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2015 Poz

Cardiomyopathy can also be seen in older patients with a metabolic presentation, even if asymptomatic from a cardiac standpoint

In human NASH, the progression to hepatocellular carcinoma is usually mediated by fibrosis and cirrhosis throughout tumorigenesis

This dormancy is believed to be maintained by the immune system and by specific signals from the microenvironment,121,122 which include a stable extracellular matrix, the suppression of angiogenesis,122,123 and surveillance by cytotoxic T cells.123,124 The focus of therapeutic efforts should be on supporting the microenvironment that allows disseminated tumor cells (DTCs) to remain dormant, rather than aggressively trying to eliminate them.71,125 Clinical observations have indicated that disruptions to this microenvironmentsuch as inflammation, tissue remodeling, surgery, or traumacan reactivate dormant cells.126,127 Therefore, proponents of this approach have suggested that maintaining a stable state of dormancy may be a better strategy when cell removal is not feasible, as it may help prevent recurrence and metastasis