Recent advances in cytogenetics and molecular biology of adult hepatocellular tumors

Implications for imaging and management

Alampady K. Shanbhogue, Srinivasa R. Prasad, Naoki Takahashi, Raghunandan Vikram, Dushyant V. Sahani

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Focal nodular hyperplasia (FNH), hepatocellular adenoma (HCA), and hepatocellular carcinoma (HCC) compose hepatocellular neoplasms that occur in adults. These tumors demonstrate characteristic epidemiologic and histopathologic features and clinical and imaging manifestations. HCAs are monoclonal neoplasms characterized by increased predilection to hemorrhage or rupture and occasional transformation to HCC. On the other hand, FNH is a polyclonal tumorlike lesion that occurs in response to increased perfusion and has an indolent clinical course. Up to 90% of HCCs occur in the setting of cirrhosis. Chronic viral hepatitis (hepatitis B and hepatitis C) infection and metabolic syndrome are major risk factors that can induce HCCs in nonfibrotic liver. Recent advances in pathology and genetics have led to better understanding of the histogenesis, natural history, and molecular events that determine specific oncologic pathways used by these neoplasms. HCAs are now believed to result from specific genetic mutations involving TCF1 (transcription factor 1 gene), IL6ST (interleukin 6 signal transducer gene), and CTNNB1(β catenin-1 gene); FNHs are characterized by an "imbalance" of angiopoietin. While the β catenin signaling pathway is associated with well- and moderately differentiated HCCs, mutations involving p53 (tumor protein 53 gene), MMP14 (matrix metalloproteinase 14 gene), and RhoC (Ras homolog gene family, member C) are associated with larger tumor size, higher tumor grade with resultant shortened tumor-free survival, and poor prognosis. Fibrolamellar carcinoma (FLC), a unique HCC subtype, exhibits genomic homogeneity that partly explains its better overall prognosis. On the basis of recent study results involving cytogenetics and oncologic pathways of HCCs, novel drugs that act against molecular targets are being developed. Indeed, sorafenib (a multikinase inhibitor) is currently being used in the successful treatment of patients with advanced HCC. Characterization of genetic abnormalities and genotype-phenotype correlations in adult hepatocellular tumors provides better understanding of tumor pathology and biology, imaging findings, prognosis, and response to molecular therapeutics.

Original languageEnglish (US)
Pages (from-to)673-693
Number of pages21
JournalRadiology
Volume258
Issue number3
DOIs
StatePublished - Mar 2011

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Cytogenetics
Molecular Biology
Neoplasms
Hepatocellular Carcinoma
Focal Nodular Hyperplasia
Catenins
Genes
Angiopoietins
Liver Cell Adenoma
Pathology
Matrix Metalloproteinase 14
Mutation
ras Genes
Genetic Association Studies
Chronic Hepatitis
Hepatitis C
Natural History
Hepatitis B
Transducers
Rupture

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Recent advances in cytogenetics and molecular biology of adult hepatocellular tumors : Implications for imaging and management. / Shanbhogue, Alampady K.; Prasad, Srinivasa R.; Takahashi, Naoki; Vikram, Raghunandan; Sahani, Dushyant V.

In: Radiology, Vol. 258, No. 3, 03.2011, p. 673-693.

Research output: Contribution to journalArticle

Shanbhogue, Alampady K. ; Prasad, Srinivasa R. ; Takahashi, Naoki ; Vikram, Raghunandan ; Sahani, Dushyant V. / Recent advances in cytogenetics and molecular biology of adult hepatocellular tumors : Implications for imaging and management. In: Radiology. 2011 ; Vol. 258, No. 3. pp. 673-693.
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