Q:

Which of the following statement(s) is/are true concerning the pathogenesis of hepatocelluar carcinoma?

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Which of the following statement(s) is/are true concerning the pathogenesis of hepatocelluar carcinoma?


  1. Hepatocellular carcinoma is associated with infection with hepatitis A, hepatitis B, and hepatitis C
  2. The risk of developing hepatocellular carcinoma related to hepatitis B viral infection is related to the chronicity of the infection
  3. Hepatocellular carcinoma only develops in cirrhosis associated with hepatitis
  4. Alfatoxin B1 is a potent carcinogen in the development of hepatocellular carcinoma

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b. The risk of developing hepatocellular carcinoma related to hepatitis B viral infection is related to the chronicity of the infection

d. Alfatoxin B1 is a potent carcinogen in the development of hepatocellular carcinoma

Hepatocellular carcinoma has three well-known epidemiologic associations: hepatitis B infection, cirrhosis, and various hepatotoxins, most notably aflatoxin B1 (a microtoxin from the fungus Aspergillus flavus). Hepatocellular carcinoma is strongly associated with hepatitis B viral infection but there is no link between the neoplasm and the hepatitis A viral infection. There does appear to be some link between hepatocellular carcinoma and hepatitis C virus. Cirrhosis, predominantly macronodular, is a frequent result of hepatitis B viral infection and is a risk factor for hepatocellular carcinoma. Nevertheless, the micronodular form, which is more common in early alcoholic cirrhosis, will progress to hepatocellular carcinoma in about 2% to 3% of cases. Thus, hepatocellular carcinoma can develop in patients with hepatitis B viral infection and cirrhosis, hepatitis B viral infection alone, and with cirrhosis from any cause alone.

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