Thursday, May 5, 2011

Liver cell cancer hepatocellular carcinoma

Liver cell cancer (hepatocellular carcinoma) : The liver is a large organ, solid, which is attached to near the body cavity in the upper right abdomen and protected entirely by a framework of ribs. Liver has a dual function: first, produce and drain the bile into the intestine for digestion of fat and second, processing the food coming from the intestines through the portal vein, to the important parts of metabolism, in all tissues and organs. 

For that there are four branches throughout the liver system. First, the two blood vessels in, namely the liver artery that contains a full blood acidity and portal vein from the intestines that contains a food that is both naturally branched throughout the liver. Then, two systems out: small bile ducts of the liver which merged into the bile duct into the intestine and liver to the bleeding veins of the body with nutrients for metabolism and carbonic acid that will be cleared in the lung. Hearts were divided into various sections.

Heart has a special ability to regenerate after loss of tissue or injured. Tissue loss by any cause, quite quickly compensated and replaced, without leaving a scar that difficult. In the long-standing inflammation, tissue inflammation transformed into rigid connective tissue that mengisut, which can result in serious loss of function. This situation, according to the color (yellow-orange) is called cirrhosis (kirrhos = orange-yellow) is one basis for liver cancer.

Under the terms of liver cancer, as well as talk about primary and secondary liver cancer. The first, which stems from the liver cells, called cell cancer of the liver (hepatocellular carcinoma). The second consists of a group of metastatic tumors originating from the parent anywhere in the body. We will first discuss the problem of liver cell cancer and after that, some general features of metastasis in the liver.

Liver cell cancer
Liver cell cancer, liver cancer is 'normal' happens anywhere in the world, but there are endemic in native populations in China, Southeast Asia, and countries in Africa south of Sahara. In these countries, especially developing cancer in the liver of infected chronic hepatitis-B. The incidence (frequency of occurrence) in this endemic area, thirty per 100,000 population per year, is ten times higher than the low-risk country, a place where alcohol plays the most important. Intensive use of alcohol and prolonged in Western countries is always an important cause of cirrhosis and liver with the consequent increase in the incidence of hepatocellular cancer is not inevitable.
Primary liver cancer in endemic areas often develop quickly and be fatal. This is the picture that is marked by a determination in the diagnosis of a terminal phase. The more serious cirrhosis due to chronic hepatitits, the greater the risk for development of hepatocellular carcinoma. According to the Child this state was divided into three classes (A, B, and C) according to the seriousness of the disease, based on results of blood tests and clinical picture. Here, Child C is the most serious.

Filtering, mainly directed at patients with cirrhosis Child A, through blood tests (al marker alpha-foetoprotein [AFP]) and ekhografi can produce a number of cases of early diagnosis.

These tumors have a lot of images, shapes, and expansion. Sometimes its source remote, but generally there are a lot of diffuse tumors that spread throughout the liver. Therefore, hepatocellular carcinoma often intangible as a multifocal process. An isolated tumor without symptoms, with a cross section of less than three centimeters, after three years has the percentage of survival of about fifty and after five years of approximately ten more. Metastasisnya mainly to pare and bone.

Pathology hepatoma 
Clinical features
Usually take long before the advent of complaints and symptoms. During the tumor was surrounded by liver tissue no symptoms. Just when the tumor grew through the liver capsule, it will feel pain. Acute pain occurs because of bleeding and tumors. Often, abdominal swelling (edema) because of fluid (ascites) caused by the damming of portal vein due to sirosisnya. In more advanced stages, loss of appetite and may appear jaundice (jaundice) due to bile duct dam. Complaints are often dominated by decompensation sirosisnya: dam with ascites (edema) serious bleeding esophageal veins are clogged, and poor general condition. In cirrhosis of the liver with elevated AFP levels in the blood of the source tumor in the liver as shown in ekhogafis, only require cytological examination and puncture fluid tumor to prove the diagnosis of hepatocellular carcinoma.

Before treatment begins, there should be a clear picture of the patient's general condition and the local situation. Often the severity of liver cirrhosis to determine treatment. If liver function is disturbed there is no treatment. Also, because sirosisnya terbendungnya heart will paralyze any curative activity. Limits surgical therapy is also located in the heart of local circumstances and the expansion of the tumor. Patients with cirrhosis Child A, may be operated on, but the operation can no longer be considered in Child C. Operation and this tumor, just maybe, if still limited to one or two baga. The operation is not possible if there are multiple tumors in the more and the two sections, the tumor has spread to surrounding organs, there is metastasis (often in lung or bone), tumors grow into the bile duct and / or to the blood vessels in and out .

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