI Web of Science (WOS) (literal)
- Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#affiliazioni
- Institute of Internal Medicine, Institute of Development Biology, CNR, University of Palermo, Palermo, Italy. (literal)
- Titolo
- Epidemiology, risk factors, and natural history of hepatocellular carcinoma (literal)
- Abstract
- The incidence of hepatocellular carcinoma is increasing in many countries.
The estimated number of new cases annually is over 500,000, and the yearly
incidence comprises between 2.5 and 7% of patients with liver cirrhosis.
The incidence varies between different geographic areas, being higher in
developing areas; males are predominantly affected, with a 2:3 male/female
ratio. The heterogeneous geographic distribution reflects the
epidemiologic impact of the main etiologic factors and environmental risk,
which are the hepatitis B (HBV) and hepatitis C (HCV) viruses. The
percentage of cases of hepatocellular carcinoma attributable to HBV
worldwide is 52.3% and is higher in Asia where the seroprevalence of HBsAg
in the population is high. However, the vaccination campaign against this
virus in some eastern countries has tended to lower the incidence of new
cases of hepatocellular carcinoma. The percentage of cases of
hepatocellular carcinoma attributable to HCV is 25%, and it is more
prevalent in Japan, Spain, and Italy where the association between
hepatocellular carcinoma and antibodies to HCV ranges between 50 and 70%.
In most cases hepatocellular carcinoma develops in cirrhotic livers, where
the persistent proliferation of liver cells represents the key factor of
progression to hepatocellular carcinoma independent of the etiology.
Another minor risk factor is aflatoxin B1 consumption, which is
responsible for most cases of hepatocellular carcinoma in Africa, where
the consumption of contaminated foods is common. Other known risk factors
are some hereditary diseases, such as hemochromatosis, porphyria cutanea
tarda, hereditary tyrosinemia, and alpha1 anti-trypsin deficiency. The
natural history of hepatocellular carcinoma is heterogeneous and is
influenced by nodule dimension, the mono- or plurifocality of lesions at
diagnosis, the growth rate of the tumor, and the stage of the underlying
cirrhosis. Available data to date suggest that tumor growth in a cirrhotic
liver is variable and that the time in which a lesion in undetectable
until it becomes 2 cm is between 4 and 12 months. Therefore, the suggested
interval for surveillance screening with ultrasound in patients with liver
cirrhosis has been set at 6 months. Patients who should benefit from
screening programs are those who would be treated with curative therapy if
diagnosed with hepatocellular carcinoma. Thus, the ideal target population
should be limited to Child-Pugh's class A cirrhotic patients without
significant comorbidity. (literal)
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- Autore CNR
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