A 68-year-old man with a 20-year history of hepatitis C and known cirrhosis presents with right upper quadrant pain and early satiety. Vital signs are stable. Ultrasound reveals a 3.5 cm nodule in the right hepatic lobe with arterial-phase enhancement on contrast-enhanced CT. Serum alpha-fetoprotein (AFP) is elevated at 480 ng/mL. The patient meets imaging criteria for hepatocellular carcinoma (HCC). A biopsy shows microscopic vascular invasion. Which of the following molecular alterations best explains the aggressive phenotype with vascular invasion observed in this patient's tumor?
- A)Increased HIF-1α stabilization and VEGF upregulation promoting tumor angiogenesis
- B)Loss of E-cadherin expression and activation of Wnt/β-catenin signaling driving epithelial-mesenchymal transitionGABARITO
- C)TP53 mutations leading to loss of apoptotic capacity and genomic instability
- D)MYC amplification causing increased proliferative rate and reduced differentiation
- E)EGFR overexpression through integration of hepatitis C viral oncoproteins
Explicação
Loss of E-cadherin and Wnt/β-catenin activation are hallmark features of epithelial-mesenchymal transition (EMT), a critical process enabling vascular invasion and metastatic dissemination in HCC. E-cadherin loss removes cell-cell adhesion constraints, while β... Ver explicação completa e trilha adaptativa →