Hepatocellular Carcinoma: a Comprehensive Review of Biomarkers, Clinical Aspects, and Therapy

Abstract

Hepatocellular carcinoma (HCC) is a cause of several deaths related to cancer worldwidely. In early stage, curative treatments such as surgical resection, liver transplant and local ablation can improve the patient ´s survival. However, the disease is detected in advanced stage; moreover some available therapies are restricted to palliative care and local treatment. Early detections of HCC and adequate therapy are crucial to increase survival as well as to improve the patient´s quality of life. Therefore, researchers have been investigating molecular biomarkers with high sensibility and reliability as Golgi 73 protein (GP73), Glypican-3 (GPC3), Osteopontin (OPN), microRNAs and others. MicroRNAs can regulate important pathways on carcinogenesis, as tumor angiogenesis and progression. So, they can be considered as possible markers of prognosis in HCC, and therapeutic target for this tumor type. In this review, we discuss the recent advances related to the cause (highlighting the main risk factors), treatment, biomarkers, clinic aspects, and outcome in hepatocellular carcinoma.

Keywords: Hepatocellular carcinoma; causes; biomarkers; treatment; prognosis.

Figure 1

Risk Factors for the Development Stage of Hepatocellular Carcinoma. HCV (Hepatitis C virus), HBV (Hepatitis B virus), ¹AIH (Autoimmune Hepatitis), ²Genetic Diseases: Alpha-1-antitrypsin deficiency, Hemochromatosis, Porphyria and Tyrosinemia. *The Spectrum of NAFLD: Steatosis, NASH and Cirrhosis.

Figure 2

The Barcelona Clinic Liver Cancer Stanging and Treatment Allocation. Adapted from Bruix J. Sherman M. Management of Hepatocellular Carcinoma: an Update, 2010. CLT, Cadaveric Liver Transplantation; HCC, Hepatocellular Carcinoma; LDLT, Living Donor Liver Transplantation; M, Metastasis Classification; N, Node Classification; OS, Overall Survival; PEI, Percutaneous Ethanol Injection; PST, Performance Status Test; RF, Radiofrequency.