Das hepatozelluläre Karzinom

Abstract

Hepatocellular carcinoma (hepatoma) accounts for over 80% of primary liver tumors. Although relatively uncommon in North America and Europe, hepatocellular carcinoma is the dominant malignant carcinoma in Southeast Asia and South and West Africa. About 80% of the patients have cirrhosis. The tumor has a grim prognosis with an average survival time of 4.5-13 months after the onset of complaints. Beginning with the observation of the striking coincidence of the geographic distribution of hepatocellular carcinoma with the endemic distribution of virus hepatitis, many studies have demonstrated the close correlation of the carcinoma with chronic hepatitis B. In the endemic areas vertical perinatal transmission of the virus from mother to the newborn is an important route of transmission. While only about 10% of infected adults develop HBs antigen carrier status, the carrier rate of perinatal infections is about 95%. In chronic infection the virus DNA can be integrated into the host genome and may become carcinogenic with time. Many studies have substantiated an increased incidence of liver adenoma and resulting complications among women taking oral contraceptives; evidence for a relationship between oral contraceptives and hepatoma has not been established. No increase in hepatoma has been observed among young women following the introduction of oral contraceptives in the USA and in Denmark.