Journal of Clinical & Experimental Pathology
Open Access

Hepatocellular Carcinoma (HCC) is a primary malignancy of the liver and is the most common type of liver cancer. It is a significant health burden worldwide, particularly in regions with high rates of hepatitis B and C infections. Early detection of HCC is important for improving patient outcomes. HCC often develops in the context of chronic liver disease, particularly cirrhosis, which is a common endpoint for chronic hepatitis B and C infections, as well as Non- Alcoholic Fatty Liver Disease (NAFLD) and alcohol-related liver disease. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) techniques provide detailed images of liver lesions, helping to characterize the nature of detected abnormalities. MRI, particularly with contrast agents, is highly effective in identifying HCC. For the diagnosis of HCC, liver tissue histopathological investigation continues to be the highest possible standard. Biopsies show cellular and architectural anomalies, including vascular invasion, cellular atypia, and trabecular growth patterns, that are typical of HCC.

After a diagnosis, it's critical to track how the HCC develops and how the treatment is working. To evaluate the number, size, and spread of tumors, imaging studies and serum markers are frequently used. Monitoring Alpha Fetoprotein (AFP) levels can also help in determining how well a treatment is working and in identifying recurrence. Treatment of HCC varies based on the stage of the disease and liver function. Options include surgical resection, liver transplantation, locoregional therapies, and systemic treatments. Liver resection is suitable for early-stage HCC with preserved liver function. Liver transplantation is considered for patients with early HCC and advanced liver disease, as it treats both the tumor and the underlying cirrhosis. Radiofrequency Ablation (RFA) and microwave ablation are minimally invasive procedures that destroy tumor cells through heat. Chemoembolization (TACE) therapy delivers chemotherapy directly to the tumor thrugh its blood supply, often used for intermediate-stage HCC. Changes in DNA methylation, histone modifications, and noncoding RNA expression can drive HCC by altering gene expression without changing the DNA sequence. The interaction between tumor cells and immune cells in the liver microenvironment plays a critical role in HCC progression. Tumor-associated macrophages, regulatory T cells, and myeloid-derived suppressor cells contribute to immune evasion. HCC is a highly vascular tumor. Research into the mechanisms of angiogenesis, particularly the role of Vascular Endothelial Growth Factor (VEGF), is critical for developing antiangiogenic therapies.

Experimental pathology is integral to the development of new therapies for HCC. Preclinical studies using cell lines, organoids, and animal models help in understanding drug mechanisms and efficacy before clinical trials. Human HCC cell lines are used to study the biology of HCC and test new drugs in vitro. Three-dimensional cultures derived from patient tumors provide a more accurate model of the tumor microenvironment. Genetically engineered mice and xenograft models are used to study HCC, allowing for the evaluation of tumor growth and response to treatments.

Research is ongoing to identify new molecular targets and develop drugs that specifically inhibit these targets. Identifying reliable biomarkers for early detection, prognosis, and treatment response remains a significant challenge. Biomarkers could improve patient stratification and guide personalized treatment strategies. Reducing the frequency of risk factors like hepatitis B and C and expanding access to screening and treatment in places with low resources are necessary to address the worldwide impact of HCC. Pathology in both clinical and experimental settings is significantly impacted by hepatocellular carcinoma. Improving patient outcomes in clinical settings requires early detection, precise diagnosis, and efficient treatment plans. The development of novel therapeutics is enabled by experimental pathology, which offers insights into the molecular mechanisms underlying HCC. Progress in science and technology will improve our knowledge and handling of this difficult illness, leading to higher survival rates and better quality of life for HCC patients.