Der Gastroenterologe

, Volume 7, Issue 5, pp 382–389 | Cite as

Epidemiologie und molekulare Pathogenese des hepatozellulären Karzinoms

Schwerpunkt
  • 198 Downloads

Zusammenfassung

Das hepatozelluläre Karzinom (HCC) ist weltweit einer die häufigsten Tumoren, der aufgrund der nur wenigen therapeutischen Optionen für Patienten in den fortgeschrittenen Tumorstadien weiterhin mit einer hohen Mortalität assoziiert ist. Virale Hepatitiden, Alkohol und in Zukunft wahrscheinlich vermehrt auch die nichtalkoholische Steatohepatitis (NASH) sind wichtige Risikofaktoren für das HCC. Die Erkenntnis der epidemiologischen Zusammenhänge sollte in der Zukunft eine noch bessere Prävention und Überwachungsstrategien für Risikopatienten ermöglichen. Ein besseres Verständnis der molekularen Pathogenese wird es ermöglichen, neue molekulare Therapien gezielt beim HCC einzusetzen.

Schlüsselwörter

Leberkarzinom Mortalitätsraten Risikofaktoren Angiogenetische Signalwege Molekulare Therapie 

Hepatocellular carcinoma: epidemiology and molecular pathogenesis

Abstract

Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide which is still associated with a high mortality due to the few therapeutic options available for patients with advanced stage tumors. Viral hepatitis, alcohol and also probably more often in the future non-alcoholic steatohepatitis (NASH) are important risk factors for HCC. The epidemiological associations should allow further improvement in prevention and surveillance strategies for risk patients in the future. A better understanding of the molecular pathogenesis will allow new targeted molecular therapies to be used for HCC.

Keywords

Liver cancer Mortality Risk factors  Angiogenetic pathways Molecular therapy 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seinen Koautor an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    El-Serag HB, Mason AC (1999) Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med 340: 745–750PubMedCrossRefGoogle Scholar
  2. 2.
    Tanaka H, Imai Y, Hiramatsu N et al (2008) Declining incidence of hepatocellular carcinoma in Osaka, Japan, from 1990 to 2003. Ann Intern Med 148: 820–826PubMedGoogle Scholar
  3. 3.
    Jemal A, Siegel R, Ward E et al (2008) Cancer statistics, 2008. CA Cancer J Clin 58: 71–96PubMedCrossRefGoogle Scholar
  4. 4.
    Bosetti C, Levi F, Boffetta P et al (2008) Trends in mortality from hepatocellular carcinoma in Europe, 1980–2004. Hepatology 48: 137–145PubMedCrossRefGoogle Scholar
  5. 5.
    Naugler WE, Sakurai T, Kim S et al (2007) Gender disparity in liver cancer due to sex differences in MyD88-dependent IL-6 production. Science 317: 121–124PubMedCrossRefGoogle Scholar
  6. 6.
    Chen CJ, Yang HI, Su J et al (2006) Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA 295: 65–73PubMedCrossRefGoogle Scholar
  7. 7.
    Yu MW, Yeh SH, Chen PJ et al (2005) Hepatitis B virus genotype and DNA level and hepatocellular carcinoma: a prospective study in men. J Natl Cancer Inst 97: 265–272PubMedCrossRefGoogle Scholar
  8. 8.
    Chang MH, Chen CJ, Lai MS et al (1997) Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group. N Engl J Med 336: 1855–1859PubMedCrossRefGoogle Scholar
  9. 9.
    Donato F, Tagger A, Gelatti U et al (2002) Alcohol and hepatocellular carcinoma: the effect of lifetime intake and hepatitis virus infections in men and women. Am J Epidemiol 155: 323–331PubMedCrossRefGoogle Scholar
  10. 10.
    Lok AS, Seeff LB, Morgan TR et al (2009) Incidence of hepatocellular carcinoma and associated risk factors in hepatitis C-related advanced liver disease. Gastroenterology 136: 138–148PubMedCrossRefGoogle Scholar
  11. 11.
    Asahina Y, Tsuchiya K, Tamaki N et al (2010) Effect of aging on risk for hepatocellular carcinoma in chronic hepatitis C virus infection. Hepatology 52: 518–527PubMedCrossRefGoogle Scholar
  12. 12.
    Lok AS, Everhart JE, Wright EC et al (2011) Maintenance peginterferon therapy and other factors associated with hepatocellular carcinoma in patients with advanced hepatitis C. Gastroenterology 140: 840–849, quiz e812PubMedCrossRefGoogle Scholar
  13. 13.
    Trichopoulos D, Bamia C, Lagiou P et al (2011) Hepatocellular carcinoma risk factors and disease burden in a European cohort: a nested case-control study. J Natl Cancer Inst 103: 1686–1695PubMedCrossRefGoogle Scholar
  14. 14.
    Ascha MS, Hanouneh IA, Lopez R et al (2010) The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis. Hepatology 51: 1972–1978PubMedCrossRefGoogle Scholar
  15. 15.
    Chuang SC, Lee YC, Hashibe M et al (2010) Interaction between cigarette smoking and hepatitis B and C virus infection on the risk of liver cancer: a meta-analysis. Cancer Epidemiol Biomarkers Prev 19: 1261–1268PubMedCrossRefGoogle Scholar
  16. 16.
    Bravi F, Bosetti C, Tavani A et al (2007) Coffee drinking and hepatocellular carcinoma risk: a meta-analysis. Hepatology 46: 430–435PubMedCrossRefGoogle Scholar
  17. 17.
    Larsson SC, Wolk A (2007) Overweight, obesity and risk of liver cancer: a meta-analysis of cohort studies. Br J Cancer 97: 1005–1008PubMedGoogle Scholar
  18. 18.
    Wang C, Wang X, Gong G et al (2012) Increased risk of hepatocellular carcinoma in patients with diabetes mellitus: a systematic review and meta-analysis of cohort studies. Int J Cancer 130: 1639–1648 (Journal international du cancer)PubMedCrossRefGoogle Scholar
  19. 19.
    Ertle J, Dechene A, Sowa JP et al (2011) Non-alcoholic fatty liver disease progresses to hepatocellular carcinoma in the absence of apparent cirrhosis. Int J Cancer 128: 2436–2443 (Journal international du cancer)PubMedCrossRefGoogle Scholar
  20. 20.
    Baffy G, Brunt EM, Caldwell SH (2012) Hepatocellular carcinoma in non-alcoholic fatty liver disease: an emerging menace. J Hepatol 56(6): 1384–1391PubMedCrossRefGoogle Scholar
  21. 21.
    Noto H, Goto A, Tsujimoto T, Noda M (2012) Cancer risk in diabetic patients treated with metformin: a systematic review and meta-analysis. PLoS One 7: e33411PubMedCrossRefGoogle Scholar
  22. 22.
    Mas VR, Maluf DG, Archer KJ et al (2007) Angiogenesis soluble factors as hepatocellular carcinoma noninvasive markers for monitoring hepatitis C virus cirrhotic patients awaiting liver transplantation. Transplantation 84: 1262–1271PubMedCrossRefGoogle Scholar
  23. 23.
    Llovet JM, Ricci S, Mazzaferro V et al (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359: 378–390PubMedCrossRefGoogle Scholar
  24. 24.
    Llovet JM, Pena CE, Lathia CD et al (2012) Plasma Biomarkers as Predictors of Outcome in Patients with Advanced Hepatocellular Carcinoma. Clin Cancer Res 18: 2290–2300PubMedCrossRefGoogle Scholar
  25. 25.
    Chao Y, Li CP, Chau GY et al (2003) Prognostic significance of vascular endothelial growth factor, basic fibroblast growth factor, and angiogenin in patients with resectable hepatocellular carcinoma after surgery. Ann Surg Oncol 10: 355–362PubMedCrossRefGoogle Scholar
  26. 26.
    Abu Dayyeh BK, Yang M, Fuchs BC et al (2011) A functional polymorphism in the epidermal growth factor gene is associated with risk for hepatocellular carcinoma. Gastroenterology 141: 141–149CrossRefGoogle Scholar
  27. 27.
    Ueki T, Fujimoto J, Suzuki T et al (1997) Expression of hepatocyte growth factor and its receptor c-met proto-oncogene in hepatocellular carcinoma. Hepatology 25: 862–866PubMedCrossRefGoogle Scholar
  28. 28.
    Kaposi-Novak P, Lee JS, Gomez-Quiroz L et al (2006) Met-regulated expression signature defines a subset of human hepatocellular carcinomas with poor prognosis and aggressive phenotype. J Clin Invest 116: 1582–1595PubMedCrossRefGoogle Scholar
  29. 29.
    You H, Ding W, Dang H et al (2011) c-Met represents a potential therapeutic target for personalized treatment in hepatocellular carcinoma. Hepatology 54: 879–889PubMedCrossRefGoogle Scholar
  30. 30.
    Calvisi DF, Ladu S, Gorden A et al (2006) Ubiquitous activation of Ras and Jak/Stat pathways in human HCC. Gastroenterology 130: 1117–1128PubMedCrossRefGoogle Scholar
  31. 31.
    Schmitz KJ, Wohlschlaeger J, Lang H et al (2008) Activation of the ERK and AKT signalling pathway predicts poor prognosis in hepatocellular carcinoma and ERK activation in cancer tissue is associated with hepatitis C virus infection. J Hepatol 48: 83–90PubMedCrossRefGoogle Scholar
  32. 32.
    O’Neil BH, Goff LW, Kauh JS et al (2011) Phase II study of the mitogen-activated protein kinase 1/2 inhibitor selumetinib in patients with advanced hepatocellular carcinoma. J Clin Oncol 29: 2350–2356CrossRefGoogle Scholar
  33. 33.
    Hatzivassiliou G, Song K, Yen I et al (2010) RAF inhibitors prime wild-type RAF to activate the MAPK pathway and enhance growth. Nature 464: 431–435PubMedCrossRefGoogle Scholar
  34. 34.
    Feitelson MA, Pan J, Lian Z (2004) Early molecular and genetic determinants of primary liver malignancy. Surg Clin North Am 84: 339–354PubMedCrossRefGoogle Scholar
  35. 35.
    Watanabe S, Horie Y, Suzuki A (2005) Hepatocyte-specific Pten-deficient mice as a novel model for nonalcoholic steatohepatitis and hepatocellular carcinoma. Hepatol Res 33: 161–166PubMedCrossRefGoogle Scholar
  36. 36.
    Ferlay J, Shin HR, Bray F et al (2010) Cancer Incidence and Mortality Worldwide. GLOBOCAN 2008 v1.2, IARC CancerBase No. 10. Lyon, France. http://globocan.iarc.fr (accessed on 07/07/2012)Google Scholar
  37. 37.
    Whittaker S, Marais R, Zhu AX (2010) The role of signaling pathways in the development and treatment of hepatocellular carcinoma. Oncogene 29: 4989–5005PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Klinik für Gastroenterologie, Hepatologie und EndokrinologieMedizinische Hochschule HannoverHannoverDeutschland

Personalised recommendations