Review of hepatocellular carcinoma: Epidemiology, etiology, and carcinogenesis

Abstract

Since the 1970s, the epidemic of hepatocellular carcinoma (HCC) has spread beyond the Eastern Asian predominance and has been increasing in Northern hemisphere, especially in the United States (US) and Western Europe. It occurs more commonly in males in the fourth and fifth decades of life. Among all cancers, HCC is one of the fastest growing causes of death in the US and poses a significant economic burden on healthcare. Chronic liver disease due to hepatitis B virus or hepatitis C virus and alcohol accounts for the majority of HCC cases. Incidence of nonalcoholic fatty liver disease has been on the risem and it has also been associated with the development of HCC. Its pathogenesis varies based on the underlying etiological factor although majority of cases develop in the setting of background cirrhosis. Carcinogenesis of HCC includes angiogenesis, chronic inflammation, and tumor macroenvironment and microenvironment. There is a significant role of both intrinsic genetic risk factors and extrinsic influences such as alcohol or viral infections that lead to the development of HCC. Understanding its etiopathogenesis helps select appropriate diagnostic tests and treatments.

Long‐term outcomes of patients with hepatitis B virus‐related acute on chronic liver failure: An observational cohort study

“…Cirrhosis and age are both strong risk factors for the development of HCC. 16 In this cohort, although ACLF patients had a lower rate of underlying cirrhosis and younger age, the incidence of HCC in ACLF group was still comparable to that of the cirrhosis group. This data suggested a high risk for the development of HCC in ACLF patients.…”

Adipocyte JAK2 mediates aging-associated metabolic liver disease and progression to hepatocellular carcinoma

“…A subset of patients with NAFLD go on to develop non-alcoholic steatohepatitis (NASH) with associated inflammation and fibrosis. NASH is now the leading cause of liver transplantation in the United States and predisposes to HCC (2), the most common malignancy of liver worldwide (3). Currently, there are no FDA-approved treatments for NASH, which could be a reflection of the lack of faithful animal models that fully recapitulate its clinical presentation (4,5).…”

Epigenetics of gastrointestinal diseases: notes from a workshop

“…Hepatic cirrhosis is often an outcome of chronic infection by hepatitis viruses B or C, with alcoholism also playing a major role, and most HCC appear to develop by progression from premalignant cirrhotic nodules in the liver [24]. Dr. Robertson’s laboratory studied global DNA methylation patterns in multiple cirrhotic nodules and HCC from individual human liver samples.…”