الفهرس 
Introduction
EpidemiologyOnly 14 pages are availabe for public view
 |  | from | 226 |  |  |
| | | from | 226 | | |
Abstract
Hepatocellular carcinoma, like any other cancer, develops when there is a mutation to the cellular machinery that causes the cell to replicate at a higher rate and/or results in the cell avoiding apoptosis. In particular, chronic infections of hepatitis B and/or C can aid the development of hepatocellular carcinoma by repeatedly causing the body’s own immune system to attack the liver cells. While this constant cycle of damage followed by repair can lead to mistakes during repair which in turn lead to carcinogenesis, this hypothesis is more applicable, at present, to hepatitis C. Chronic hepatitis C causes HCC through the stage of cirrhosis. In chronic hepatitis B, however, the integration of the viral genome into infected cells can directly induce a non-cirrhotic liver to develop HCC. Alternatively, repeated consumption of large amounts of ethanol can have a similar effect. Besides, cirrhosis is commonly caused by alcoholism, chronic hepatitis B and chronic hepatitis C. The toxin aflatoxin from certain Aspergillus species of fungus is a carcinogen and aids carcinogenesis of hepatocellular cancer by building up in the liver. Multiple non-viral factors have been implicated in the development of HCC. Hemochromatosis and iron overload syndromes have consistently been shown to dramatically increase the rate of HCC. Additionally, factors such as obesity and diabetes, which operate via NASH cirrhosis or perhaps independently, have also been demonstrated to increase the risk of HCC. This phenomenon has closely mirrored the epidemic of obesity over the last 15-25 years. With respect to other exposures, although alcohol and tobacco clearly increase the risk of HCC development and mortality, other exposures such as coffee and high levels of vegetable consumption may be protective against this condition. Recommendation • Free facilities for easily detection of HCC cases are necessarly needed in both the primary care centers as well as the specialized centre to mange the high risk groups for early spotting of curable candidates. • It is important to stress on HBV vaccination to health care workers as well as HCV +Ve cases in addition to those primarily involved in obligatory HBV immunization Programme. • Donors’ blood as well as blood bags should be tested before transfusion, Avoid sharing drug needles or syringes, Sterilization of equipments in hospitals and any healthcare unit should be greatly considered, Diabetic people should avoid sharing their blood sugar monitoring equipment. • Diet is a double edged weapon; meat and animal protein consumption are known to increase the cancer potential in high risk groups. Intake of isoflaron rich miso soup which has anti tumour effect is adviced in HCC patients as an adjuvant therapy.