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       <tr bgcolor="#dbe0f5" valign="top">                      <td width="56%"><font face="Arial, Helvetica, sans-serif" size="2">Voir                        aussi nos dossiers :</font></td>                     <td width="44%"><font face="Arial, Helvetica, sans-serif" size="2">                        <a href="/html/sante/mag_2001/mag0803/lutte_cancer_niv2.htm">Vaincre                        le cancer</a><br>                       <a href="/html/dossiers/hepatites.htm">Les h&eacute;patites</a><br>                       <a href="/html/dossiers/hepatite_c.htm">H&eacute;patite                        C : un malaise national</a> </font></td>                   </tr>                 </table><meta name="keywords" content="cancer, foie, tumeur, hpatome">                 <p ALIGN="center"><font face="Arial, Helvetica, sans-serif" size="2"><b>Cancer                    primitif du foie</b></font></p>                 <p align="justify"><img src="/Templates/images_encyclo/kesako.gif" width="157" height="25"></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Le                    cancer primitif du foie est un cancer qui survient au niveau                    du foie de manire spontane, et se dveloppe directement au                    dpend des cellules hpatiques (cellules du foie).</font></p>                 <p align="justify"><img src="/Templates/images_encyclo/causes_facteurs.gif" width="206" height="25"></p>                 <p align="left"><font face="Arial, Helvetica, sans-serif" size="2">Le                    cancer primitif du foie&nbsp;:</font></p>                 <ul>                   <li><font face="Arial, Helvetica, sans-serif" size="2">est en                      augmentation depuis plusieurs annes&nbsp;;</font></li>                   <li><font face="Arial, Helvetica, sans-serif" size="2">est plus                      frquent dans certaines rgions du globe&nbsp;: Afrique (zones                      tropicales) et Asie du Sud-Est&nbsp;;</font></li>                   <li><font face="Arial, Helvetica, sans-serif" size="2">survient                      vers 60 ans en Europe et en Amrique du Nord et vers 35 ans                      en Afrique et en Asie&nbsp;;</font></li>                   <li><font face="Arial, Helvetica, sans-serif" size="2">est principalement                      observ chez lhomme&nbsp;;</font></li>                   <li><font face="Arial, Helvetica, sans-serif" size="2">est li                      le plus souvent  lvolution dune cirrhose pr-existante.                      En France, la cancrisation des cirrhoses dues  lalcool                      varie entre 10 et 30&nbsp;%. Dans les zones tropicales, la                      cancrisation est lie  une cirrhose dorigine virale (virus                      de lhpatite&nbsp;B). Lorsque le cancer du foie se dveloppe                      sur un foie ne prsentant pas de lsions de cirrhose, le rle                      des facteurs alimentaires a t avanc, et en particulier                      celui de certaines toxines (aflatoxine polluant la farine                      darachide en Afrique).</font></li>                 </ul>                 <p align="justify"><img src="/Templates/images_encyclo/signes_maladie.gif" width="182" height="25"></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Le                    patient peut prsenter des douleurs en regard du foie, une fivre,                    une altration de ltat gnral (amaigrissement, perte de lapptit,                    fatigue) ou un ictre (coloration jaune de la peau).</font></p>                 <p align="justify"><img src="/Templates/images_encyclo/consultation.gif" width="126" height="25"></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Lexamen                    attentif de labdomen retrouve un foie de volume augment (hpatomgalie),                    dur avec une surface irrgulire, parfois sensible ou douloureux.</font></p>                 <p align="justify"><img src="/Templates/images_encyclo/exam_analyses_compl.gif" width="272" height="25"></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Les                    examens biologiques retrouvent des lments non spcifiques&nbsp;:                    anmie (diminution du taux dhmoglobine dans le sang), augmentation                    du nombre de globules blancs dans le sang, modification du taux                    sanguin des enzymes fabriqus par le foie ( augmentation des                    gamma-GT, des phosphatases alcalines...).</font></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Le                    dosage de lalpha-foetoprotine (AFP) est utile pour le diagnostic                    de cancer primitif du foie. Cette protine est prsente ds                    la 8<sup>me</sup> semaine de la vie embryonnaire puis diminue                    chez ladulte. Dans le cadre du cancer primitif du foie, lAFP                    augmente de faon significative 9 fois sur 10. Cependant, lAFP                    est retrouve augmente dans dautres maladies (hpatites virales,                    certains cancers digestifs, femme enceinte). Toutefois, il est                    intressant de retenir que chez un sujet prsentant une affection                    hpatique chronique, laugmentation de lAFP doit faire suspecter                    la survenue dun cancer.</font></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Dautres                    paramtres biologiques directement lis au cancer sont parfois                    retrouvs&nbsp;: hypercalcmie (augmentation du calcium dans                    le sang), hypoglycmie.</font></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Les                    examens radiologiques retrouvent des lments en faveur du diagnostic                    de cancer. Lchographie du foie retrouve une ou plusieurs masses                    vocatrices.</font></p>                 <p align="justify"><img src="/Templates/images_encyclo/evolution.gif" width="177" height="25"></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Lvolution                    des cancers du foie est souvent mauvaise car le foie fabrique                    de nombreuses substances indispensables pour de nombreuses fonctions                    de lorganisme.</font></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Le                    risque de dcs du patient est li en gnral  des complications                    hmorragiques ou infectieuses.</font></p>                 <p align="justify"><img src="/Templates/images_encyclo/traitement.gif" width="97" height="25"></p>                 <p align="justify"><font face="Arial, Helvetica, sans-serif" size="2">Le                    traitement des tumeurs primitives fait appel  la chirurgie                    si celle-ci est ralisable (tat gnral du patient, localisation                    et volume de la tumeur) sous la forme dune ablation partielle                    du foie atteint. La surveillance de lAFP aprs lopration                    permet de dtecter au mieux une rcidive du cancer. Lorsque                    la chirurgie nest pas ralisable, le traitement fait appel                     la chimiothrapie par voie intra-veineuse.</font></p>                 <!-- #EndEditable -->                  <P align="center"><FONT face="Arial, Helvetica, sans-serif" size="1"><A href="/html/sante/encyclopedie/rossant.htm">                    Dr Lyonel Rossant, Dr Jacqueline Rossant-Lumbroso.</A></FONT></P>               </div>             </td>           </tr>         </table>       </div>     </td>     <td width="5">&nbsp;</td>     <td width="130" valign="top" align="right"><!-- #BeginLibraryItem "/Library/skycrapper_sante_v2.lbi" --><SCRIPT LANGUAGE="JavaScript"> document.write('<NOLAYER>'); document.write('<IFRAME SRC="http://ad.fr.doubleclick.net/adi/docdoc.fr/sky_sante;tile=3;sz=120x600;ord=' + randnum + '?" width="120" height="600" frameborder="no" border="0" MARGINWIDTH="0" MARGINHEIGHT="0" SCROLLING="no">'); document.write('<A HREF="http://ad.fr.doubleclick.net/jump/docdoc.fr/sky_sante;tile=3;sz=120x600;abr=!ie4;abr=!ie5;ord=' + randnum + '?">'); document.write('<IMG SRC="http://ad.fr.doubleclick.net/ad/docdoc.fr/sky_sante;tile=3;sz=120x600;abr=!ie4;abr=!ie5;ord=' + randnum + '?" width="120" height="600" border=0 ALT="Cliquez ici"></A>'); document.write('</IFRAME>'); document.write('</NOLAYER>'); document.write('<TABLE align="center"><TR><TD><ILAYER id="layer2" visibility="hidden" width="120" height="600"></ILAYER></TD></TR></TABLE>'); </SCRIPT>             <NOSCRIPT> <A HREF="http://ad.fr.doubleclick.net/jump/docdoc.fr/sky_sante;tile=3;sz=120x600;ord=123456789?" 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