西安交通大学医学院消化系统疾病课件 Primary Carcinoma of the Liver.pptVIP

Primary  Carcinoma  of the Liver Qiao Wen Introduction 1. Definition Primary malignant hepatic tumor is an epithelial or adenocarcinoma arising from hepatocyte or biliary epithelium. It includes hepatocellular carcinoma cholangiocarcinoma. 2. Epidemiology (1)Incidence and Geographic Disturbance Epidemiology (2) Sex Distribution male: female is 3~4: 1 (3) Age Distribution 40~49 years old is most. Etiology Pathogenesis Etiology and Pathogenesis 1.? Virus hepatitis (1) Hepatitis B Virus a. HBV DNA is integrated into cellular DNA b. Dissociate copied defect virus of HBV c. Some virus product of HBV d. The stability of inheritance decrease Etiology and Pathogenesis 2.? Cirrhosis 3%~6% HBV-related cirrhosis develop hepatic carcinoma every year. The risk factors: age, time of infection, sex, alcohol and superposition of HBV and HCV. It is said that biliary cirrhosis, congestive cirrhosis isn’t link with hcc. Etiology and Pathogenesis 3.?Aflatoxin The metabolism product of aflatoxin is aflatoxin B1 (AFB1), it has intensity carcinogenic effect. AFB1 can cooperate with HBV. Etiology and Pathogenesis 4.?Polluted drinking water Alga in the pond can produce toxin to pollute the water. 5. Inheritance Etiology and Pathogenesis 5. Others (1) Some chemical substance such as nitrosamine, azoimide (2) Parasite such as Clonorchiasis Sinensis Pathology 1. Classification  (1) MorphologyMassive type The diameter of tumor is ?5cm Nodular type The diameter of tumor is 5cm Diffuse type difficult differentiate to cirrhosis Small carcinoma type signal nodular 3cm The summation of two border upon nodulars3cm 2. Histology (1) hepatocellular carcinoma : 90% (2) cholangiocarcinoma: 10% (3) mixed hepatocellular- cholangiocarcinom