Abstract

VELOSA, José. Precursor Lesions of Liver Cancer. J Port Gastrenterol. [online]. 2011, vol.18, n.6, pp.285-297. ISSN 0872-8178.

The identification of precancerous hepatic lesions is an important step in the prevention and clinical management of liver cancer. Cirrhosis, irrespective of its etiology, and hepatocellular adenoma (HA) are the most important predisposing conditions for hepatocellular carcinoma (HCC). As far as colangiocarcinoma is concerned, potentially premalignant pathologies include primary sclerosing cholangitis, hepatolithiasis and biliary malformations. In both tumors, malignant transformation is a multistep process through intermediary stages dominated by the dysplasia-carcinoma sequence. Chronic inflammation is the determinant factor pro­moting genetic mutations involved in hepatocarcinogenesis. Regenerative macronodule and dysplasia, particularly small cells dysplastic nodules, are documented as intermediary lesions in neoplastic transformation in cirrhotic patients. HA, particularly when associated with β-catenin mutations, is responsible for HCC in non cirrhotic patients. Diagnosis and evaluation of the malignant potential of dysplastic nodules requires histological examination, because current radiologic tools are relatively insensitive in detecting or elucidating borderline lesions. In future, advances in radiolo­gic methods and development of new serologic assays could allow non invasive screening of precursor lesions of liver cancer

Keywords : Macroregenerative nodule; dysplastic nodule; cirrhosis; hepatocellular carcinoma; intrahepatic cholangiocarcinoma.

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