R0 resection Cancer in polyp
Hep B / HCC screening - ReachB
https://www.youtube.com/watch?v=3cP2kvPq7iQ m.c form of acquiring Hep B in Asia - Vertically m.c form of acquiring Hep B in western coutnries: Parenterally (sexual / needles etc) Neonates have immature immune system, so they cant 'fight-off' vertically acquired virus. Over 90% of babies infected with Hep B, go on to have chronic Hep B infection 95% of adults if they acquire Hep B - fight it off! HBV is a DNA virus - replicates efficiently. But is error-prone. Plagued with mutants. e-antigen negative mutant - tend to be in older patients, tend to be more aggressive. 30-50% of HCC in HBV occurs in absence of cirrhosis. Reveal study - 15 year follow-up study of untreated patients with HEp B. The only factor that was relevant in predicting risk of HCC was viral load at base-line! Viral load more than 10*4 (2000 IU/ml) was predictive of risk of HCC or Cirrhosis (similar graph for Cirrhosis as for HCC) Immune Tolerant Phase: typically after vertical infection. DNA remains very hig...
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