[Hepatocellular carcinoma--from macroscopy to molecular pathology]

Area of Science:

• Hepatobiliary pathology
• Molecular oncology
• Diagnostic biomarkers

Context:

• Hepatocellular carcinoma (HCC) presents a poor prognosis, necessitating advancements in diagnostics and treatment.
• Cirrhosis is a common precursor, with premalignant alterations including dysplastic nodules.
• Understanding molecular pathogenesis is crucial for improving patient outcomes.

Purpose:

• To review current progress in HCC diagnostics and treatment.
• To explore the molecular pathogenesis and classification of HCC.
• To highlight key diagnostic markers and staging systems.

Summary:

• HCC exhibits diverse histological forms (trabecular, acinar, scirrhous, solid) and special subtypes (clear cell, fibrolamellar).
• Diagnostic markers include alpha-fetoprotein (AFP), glypican-3, survivin, agrin, claudins, hepatocyte specific antigen (HSA), and microRNAs like mir122.
• Molecular classification complements staging systems like the Barcelona Clinic Liver Cancer (BCLC) staging.

Impact:

• Improved diagnostic accuracy through novel biomarkers.
• Enhanced understanding of HCC heterogeneity and molecular drivers.
• Potential for more targeted and effective therapeutic strategies based on molecular classification.