The hepatic role in carcinogenesis and its early detection--the vinyl chloride model.

The liver's role in vinyl chloride toxicity and carcinogenicity is providing a better understanding of the chemical carcinogenesis mechanism. A variety of both malignant and benign hepatic tumors has been demonstrated with prolonged exposure to vinyl chloride. The multi-system involvment of this carcinogen and toxin has provided a model for the study of chemical carcinogenesis common to both man and animal. Clinical studies have shown the usefulness of biochemical, radioisotopic, and radiological studies in the detection of toxic and carcinogenic lesions. Animal studies have demonstrated the biochemical metabolism by the liver of vinyl chloride-produced intermediates which are mutagenic in bacterial systems and may be the ultimate carcinogens. Hepatic subcellular enzyme studies prove preliminary evidence of cellular adaptation and increased detoxification. Disruption of this oxidization and detoxification balance may be the key to the malignant transformation of cells. A working hypothesis is presented which may explain the metabolism of vinyl chloride into mutagenic intermediates by the liver cell and the development of malignant transformation by extra hepatic sinusoidal lining cells, lung cells, and brain tissue.