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after cellular damage, enters blood circulation. This is due prominent nucleoli. The importance of cell pleomorphism
[49]
to the increased permeability of the plasma membrane or varies according to the degree of differentiation. Several
cellular necrosis leading to leakage of the enzymes into the variants of HCC are described regarding the cytological
blood stream. [50] aspect of the hepatocellular proliferation. The clear cell
variant is made of clear cells that may contain fat or glycogen.
ALP is used as a specific tumor marker during diagnosis In the scirrhous HCC, tumor cells are generally smaller in
in the early detection of cancer. It is involved in the size, showing a granular eosinophilic cytoplasm, vesicular
[51]
transport of metabolites across cell membranes, protein nuclei, and conspicuous nucleoli. Sarcomatoid HCC is
[58]
synthesis, secretory activities, and glycogen metabolism. It characterized by a sarcomatous-appearing component of
is a membrane bound enzyme and its alteration is likely to spindle-shaped or giant tumor cells. [59]
affect membrane permeability and induces derangement in
the transport of metabolites. The increase of ALP in HCC In this study, IN has a prebiotic effect indicated by a decrease
[52]
rat groups found in this study may be due to the disturbance in the lipid profile (total lipids, cholesterol, triglyceride,
in secretion activity or due to altered gene expression. The LDL-C, and VLDL-C) but increased HDL-C and AFP, as well as
development of a tumor results in tissue damage that leads total protein and albumin. Experimental data demonstrate
to the release of ALP into circulation and the liver tissues that IN affect processes and parameters involved in lipid
of the tumor-bearing animals. Elevation of ALP is one of metabolism and thus produces a beneficial effect on
the signs suggesting space-occupying lesions in the liver. diseases related to lipid disorders such as reductions in TG,
[53]
The rise in the activity of ALP in cancer-bearing animals may while showing modest reductions in total, LDL-C and VLDL
be due to a disturbance in secretory activity, the transport particles due to the inhibition of fatty acid synthesis. The
[60]
[14]
of metabolites, or may be due to the altered synthesis of lipid-lowering action of this natural product may be mediated
certain enzymes in these conditions. In addition, GGT is through the inhibition of hepatic cholesterol biosynthesis,
overexpressed in tumor cells. [54] increased faucal bile acid excretion, enhanced plasma lecithin,
cholesterol acyltransferase activity, and the reduction of lipid
CIS is one of the most potent chemotherapy drugs widely absorption in the intestine. The IN extracted from chicory
[61]
used for cancer treatment. It was a keystone that triggered contains some fructooligosaccharides (FOSs) in addition to
the interest in platinum (II) and other metal-containing polysaccharides, which may provide another mechanism of
compounds as potential anticancer drugs. The related action. It is well established that FOSs, besides their effect
[55]
[62]
action of CIS activated nucleases and acid phosphatase on the gastrointestinal tract, are also able to exert systemic
lead not only to the breakdown of nucleic acids but also effects by modifying the hepatic metabolism of lipids in
to the further dephosphorylation of mononucleotides, many animal models. Colonic fermentation of FOSs results
[63]
thereby leading to the acceleration of the processes of cell in the synthesis of short-chain fatty acids, which influence
degeneration. In histology, the main hallmark of HCC is its lipid metabolism in humans. In addition, IN is soluble in
[56]
[64]
resemblance to the normal liver both in its plate-like growth water and not hydrolyzed by human digestive enzymes;
and its cytology. [57] it is expected to behave like a soluble fiber and to have a
hypolipidemic effect. [61,65] IN lowers serum cholesterol when
HCC is usually a hypervascularized tumor showing different added to the diet of rats, and may decrease cholesterol
degrees of hepatocellular differentiation, ranging from well synthesis by inhibiting hydroxymethylglutaryl-coenzyme
to poorly differentiated, based on the architectural and reductase. A mechanism of action of oligofructose was
cytologic features. Different histological patterns may be associated with the modulation of de novo cholesterol
seen: (1) The trabecular pattern of growth in which tumoral synthesis by short-chain fatty acids produced by gut
hepatocytes are arranged in plates of various thickness, microflora during the fermentation process. The current
[66]
separated by sinusoid vascular spaces; (2) the acinar or study is in agreement with a previous study suggesting that
pseudoglandular pattern showing gland-like dilatation of chicory extract can minimize liver enzymes (AST, ALT, ALP, CK,
the canaliculi between tumor cells (lumens can contain bile) and LDH) activity. This finding may be attributed to chicory
or central degeneration of trabeculae (lumen containing extracts having hepatoprotective and antioxidant effects
mainlyfibrin); and (3) the compact or solid pattern composed that were effective in reducing serum liver enzymes toward
of thick trabeculae compressed into a compact mass that or even below the normal value. [67,68] Regarding the present
causes liver damage. [57] histopathological examination of the liver sections of HCC
rats that received IN showed that the administration of IN
Cytologically, tumoral hepatocytes are polygonal, displaying protected rat livers from inflammation, necrosis, fibrosis,
an eosinophilic granular cytoplasm, rounded nuclei, and and steatosis. This was indicated by the efficiency of chicory

152 Hepatoma Research | Volume 1 | Issue 3 | October 15, 2015