Abstract
Primary hepatocellular carcinoma (HCC) is one of the most common forms of malignant
cancer with the fourth highest mortality rate worldwide. Major risk factors for the
development of HCC include chronic infections with the hepatitis B or C virus, alcohol
consumption, exposure to dietary aflatoxin B1, hereditary liver disease or liver cirrhosis
of any etiology. Recent studies have discovered changes in the insulin-like growth
factor (IGF) axis that affect the molecular pathogenesis of HCC, including the autocrine
production of IGFs, IGF binding proteins (IGFBPs), IGFBP proteases, and IGF receptor
expression. Characteristic alterations detected in HCC and hepatoma cell lines comprise
the overexpression of IGF-II and the IGF-I receptor emerging as critical events in
malignant transformation and growth of tumors. Simultaneous reduction of IGFBP expression
and the increase in proteolytic cleavage of IGFBPs result in an excess of bioactive
IGFs. Finally, defective functions of the IGF-II/mannose 6-phosphate receptor involved
in degradation of IGF II, the activation of the growth inhibitor TGF-β1, and the lysosomal
targeting of cathepsin proteases capable to degrade extracellular matrix proteins
may contribute to the development of HCC.
Key words
Insulin-like Growth Factors - IGF Binding Proteins - IGF-I Receptor - IGF-II/ Mannose
6-Phosphate Receptor - Hepatocarcinogenesis - Hepatocellular Carcinoma
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PD Dr. med. J.-G. Scharf, M. D.
Zentrum Innere Medizin, Abteilung Gastroenterologie und Endokrinologie
Robert-Koch-Str. 40 · 37075 Göttingen · Germany
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