title: [Epidemiology, risk factors and molecular pathogenesis of primary liver cancer].
abstract: Primary liver cancer is the fifth most common cancer worldwide. Hepatocellular carcinoma accounts for 85-90% of primary liver cancers. Distribution of hepatocellular carcinoma shows variations among geographic regions and ethnic groups. Males have higher liver cancer rates than females. Hepatocellular carcinoma occurs within an established background of chronic liver disease and cirrhosis (70-90%). Major causes (80%) of hepatocellular carcinoma are hepatitis B, C virus infection, and aflatoxin exposition. Its development is a multistep process. We have a growing understanding on the molecular pathogenesis. Genetic and epigenetic changes activate oncogenes, inhibit tumorsuppressor genes, which result in autonomous cell proliferation. The chromosomal instability caused by telomere dysfunction, the growth-retrained environment and the alterations of the micro- and macroenvironment help the expansion of the malignant cells. Understanding the molecular mechanisms could improve the screening of patients with chronic liver disease, or cirrhosis, and the prevention as well as treatment of hepatocellular carcinoma.
authors.affiliation: Semmelweis Egyetem, Budapest. hkriszti@bel2.sote.hu
authors.forename: Krisztina
authors.initials: K
authors.lastname: Hagymási
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Tulassay
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D003276:Contraceptives, Oral / Q000009:adverse effects; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D048909:Diabetes Complications / Q000453:epidemiology; D005234:Fatty Liver / Q000150:complications; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006432:Hemochromatosis / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D009765:Obesity / Q000150:complications; D009857:Oncogenes; D012194:RNA-Directed DNA Polymerase / Q000378:metabolism; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D019098:Telomerase / Q000378:metabolism; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D003276:Contraceptives, Oral; D019941:Cyclin-Dependent Kinase Inhibitor p16; D036341:Intercellular Signaling Peptides and Proteins; D016159:Tumor Suppressor Protein p53; D012194:RNA-Directed DNA Polymerase; D019098:Telomerase