HEPATOCELLULAR-CARCINOMA

Detailed analyses of chromosomal damage in hepatocellular carcinoma ha ve confirmed the results of previous studies that identified regions o f significant loss. In addition, these studies examined the clinicopat hological correlates of this damage, identified new sites for future i nvestigation, and provided evidence of interactions between genes, The insulin-like growth factor II receptor gene is a target for inactivat ion through chromosomal loss and mutation, with loss also occurring in the cirrhotic liver. The insulin-like growth factor II receptor gene plays a central role in coordinating the competing actions of insulin- like growth factor and transforming growth factor-beta on cell prolife ration. Our understanding of the changes in these growth factor pathwa ys helps explain the apparent increase in risk of hepatocellular carci noma in diabetic patients and the potential use of urinary transformin g growth factor-beta in screening tests. Vaccination for hepatitis B i n Taiwan has had a significant effect on the incidence of childhood he patocellular carcinoma. Universal vaccination should result in a major reduction in the incidence of hepatocellular carcinoma worldwide.