Potential ultrastructure predicting factors for hepatocellular carcinoma in HCV infected patients

ABSTRACT

Hepatitis C virus represents one of the rising causes of hepatocellular carcinoma (HCC). Although the early diagnosis of HCC is vital for successful curative treatment, the majority of lesions are diagnosed in an irredeemable phase. This work deals with a comparative ultrastructural study of experimentally gradually induced HCC, surgically resected HCC, and potential premalignant lesions from HCV-infected patients, with the prospect to detect cellular criteria denoting premalignant transformation. Among the main detected pathological changes which are postulated to precede frank HCC: failure of normal hepatocyte regeneration with star shape clonal fragmentation, frequent elucidation of hepatic progenitor cells and Hering canals, hepatocytes of different electron density loaded with small sized rounded monotonous mitochondria, increase junctional complexes bordering bile canaliculi and in between hepatocyte membranes, abundant cellular proteinaceous material with hypertrophied or vesiculated rough endoplasmic reticulum (RER), sequestrated nucleus with proteinaceous granular material or hypertrophied RER, formation of lipolysosomes, large autophagosomes, and micro-vesicular fat deposition.

In conclusion, the present work has visualized new hepatocytic division or regenerative process that mimic splitting or clonal fragmentation that occurs in primitive creature. Also, new observations that may be of value or assist in predicting HCC and identifying the appropriate patient for surveillance have been reported. Moreover, it has pointed to the possible malignant potentiality of liver stem/progenitor cells.

For reliability, the results can be subjected to cohort longitudinal study.

KEYWORDS:

• Experimental HCC
• hepatic progenitor cell
• hepatocellular carcinoma
• liver regenerative nodules
• liver stem/progenitor cells
• oval cell

Declaration of interest

The authors who have taken part in this work declared that they do not have any conflict of interest in regarding this manuscript.

Funding

The authors are grateful to the Theodor Bilharz Research Institute for supporting the realization of this work by funding the two projects 8k and 111T.

Additional information

Funding

The authors are grateful to the Theodor Bilharz Research Institute for supporting the realization of this work by funding the two projects 8k and 111T.