Tumors and Tumor-Like Lesions of the Hepatobiliary Tract pp 2931-2959 | Cite as
Etiology and Pathogenesis of Hepatocellular Carcinoma: Inflammatory and Toxic Causes
Abstract
The main risk factors for the development of hepatocellular carcinoma (HCC) include chronic fibrosing liver disease and cirrhosis. Hepatic fibrosis and cirrhosis are most commonly caused by hepatitis virus infection and numerous nonviral factors. Worldwide, hepatitis B virus and hepatitis C virus infections play a central role as etiologic factors for liver cirrhosis and associated HCC, but in addition to their pro-cirrhosis effect, these viruses can also act as oncogenic agents. A second group of important hepatic inflammatory conditions that increase risk for HCC are various forms of nonalcoholic steatohepatitis and associated metabolic disorders. Hepatotoxic factors that increase HCC risk include alcohol (alcoholic liver disease, in part associated with fibrosing inflammation), aflatoxin, iron (mainly in hemochromatosis), pesticides, and a large spectrum of other toxic molecules. Certain drugs, in particular sex steroids and their derivates, can augment liver cancer risk. Apart from the various types of hemochromatosis, other inborn errors of metabolism bear an increased HCC risk, including Wilson’s disease, glycogenoses, and tyrosinemia.
Keywords
Androgen Receptor Primary Biiary Cirrhosis Primary Sclerosing Cholangitis Primary Biiary Cirrhosis Patient Primary Sclerosing Cholangitis PatientReferences
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