Patients with Liver Diseases Causing Cirrhosis May Be Predisposed to HCC

Liver cirrhosis (scarring) can be fatal because damage to the liver is irreversible. A cirrhotic liver leads to liver failure, liver cancer, and eventually death. According to a report in Research Square, liver cirrhosis disorder constitutes a scarred, shrunken, hardened liver leading to eventual deterioration. It is the result of long-term damage from various causes.

Tan Hiang Keat, M.D. of GI and Hepatology at the SingHealth group explained that not everyone who consumes large quantities of alcohol will develop liver cirrhosis. He specified that people who have hepatitis C and consume large amounts of alcohol would be much more likely to develop cirrhosis.

A new study may shed light on which of the cirrhosis types are most predisposed to hepatocellular carcinoma (HCC). To date, the effect of cirrhosis on HCC is unclear. Therefore, the study of cell growth or death (apoptosis) may indicate which type of cirrhosis is more likely to cause HCC.

Hepatocellular carcinoma (liver cancer) originates in the liver. It differs from “secondary” liver cancers which metastasize to the liver from other organs.

The Primary Risk Factors

Cirrhosis is the primary risk factor in developing HCC, with hepatitis B virus (HBV) or hepatitis C (HCV) infection as the principal cause. Worldwide evidence shows fifty percent of cases of HCC are caused by HBV and twenty-five percent of cases are associated with HCV.

About the Study

Fifteen livers with steatosis (fatty livers) and fifteen control livers were used for the study. A polymerase chain reaction was implemented to analyze the subjects.

The new study investigates gene expression of AMPK, p53, and pAMPK as well as cirrhotic livers with AgNOR features.

pAMPK and AMPK protein levels, the p53 gene expression, and AgNOR were investigated in 15 livers with nonalcoholic steatohepatitis (NASH), 15 with autoimmune hepatitis (AIH), 14 with HBV/HCV, and 15 with primary sclerosing cholangitis (PSC).

NASH, an inflammatory subtype of NAFLD, may result in cirrhosis and require a liver transplant. NAFLD is an acronym for nonalcoholic fatty liver disease.

Gene expression shows how the sequence of DNA base pairs converts to either RNA or a protein that makes structures and enzymes in a cell.

Results of the Study

  • Cirrhotic groups: the protein levels in livers were increased significantly
  • Simple steatosis: the protein levels in livers were decreased slightly

The goal of the study was to investigate gene expression of p53, AMPK, and Pampk protein expressions including AgNOR in fatty livers with varied causes.

The investigators found that the mRNA level of AgNOR and p53 had increased in NASH, AIH, and PSC cirrhosis. There were correlations in cirrhotic tissues between the p53 mRNA level and AgNOR’s features.

In conclusion, the hypothesis is that increased pAMPK levels may be a response to the common etiology of liver disease. It is believed that people with PSC, AIH, and NASH are predisposed to developing HCC more so than people with alcoholic and viral cirrhosis.

Rose Duesterwald

Rose Duesterwald

Rose became acquainted with Patient Worthy after her husband was diagnosed with Acute Myeloid Leukemia (AML) six years ago. During this period of partial remission, Rose researched investigational drugs to be prepared in the event of a relapse. Her husband died February 12, 2021 with a rare and unexplained occurrence of liver cancer possibly unrelated to AML.

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