Ethnic differences in hepatocellular carcinoma prevalence and therapeutic outcomes

BACKGROUND

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide. The incidence of HCC is affected by genetic and non-genetic factors. Genetically, mutations in the genes, tumor protein P53 (TP53), catenin beta 1 (CTNNB1), AT-rich interaction domain 1A (ARIC1A), cyclin dependent kinase inhibitor 2A (CDKN2A), mannose 6-phosphate (M6P), smooth muscle action against decapentaplegic (SMAD2), retinoblastoma gene (RB1), cyclin D, antigen presenting cells (APC), AXIN1, and E-cadherin, have been shown to contribute to the occurrence of HCC. Non-genetic factors, including alcohol consumption, exposure to aflatoxin, age, gender, presence of hepatitis B (HBV), hepatitis C (HCV), and non-alcoholic fatty liver disease (NAFLD), increase the risk of HCC.

RECENT FINDINGS

The severity of the disease and its occurrence vary based on geographical location. Furthermore, men and minorities have been shown to be disproportionately affected by HCC, compared with women and non-minorities. Ethnicity has been reported to significantly affect tumorigenesis and clinical outcomes in patients diagnosed with HCC. Generally, differences in gene expression and/or the presence of comorbid medical diseases affect or influence the progression of HCC. Non-Caucasian HCC patients are significantly more likely to have poorer survival outcomes, compared to their Caucasian counterparts. Finally, there are a number of factors that contribute to the success rate of treatments for HCC.

CONCLUSION

Assessment and treatment of HCC must be consistent using evidence-based guidelines and standardized outcomes, as well as international clinical practice guidelines for global consensus. Standardizing the assessment approach and method will enable comparison and improvement of liver cancer research through collaboration between researchers, healthcare providers, and advocacy groups. In this review, we will focus on discussing epidemiological factors that result in deviations and changes in treatment approaches for HCC.

Sexual and Psychological Implications of Gynecologic Malignancy

The sexual implications of gynecologic malignancy are best understood by asking, and answering, the following three questions. What is the psychological effect on the woman? What is the physiological effect on the woman? What is the psychological effect on the partner? The psychological effect of the cancer on the woman is primarily determined by whether the malignancy is primary, recurrent, or terminal; the primary physiological determinants are whether the treatment is with surgery, radiation, or chemotherapy. The partner can be affected psychologically by all six of the variables. Preoperative knowledge of the woman's sexual history may influence subsequent treatments.

Variation in the lethal response in mice to yeast-like and pseudohyphal forms of Candida albicans

The lethal response in mice to yeast-like cells of Candida albicans grown for 3, 6, or 9 h in a defined minimal culture medium was more severe than that observed with corresponding pseudohyphal preparations. This differential effect could be only partially correlated with the greater number of viable units in respective yeast-like cultures. No significant differences between yeast-like and pseudohyphal syspensions were detected when turbidity-mass ratios were examined. The injection of physiological saline suspensions containing increasing quantities of yeast-like cells resulted in proportional decreases in mouse survival times. Conversely, when comparable experiments were conducted with pseudohyphal preparations no significant decreases in survival times occurred. The data indicate that these differences in the lethal response cannot be explained solely on the basis of a variation in the number of viable units or cell mass in corresponding yeast-like and pseudohyphal preparations. Factors contributing to this phenomenon may therefore include altered susceptibilities to host defense mechanisms in the early stages of the infectious process as a result of differences between these yeast-like and pseudohyphal inocula.