The histopathological and molecular heterogeneity of hepatocellular carcinoma: a narrative review
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related deaths worldwide, with poor clinical outcomes due to challenges in early detection and limited efficacy of current treatments such as receptor tyrosine kinase inhibito...
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| Format: | Article |
| Language: | English |
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Ewha Womans University College of Medicine
2024-10-01
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| Series: | The Ewha Medical Journal |
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| Online Access: | http://www.e-emj.org/archive/view_article?pid=emj-47-4-54 |
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| _version_ | 1846120596402864128 |
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| author | Wonju Chung Haeryoung Kim |
| author_facet | Wonju Chung Haeryoung Kim |
| author_sort | Wonju Chung |
| collection | DOAJ |
| description | Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related deaths
worldwide, with poor clinical outcomes due to challenges in early detection and
limited efficacy of current treatments such as receptor tyrosine kinase
inhibitors and immunotherapy. HCC exhibits significant heterogeneity at both
histopathological and molecular levels, complicating its management but offering
potential for personalized therapeutic approaches. This review outlines the
morpho-molecular heterogeneity of HCC and summarizes various histological
subtypes, including steatohepatitic, clear cell, macrotrabecular-massive,
scirrhous, lymphocyte-rich, and fibrolamellar HCCs. Each subtype possesses
distinct clinical, histological, and molecular features; for instance,
steatohepatitic HCC is associated with metabolic dysfunction and shows
IL-6/JAK/STAT activation, while clear cell HCCs often have IDH1
mutations and favorable prognosis. The macrotrabecular-massive subtype is linked
to poor outcomes and TP53 mutations, whereas scirrhous HCCs
express stemness markers and have TSC1/TSC2 mutations.
Lymphocyte-rich HCCs are characterized by immune cell infiltration and better
prognosis. CTNNB1-mutated HCCs show specific morphological
features and may benefit from targeted therapies. Understanding these subtypes
and associated molecular alterations is crucial for developing effective
diagnostic and therapeutic strategies, including potential predictive biomarkers
and personalized treatments. Additionally, the identification of patterns like
vessels-encapsulating-tumor-clusters offers prognostic implications and may
guide therapeutic decisions. Recent molecular studies have enhanced our
comprehension of HCC heterogeneity, laying the groundwork for more personalized
approaches. Pathologists play a vital role in recognizing these subtypes, aiding
in prognosis prediction and treatment planning. Advances in digital pathology
and artificial intelligence may further facilitate biomarker research,
ultimately improving patient outcomes in HCC management. |
| format | Article |
| id | doaj-art-9e7a0b5f102d467dafb072ef8b571ae3 |
| institution | Kabale University |
| issn | 2234-2591 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Ewha Womans University College of Medicine |
| record_format | Article |
| series | The Ewha Medical Journal |
| spelling | doaj-art-9e7a0b5f102d467dafb072ef8b571ae32024-12-16T08:43:16ZengEwha Womans University College of MedicineThe Ewha Medical Journal2234-25912024-10-0147410.12771/emj.2024.e58emj-47-4-54The histopathological and molecular heterogeneity of hepatocellular carcinoma: a narrative reviewWonju ChungHaeryoung KimHepatocellular carcinoma (HCC) remains a leading cause of cancer-related deaths worldwide, with poor clinical outcomes due to challenges in early detection and limited efficacy of current treatments such as receptor tyrosine kinase inhibitors and immunotherapy. HCC exhibits significant heterogeneity at both histopathological and molecular levels, complicating its management but offering potential for personalized therapeutic approaches. This review outlines the morpho-molecular heterogeneity of HCC and summarizes various histological subtypes, including steatohepatitic, clear cell, macrotrabecular-massive, scirrhous, lymphocyte-rich, and fibrolamellar HCCs. Each subtype possesses distinct clinical, histological, and molecular features; for instance, steatohepatitic HCC is associated with metabolic dysfunction and shows IL-6/JAK/STAT activation, while clear cell HCCs often have IDH1 mutations and favorable prognosis. The macrotrabecular-massive subtype is linked to poor outcomes and TP53 mutations, whereas scirrhous HCCs express stemness markers and have TSC1/TSC2 mutations. Lymphocyte-rich HCCs are characterized by immune cell infiltration and better prognosis. CTNNB1-mutated HCCs show specific morphological features and may benefit from targeted therapies. Understanding these subtypes and associated molecular alterations is crucial for developing effective diagnostic and therapeutic strategies, including potential predictive biomarkers and personalized treatments. Additionally, the identification of patterns like vessels-encapsulating-tumor-clusters offers prognostic implications and may guide therapeutic decisions. Recent molecular studies have enhanced our comprehension of HCC heterogeneity, laying the groundwork for more personalized approaches. Pathologists play a vital role in recognizing these subtypes, aiding in prognosis prediction and treatment planning. Advances in digital pathology and artificial intelligence may further facilitate biomarker research, ultimately improving patient outcomes in HCC management.http://www.e-emj.org/archive/view_article?pid=emj-47-4-54carcinomahepatocellularliverpathology |
| spellingShingle | Wonju Chung Haeryoung Kim The histopathological and molecular heterogeneity of hepatocellular carcinoma: a narrative review The Ewha Medical Journal carcinoma hepatocellular liver pathology |
| title | The histopathological and molecular heterogeneity of hepatocellular
carcinoma: a narrative review |
| title_full | The histopathological and molecular heterogeneity of hepatocellular
carcinoma: a narrative review |
| title_fullStr | The histopathological and molecular heterogeneity of hepatocellular
carcinoma: a narrative review |
| title_full_unstemmed | The histopathological and molecular heterogeneity of hepatocellular
carcinoma: a narrative review |
| title_short | The histopathological and molecular heterogeneity of hepatocellular
carcinoma: a narrative review |
| title_sort | histopathological and molecular heterogeneity of hepatocellular carcinoma a narrative review |
| topic | carcinoma hepatocellular liver pathology |
| url | http://www.e-emj.org/archive/view_article?pid=emj-47-4-54 |
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