Liver disease-silent killer! Eliminating hepatitis-there is a long way to go
Today, let's take a look at what causes posthepatitic cirrhosis and even liver cancer. Posthepatitic cirrhosis (posthepatitic cirrhosis) refers to the development of viral hepatitis to the later stage of liver cirrhosis. Hepatitis B and C are easy to turn into chronic active hepatitis and liver cirrhosis. In 1974, Shikatu reported that HBsAg (hepatitis B surface antigen) could be displayed by immunofluorescence. It provides a reliable basis for liver cirrhosis caused by hepatitis B virus. At the same time of removing the virus, the hepatocytes are denatured and necrotic, and fibrous septum and regenerated nodules can be formed in the hepatic lobules to form cirrhosis. 30% of chronic hepatitis C develops into liver cirrhosis. However, it often aggravates the activity of the lesions and accelerates the occurrence of liver cirrhosis. Liver cirrhosis caused by chronic active hepatitis, resulting in macronodular cirrhosis. For example, the pathological changes of hepatitis are mild.
Many times when it comes to hepatitis, it will make people feel frightened and uneasy, and posthepatitic cirrhosis will undoubtedly make things worse. But hepatitis has been cured, why liver cirrhosis? Today, let's take a look at what causes posthepatitic cirrhosis and even liver cancer.
Posthepatitic cirrhosis (posthepatitic cirrhosis) refers to the development of viral hepatitis to the later stage of liver cirrhosis. It is known that there are hepatitis A, B, C, D, E and other types. Recent studies have shown that patients with hepatitis An and E without chronic hepatitis do not form liver cirrhosis except for acute severe hepatitis. Hepatitis B and C are easy to turn into chronic active hepatitis and liver cirrhosis.
In 1974, Shikatu reported that HBsAg (hepatitis B surface antigen) could be displayed by immunofluorescence. Under the microscope, the cytoplasm containing HBsAg was ground glass, and the cytoplasm containing HBsAg could be stained bright orange by Orecein staining. Liver cirrhosis specimens preserved for many years can also show hepatocytes containing HBsAg by this method, which provides a reliable basis for liver cirrhosis caused by hepatitis B virus. 10% to 20% of hepatitis B patients showed chronic history, long-term HBsAg positive, intermittent or persistent abnormal liver function. Continuous replication of hepatitis B virus in the liver can make lymphocytes infiltrate in the liver, release a large number of cytokines and inflammatory mediators, and make hepatocytes degeneration and necrosis at the same time of removing the virus. If the pathological changes continue to develop repeatedly, fibrous septum and regenerated nodules can be formed in the hepatic lobules to form liver cirrhosis. 68% of hepatitis C is a chronic process, and 30% of chronic hepatitis C develops into liver cirrhosis. Hepatitis D can be co-infected or superinfected with hepatitis B. it can slow down the replication of hepatitis B virus, but it often aggravates the activity of lesions and accelerates the occurrence of liver cirrhosis.
In the acute severe type of viral hepatitis, massive necrotic fusion of hepatocytes extends from the center of the lobule to the portal area, causing the reticular stent to collapse, close together and form fibrous septum. And produce the phenomenon of bridging from the center of the lobule to the portal area, and form macronodular cirrhosis. Liver cirrhosis caused by chronic active hepatitis has obvious inflammation and fibrosis in the portal area, forming a wide and irregular "active" fibrous septum, which extends into the lobules and interlobules, so that the adjacent lobules are separated and destroyed by the fibrous septum. At this time, although the structure of the liver has been reconstructed, it is not liver cirrhosis, but the stage of liver fibrosis. When the inflammation extends from the edge of the hepatic lobule to the center, causing patchy necrosis and monocyte infiltration, the fibrous septum continues to expand to the center, dividing the hepatic lobule, and hepatocyte regeneration to form regenerated nodules surrounded by connective tissue. It becomes liver cirrhosis. To the end of the lesion, inflammation and hepatocyte necrosis can disappear completely, but in the fibrous septum there are many nodules of different sizes, nodules are multilobular, forming large nodular cirrhosis. If the pathological changes of hepatitis are mild and the course of disease is slow, it can also form small nodular cirrhosis, mixed cirrhosis or unclearly dominant cirrhosis of regenerated nodules (incomplete separated cirrhosis). From viral hepatitis to liver cirrhosis, studies have shown that it has nothing to do with the amount of infection antigen, but has a significant relationship with viral virulence and human immune status. Genetic factors are related to chronic tendency and seem to be related to the deficiency of human leukocyte antigen HL-A1 and HL-A8, but they need to be further studied.
At present, primary liver cancer is the fourth most common cause of malignant tumor in China, which is a serious threat to the life and health of our people. The screening of high-risk population of liver cancer is helpful to the early detection, early diagnosis and early treatment of liver cancer, and is the key to improve the curative effect of liver cancer. In China, people at high risk of liver cancer mainly include people with hepatitis B virus (HBV) and / or hepatitis C virus (HCV) infection, excessive alcohol consumption, non-alcoholic steatohepatitis, long-term consumption of food contaminated with aflatoxin, liver cirrhosis caused by various other causes, and family history of liver cancer, especially men aged-gt;40. With the help of liver ultrasound examination and serum alpha-fetoprotein (AFP) for early screening of liver cancer, it is recommended that high-risk groups should be examined at least every 6 months.
These are the causes of posthepatitic cirrhosis and liver cancer. I hope everyone will stay away from these factors. If you want to know more, you can consult a specialist hospital. The sixth people's Hospital of Shenyang has many of the most authoritative experts in this field, and they will create a set of solutions for you. Finally, I sincerely wish all of you good health.
[introduction to experts]
Yang Fang
Director, Master of Medicine and Chief physician of three departments of liver Diseases in Shenyang sixth people's Hospital
Excellent scientific and technological workers in Liaoning Province
As the first responsible person, he won the third prize for scientific and technological progress in Shenyang.
Young member of Infectious Diseases Specialty of Chinese Society of Integrated traditional Chinese and Western Medicine
Member of the liver Cancer Youth Committee of Liaoning Anti-Cancer Association
Member of MDT Professional Committee of China Branch of International Hepatobiliary Pancreatic Association
Source: Shenyang sixth people's Hospital