Liver Cell Cancer

Liver Cell Cancer focuses on liver cell cancer, which is considered one of the most aggressive malignant tumors, and in turn, one of the most intensively studied tumors in man and experimental animals. This book discusses the geographic pathology, alpha-fetoprotein, diagnosis, treatment, and background of liver cell cancer. The clinical problem of liver cell cancer in a high incidence area; primary hepatocellular carcinoma; induction of liver cell cancer by chemicals; cell proliferation and experimental liver cancer; and immunology and pathology of experimental liver cell cancer are also discussed in the chapters. This book aims to provide a ready reference for clinicians for research, present a clear and unambiguous picture to research workers of the problems inherent in the clinical situation, and introduce a reasoned assessment of the findings, both clinical and experimental.

List of contributors Preface Chapter 1 The geographic pathology of liver cell cancer 1.1 The global pattern of liver cell cancer 1.2 Nomenclature and classification 1.3 Descriptive epidemiology - ratio studies 1.4 Incidence studies 1.4.1 Liver cell cancer in Africa 1.4.2 Liver cell cancer in South East Asia 1.4.3 Areas of low frequency of liver cell cancer 1.4.4 Liver cell cancer in migrants 1.5 The influence of sex and age on the incidence of liver cell cancer 1.6 Time trends 1.7 Associated diseases and their geography 1.7.1 Parasites and bile duct cancer 1.7.2 Cirrhosis and liver cancer 1.7.3 Other suspected etiological factors Chapter 2 The pathology of liver cell cancer 2.1 Gross pathology 2.1.1 Regional variations 2.2 Microscopic pathology 2.2.1 Grading 2.3 Differential diagnosis 2.3.1 Dysplasia 2.3.2 Carcinoma of bile duct (cholangiocarcinoma) 2.3.3 Adenoma and nodular hyperplasia 2.3.4 Mesenchymal hamartoma 2.3.5 Hepatoblastoma 2.3.6 Metastatic tumor 2.4 Ultrastructure 2.5 Spread of tumor 2.6 Association of liver cell cancer with other diseases 2.6.1 Cirrhosis 2.6.2 Hemochromatosis 2.6.3 Peptic ulceration 2.6.4 Diabetes mellitus 2.7 Association of liver cell cancer with hormonal abnormalities (the 'ectopic hormone syndromes') 2.7.1 Erythrocytosis 2.7.2 Hypoglycemia 2.7.3 Hypercalcemia 2.7.4 Carcinoid syndrome 2.7.5 Gonadotrophins 2.8 Course and mode of death Chapter 3 The clinical problem of liver cell cancer in a high incidence area 3.1 Age 3.2 Sex 3.3 Clinical features 3.4 Laboratory investigations 3.4.1 Liver biopsy 3.4.2 Alpha-fetoprotein 3.5 Special investigations 3.5.1 Radiology 3.5.2 Scintigraphy 3.5.3 Diagnostic ultrasound 3.5.4 Laparoscopy 3.6 Differential diagnosis 3.7 Management Chapter 4 Alpha-fetoprotein and the diagnosis of liver cell cancer 4.1 The Physiology of alpha-fetoprotein 4.1.1 Embryo-specific proteins 4.1.2 Embryonic physiology of alpha-fetoprotein 4.1.3 The sites of synthesis of alpha-fetoprotein in the embryo 4.1.4 The isolation and properties of alpha-fetoprotein 4.1.5 Assay of alpha-fetoprotein 4.1.6 Function of alpha-fetoprotein 4.1.7 The occurrence of alpha-fetoprotein in normal adults 4.2 The significance of raised alpha-fetoprotein levels 4.2.1 Alpha-fetoprotein-positivity rates in established liver cell cancer 4.2.2 Alpha-fetoprotein levels in relation to established liver cell cancer cases 4.2.3 Correlations with treatment and tumor growth rates 4.2.4 The detection of alpha-fetoprotein in liver cell cancer cases 4.2.5 Alpha-fetoprotein in other neoplastic diseases 4.2.6 Alpha-fetoprotein levels in non-neoplastic diseases 4.3 Surveys for liver cell cancer detection 4.3.1 Southern African surveys 4.3.2 Surveys in other parts of Africa 4.3.3 Survey in ChinaChapter 5 The treatment of liver cell cancer 5.1 Surgery: hepatic resection 5.2 Hepatic arterial catheterization 5.3 Radiotherapy: external irradiation 5.4 Radiotherapy and chemotherapy 5.5 Placebo 5.6 Cytostatics 5.6.1 Alkylating agents 5.6.2 Antimetabolites 5.6.3 Antitumor antibiotics 5.6.4 Diverse agents 5.6.5 Chemotherapy combinations 5.7 Hope for the future Chapter 6 The background to liver cell cancer 6.1 The background to liver cell cancer 6.2 Race, sex and genetics 6.3 Malnutrition 6.4 Liver disease of the alcoholic 6.5 Iron overload 6.6 Parasites 6.