Hepatocellular Carcinoma Flashcards
what is hepatocellular carcinoma also called
hepatoma
def
cancer arising from hepatocytes
what is commonly associated (with regards to the liver) with HC
cirrhosis
when is HC not associated with cirrhosis
patients with chronic hep B
epi
elderly
men>women
what viruses are associated with HC
hep B and C
what are the major risk factors for HC
5Hs
HBV HCV heavy alcohol consumption hyperglycaemia (DM) hepatitis + cirrhosis
how does DM and obesity cause HC
insulin resistance leads to NASH which is a RF for HC
what conditions are associated with HC
HH
PBC and PSC
A1AT deficiency
what is aflotoxin
toxins produced by aspergillus flavus
what are the first and second most common causes of aspergillosis
aspergillosis fumigates
aspergillosis flavus
how does HBV cause HC
causes chronic inflammation and cirrhosis
it is a direct carinogen which causes methylation of p16 gene which is known to cause HC
how does aflatoxin cause HC
a mycotoxin produced by aspergillus what can cause mutations in p53
what cancer gene does both HBV and HCV affect
p53
risk factors
hepatitis and cirrhosis
HBV and HCV
heavy alcohol use
hyperglycaemia (DM) + obesity
features of HC
elderly
RUQ pain and hepatomegaly
signs of CLD (abdominal distension, jaundice, asterixis, palmar erythema, spider naevi)
weight loss
what tumour marker is used for HC
AFP raised
how is HC diagnosed
clinical assessment assessing features and risk factors
imaging with USS
what is the first line imaging investigation
USS
investigations
1 bloods
-FBC (microcytic anaemia +/ thrombocytopenia)
-LFTs (raised aminotransferases, ALP, bilirubin, low albumin, PT/INR)
-raised AFP
2 USS
-poorly defined margins and course irregular echoes
what causes HCC
WHAT causes HCC
Wilsons
HH
A1AT deficiency
Tyrosinosis
Hepatitis (HBV+HCV)
Cirrhosis (PBC +PSC)
Carcinogenes (aflotoxin)
