Hepatocellular carcinoma: an update

Area of Science:

• Hepatology
• Oncology
• Molecular Biology

Background:

• Hepatocellular carcinoma (HCC) is a prevalent malignancy globally, particularly in Southeast Asia and Sub-Saharan Africa.
• Key risk factors include chronic hepatitis B (HBV) and C (HCV) virus infections, aflatoxin exposure, hemochromatosis, and alpha-1-antitrypsin deficiency.
• HBV integration into host DNA and potential oncogenic effects, alongside imprecise mechanisms for HCV in hepatocarcinogenesis, highlight viral roles.

Purpose of the Study:

• To review the multifaceted etiology and pathogenesis of Hepatocellular Carcinoma (HCC).
• To discuss the cellular and molecular mechanisms underlying HCC development.
• To outline diagnostic criteria and prognostic indicators for HCC.

Main Methods:

• Review of epidemiological studies and experimental carcinogenesis research.
• Analysis of genetic and epigenetic alterations in HCC development.
• Examination of histological, cytological, and ultrastructural features of HCC.

Main Results:

• HCC development involves complex genetic/epigenetic changes, including oncogene activation and tumor suppressor gene alterations (e.g., P53 mutations linked to aflatoxin).
• Viral DNA integration, oval cell proliferation, and altered growth factor expression are implicated in early stages.
• Diagnostic tools include histological criteria, special stains (reticulin, CD34), and molecular markers like telomerase activity.

Conclusions:

• HCC pathogenesis is a multistep process influenced by viral infections, toxins, and host factors.
• Accurate diagnosis relies on integrated histological and molecular findings.
• Understanding these mechanisms is crucial for improving HCC prognosis and treatment strategies.