HEPATOCELLULAR-CARCINOMA ASSOCIATED WITH CHRONIC VIRAL-HEPATITIS - ETIOLOGY, DIAGNOSIS AND TREATMENT

Two major aetilogical factors have been definitively incriminated in the pathogenesis of HCC: these are chronic hepatitis and hepatic cirrhosis. Chronic infection with hepatotropic viruses may account for the majority of cases of hepatocellular carcinoma in high incidence areas, and a varying prevalence of human hepatitis B and hepatitis C virus infection appears to determine the differing geographical prevalence of hepatocellur carcinoma in high and low incidence areas of the world. Patients with advanced hepatocellular carcinome have a grave prognosis. However. at-risk groups have been charcterized, and recent advances in hepatic imaging and tumour marker testing have made screening for asymptomatic primary liver cancer feasible. It is not clear, however, whether screening for small hepatocellular carcinoma improves the prognosis. Lipiodol has been shown to serve as a useful vehicle for diagnosis of small, centimetre sized nodules of tumour, and for delivery of cancer chemotherpeutic or radioactive agents to HCC. The combination of early diagnosis, and coupled medical and surgical treatments including targeted lipiodol or monoclonal antibody conjugates and hepatic resection or transplanation may lead to an improved outlook for viral-associated hepatocellular carcinoma. © 1990 The British Council 1990.