1 3742 62 INSIGHTS FOR HEPATITIS C VIRUS RELATED HEPATOCELLULAR CARCINOMA GENETIC BIOMARKERS: EARLY DIAGNOSIS AND THERAPEUTIC INTERVENTION. THE CURRENT REVIEW EXPLORES THE ROLE OF EMERGING MOLECULAR CONTRIBUTING FACTORS IN LIVER CARCINOGENESIS ON TOP OF HEPATITIS C VIRUS (HCV). HERE WE WILL TRY TO DISCUSS THE ROLE GENETIC AND EPIGENETIC FACTORS IN PATHOGENESIS OF HEPATOCELLULAR CARCINOMA. UNDERSTANDING THE ROLE OF THESE FACTORS WILL HELP IN DISCOVERING THE MYSTERY OF LIVER CARCINOGENESIS ON TOP OF CHRONIC HCV INFECTION. MOREOVER, USE OF THE STUDIED MOLECULAR FACTORS WILL PROVIDE THE HEPATOLOGISTS WITH TAILORED DIAGNOSTIC PROMISING BIOMARKERS AND FLATTEN THE WAY FOR ESTABLISHMENT OF EMERGING MOLECULAR TREATMENT BASED ON EXPLORING THE MOLECULAR SUBSCRIPTION OF THIS AGGRESSIVE LIVER CANCER. 2016 2 3263 31 HEPATITIS VIRUS AND HEPATOCELLULAR CARCINOMA: RECENT ADVANCES. HEPATOCELLULAR CARCINOMA (HCC) REMAINS A GLOBAL HEALTH CHALLENGE, CAUSING 600,000 DEATHS EACH YEAR. INFECTIOUS FACTORS, INCLUDING HEPATITIS B VIRUS (HBV), HEPATITIS C VIRUS (HCV) AND HEPATITIS D VIRUS (HDV), HAVE LONG BEEN CONSIDERED THE MAJOR RISK FACTORS FOR THE DEVELOPMENT AND PROGRESSION OF HCC. THESE PATHOGENS INDUCE HEPATOCYTE TRANSFORMATION THROUGH A VARIETY OF MECHANISMS, INCLUDING INSERTIONAL MUTATIONS CAUSED BY VIRAL GENE INTEGRATION, EPIGENETIC CHANGES, AND THE INDUCTION OF LONG-TERM IMMUNE DYSFUNCTION. THE DISCOVERY OF THESE MECHANISMS, WHILE ADVANCING OUR UNDERSTANDING OF THE DISEASE, ALSO PROVIDES TARGETS FOR NEW DIAGNOSTIC AND THERAPEUTIC APPROACHES. IN ADDITION, THE DISCOVERY AND RESEARCH OF CHRONIC HEV INFECTION OVER THE PAST DECADE INDICATE THAT THIS COMMON HEPATITIS VIRUS ALSO SEEMS TO HAVE THE POTENTIAL TO INDUCE HCC. IN THIS REVIEW, WE PROVIDE AN OVERVIEW OF RECENT STUDIES ON THE LINK BETWEEN HEPATITIS VIRUS AND HCC, AS WELL AS NEW DIAGNOSTIC AND THERAPEUTIC APPROACHES TO HCC BASED ON THESE FINDINGS. FINALLY, WE ALSO DISCUSS THE POTENTIAL RELATIONSHIP BETWEEN HEV AND HCC. IN CONCLUSION, THESE ASSOCIATIONS WILL FURTHER OPTIMIZE THE DIAGNOSIS AND TREATMENT OF INFECTION-ASSOCIATED HCC AND CALL FOR BETTER MANAGEMENT POLICIES. 2023 3 4421 20 MOLECULAR AND FUNCTIONAL GENETICS OF HEPATOCELLULAR CARCINOMA. HEPATOCELLULAR CARCINOMA (HCC) IS THE FIFTH MOST COMMON CANCER AND ONE OF THE LEADING CAUSES OF CANCER DEATH WORLDWIDE. HEPATOCARCINOGENESIS IS A MULTISTEP PROCESS DEVELOPING FROM NORMAL THROUGH CHRONIC HEPATITIS/CIRRHOSIS AND DYSPLASTIC NODULES TO HCC. ALTHOUGH WE HAVE INSUFFICIENT UNDERSTANDING TO PROPOSE A ROBUST GENERAL MODEL, WITH ADVANCES IN MOLECULAR METHODS, THERE IS A GROWING UNDERSTANDING OF THE MOLECULAR MECHANISMS IN THE DEVELOPMENT OF HCC. HEPATOCARCINOGENESIS IS STRONGLY LINKED TO INCREASES IN ALLELIC LOSSES, CHROMOSOMAL CHANGES, GENE MUTATIONS, EPIGENETIC ALTERATIONS, AND ALTERATIONS IN MOLECULAR CELLULAR PATHWAYS. SPECIAL EMPHASIS IN THIS REVIEW IS GIVEN TO THE GENETICS, EPIGENETICS, AND REGULATION OF MAJOR SIGNALING PATHWAYS INVOLVED IN HCC SUCH AS WNT/B-CATENIN, RAS, AND PI3K/AKT/MTOR PATHWAYS. A DETAILED UNDERSTANDING OF THE UNDERLYING MOLECULAR MECHANISMS INVOLVED IN THE PROGRESSION OF HCC CAN IMPROVE OUR PREVENTION AND DIAGNOSTIC TOOLS FOR HCC AND BE AN IMPORTANT POTENTIAL SOURCE OF NOVEL MOLECULAR TARGETS FOR NEW THERAPIES. 2010 4 3103 23 GENOMIC LANDSCAPE OF HCC. INTRODUCTION: HEPATOCELLULAR CARCINOMA (HCC) IS A LEADING CAUSE OF CANCER RELATED MORTALITY IN THE WORLD AND IT HAS LIMITED TREATMENT OPTIONS. UNDERSTANDING THE MOLECULAR DRIVERS OF HCC IS IMPORTANT TO DEVELOP NOVEL BIOMARKERS AND THERAPEUTICS. PURPOSE OF REVIEW: HCC ARISES IN A COMPLEX BACKGROUND OF CHRONIC HEPATITIS, FIBROSIS AND LIVER REGENERATION WHICH LEAD TO GENOMIC CHANGES. HERE, WE SUMMARIZE STUDIES THAT HAVE EXPANDED OUR UNDERSTANDING OF THE MOLECULAR LANDSCAPE OF HCC. RECENT FINDINGS: RECENT TECHNOLOGICAL ADVANCES IN NEXT GENERATION SEQUENCING (NGS) HAVE ELUCIDATED SPECIFIC GENETIC AND MOLECULAR PROGRAMS INVOLVED IN HEPATOCARCINOGENESIS. WE SUMMARIZE THE MAJOR SOMATIC MUTATIONS AND EPIGENETIC CHANGES HAVE BEEN IDENTIFIED IN NGS-BASED STUDIES. WE ALSO DESCRIBE PROMISING MOLECULAR THERAPIES AND IMMUNOTHERAPIES WHICH TARGET SPECIFIC GENETIC AND EPIGENETIC MOLECULAR EVENTS. SUMMARY: THE GENOMIC LANDSCAPE OF HCC IS INCREDIBLY COMPLEX AND HETEROGENEOUS. PROMISING NEW DEVELOPMENTS ARE HELPING US DECIPHER THE MOLECULAR DRIVERS OF HCC AND LEADING TO NEW THERAPIES. 2020 5 3266 21 HEPATOCELLULAR CANCER AND GUT MICROBIOME: TIME TO UNTIE GORDIAN'S KNOT. HEPATOCELLULAR CARCINOMA (HCC) IS ONE OF THE LEADING CAUSES OF CANCER DEATH WORLDWIDE AND THE INCIDENCE IS GROWING ON A GLOBAL SCALE. ABOUT 90% OF CASES DEVELOP ON THE CIRRHOTIC LIVER AND THE ETIOLOGY IS MULTIFACTORIAL. INCREASING NUMBER OF STUDIES SUGGEST THAT GUT MICROBIOTA INFLUENCES THE DEVELOPMENT AND PROGRESSION OF LIVER DISEASES, INCLUDING CHRONIC HEPATIC INFLAMMATION, FIBROSIS, CIRRHOSIS, AND HCC. THE KEY ROLE OF GUT MICROBIOTA IN CARCINOGENESIS SEEMS TO BE ASSOCIATED WITH GENOMIC INSTABILITY OF HOST CELLS AND IMMUNE DYSREGULATION. RECENT CLINICAL STUDIES SHOWED THAT A STABLE AND HEALTHY MICROBIOTA INITIALLY COULD HAVE THE ABILITY TO RESIST THE EMERGENCE OF CHRONIC INFLAMMATION AND, THEREFORE, PREVENT THE INDUCTION OF CARCINOGENIC CELLS IN VARIOUS ORGANS SUCH AS THE ESOPHAGUS, STOMACH, COLON, AND LIVER. THE PROGRESSION FROM INFLAMMATION TO CANCER IS A STEPWISE PROCESS OCCURRING BY THE CONCERTED ACTION OF SEVERAL FACTORS SUCH AS DYSBIOSIS, INCREASED GUT PERMEABILITY, DIET, METABOLOMIC, GENETIC, AND EPIGENETIC CHANGES. IN THIS ARTICLE, WE AIMED TO REVIEW THE POSSIBLE ROLE OF GUT MICROBIOTA IN THE DEVELOPMENT, PROGRESSION, AND TREATMENT OF HCC. 2021 6 3256 27 HEPATITIS B VIRUS-ASSOCIATED HEPATOCELLULAR CARCINOMA AND HEPATIC CANCER STEM CELLS. CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS LINKED TO HEPATOCELLULAR CARCINOMA (HCC) PATHOGENESIS. DESPITE THE AVAILABILITY OF A HBV VACCINE, CURRENT TREATMENTS FOR HCC ARE INADEQUATE. GLOBALLY, 257 MILLION PEOPLE ARE CHRONIC HBV CARRIERS, AND CHILDREN BORN FROM HBV-INFECTED MOTHERS BECOME CHRONIC CARRIERS, DESTINED TO DEVELOP LIVER CANCER. THUS, NEW THERAPEUTIC APPROACHES ARE NEEDED TO TARGET ESSENTIAL PATHWAYS INVOLVED IN HCC PATHOGENESIS. ACCUMULATING EVIDENCE SUPPORTS EXISTENCE OF HEPATIC CANCER STEM CELLS (HCSCS), WHICH CONTRIBUTE TO CHEMOTHERAPY RESISTANCE AND CANCER RECURRENCE AFTER TREATMENT OR SURGERY. UNDERSTANDING HOW HCSCS FORM WILL ENABLE DEVELOPMENT OF THERAPEUTIC STRATEGIES TO PREVENT THEIR FORMATION. RECENT STUDIES HAVE IDENTIFIED AN EPIGENETIC MECHANISM INVOLVING THE DOWNREGULATION OF THE CHROMATIN MODIFYING POLYCOMB REPRESSIVE COMPLEX 2 (PRC2) DURING HBV INFECTION, WHICH RESULTS IN RE-EXPRESSION OF HCSC MARKER GENES IN INFECTED HEPATOCYTES AND HBV-ASSOCIATED LIVER TUMORS. HOWEVER, THE GENESIS OF HCSCS REQUIRES, IN ADDITION TO THE EXPRESSION OF HCSC MARKERS CELLULAR CHANGES, REWIRING OF METABOLISM, CELL SURVIVAL, ESCAPE FROM PROGRAMMED CELL DEATH, AND IMMUNE EVASION. HOW THESE CHANGES OCCUR IN CHRONICALLY HBV-INFECTED HEPATOCYTES IS NOT YET UNDERSTOOD. IN THIS REVIEW, WE WILL PRESENT THE BASICS ABOUT HBV INFECTION AND HEPATOCARCINOGENESIS. NEXT, WE WILL DISCUSS STUDIES DESCRIBING THE MUTATIONAL LANDSCAPE OF LIVER CANCERS AND HOW EPIGENETIC MECHANISMS LIKELY ORCHESTRATE CELLULAR REPROGRAMING OF HEPATOCYTES TO ENABLE FORMATION OF HCSCS. 2018 7 3269 25 HEPATOCELLULAR CARCINOMA IN ALCOHOLIC AND NON-ALCOHOLIC FATTY LIVER DISEASE-ONE OF A KIND OR TWO DIFFERENT ENEMIES? HEPATOCELLULAR CANCER (HCC) IS A CANCER WITH AN OVERALL POOR PROGNOSIS AND AN ALARMING GLOBALLY RISING INCIDENCE. WHILE VIRAL ETIOLOGY OF CHRONIC LIVER DISEASE AND HCC IS DOWN-TRENDING, ALCOHOL AND EXCESS CALORIE INTAKE HAVE EMERGED AS MAJOR CULPRITS. ALCOHOL RELATED LIVER DISEASE (ALD) AND NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) SHARE SIMILAR PATHOGENETIC MECHANISM OF HEPATIC INJURY AND IN PROMOTING DEVELOPMENT OF HCC; YET SOME GENETIC AND EPIGENETIC FEATURES ARE DISTINCT AND MAY PROMISE CLINICAL UTILITY. POPULATION BASED INTERVENTION ARE URGENTLY NEEDED TO REDUCE ALCOHOL USE AND IMPROVE METABOLIC FACTORS SUCH AS OBESITY AND DIABETES. THE GOAL IS TO IDENTIFY AT-RISK PATIENTS, TO LINK THESE PATIENTS TO CARE AND TO PROVIDE EFFECTIVE MANAGEMENT OF CHRONIC LIVER DISEASE AND HCC. THIS REVIEW FOCUSES ON THE EPIDEMIOLOGY, PATHOPHYSIOLOGY INCLUDING GENETIC AND EPIGENETIC ALTERCATION AS WELL AS CLINICAL ASPECTS OF ALD AND NAFLD ASSOCIATED HCC. 2019 8 3278 21 HEPATOEPIGENETIC ALTERATIONS IN VIRAL AND NONVIRAL-INDUCED HEPATOCELLULAR CARCINOMA. HEPATOCELLULAR CARCINOMA (HCC) IS A MAJOR PUBLIC HEALTH CONCERN AND ONE OF THE LEADING CAUSES OF TUMOUR-RELATED DEATHS WORLDWIDE. EXTENSIVE EVIDENCE ENDORSES THAT HCC IS A MULTIFACTORIAL DISEASE CHARACTERISED BY HEPATIC CIRRHOSIS MOSTLY ASSOCIATED WITH CHRONIC INFLAMMATION AND HEPATITIS B/C VIRAL INFECTIONS. INTERACTION OF VIRAL PRODUCTS WITH THE HOST CELL MACHINERY MAY LEAD TO INCREASED FREQUENCY OF GENETIC AND EPIGENETIC ABERRATIONS THAT CAUSE HARMFUL ALTERATIONS IN GENE TRANSCRIPTION. THIS MAY PROVIDE A PROGRESSIVE SELECTIVE ADVANTAGE FOR NEOPLASTIC TRANSFORMATION OF HEPATOCYTES ASSOCIATED WITH PHENOTYPIC HETEROGENEITY OF INTRATUMOUR HCC CELLS, THUS POSING EVEN MORE CHALLENGES IN HCC TREATMENT DEVELOPMENT. EPIGENETIC ABERRATIONS INVOLVING DNA METHYLATION, HISTONE MODIFICATIONS, AND NONCODING MIRNA DYSREGULATION HAVE BEEN SHOWN TO BE INTIMATELY LINKED WITH AND PLAY A CRITICAL ROLE IN TUMOUR INITIATION, PROGRESSION, AND METASTASES. THE CURRENT REVIEW FOCUSES ON THE ABERRANT HEPATOEPIGENETICS EVENTS THAT PLAY IMPORTANT ROLES IN HEPATOCARCINOGENESIS AND THEIR UTILITIES IN THE DEVELOPMENT OF HCC THERAPY. 2016 9 6798 26 [EPIDEMIOLOGY, RISK FACTORS AND MOLECULAR PATHOGENESIS OF PRIMARY LIVER CANCER]. PRIMARY LIVER CANCER IS THE FIFTH MOST COMMON CANCER WORLDWIDE. HEPATOCELLULAR CARCINOMA ACCOUNTS FOR 85-90% OF PRIMARY LIVER CANCERS. DISTRIBUTION OF HEPATOCELLULAR CARCINOMA SHOWS VARIATIONS AMONG GEOGRAPHIC REGIONS AND ETHNIC GROUPS. MALES HAVE HIGHER LIVER CANCER RATES THAN FEMALES. HEPATOCELLULAR CARCINOMA OCCURS WITHIN AN ESTABLISHED BACKGROUND OF CHRONIC LIVER DISEASE AND CIRRHOSIS (70-90%). MAJOR CAUSES (80%) OF HEPATOCELLULAR CARCINOMA ARE HEPATITIS B, C VIRUS INFECTION, AND AFLATOXIN EXPOSITION. ITS DEVELOPMENT IS A MULTISTEP PROCESS. WE HAVE A GROWING UNDERSTANDING ON THE MOLECULAR PATHOGENESIS. GENETIC AND EPIGENETIC CHANGES ACTIVATE ONCOGENES, INHIBIT TUMORSUPPRESSOR GENES, WHICH RESULT IN AUTONOMOUS CELL PROLIFERATION. THE CHROMOSOMAL INSTABILITY CAUSED BY TELOMERE DYSFUNCTION, THE GROWTH-RETRAINED ENVIRONMENT AND THE ALTERATIONS OF THE MICRO- AND MACROENVIRONMENT HELP THE EXPANSION OF THE MALIGNANT CELLS. UNDERSTANDING THE MOLECULAR MECHANISMS COULD IMPROVE THE SCREENING OF PATIENTS WITH CHRONIC LIVER DISEASE, OR CIRRHOSIS, AND THE PREVENTION AS WELL AS TREATMENT OF HEPATOCELLULAR CARCINOMA. 2008 10 5211 25 PRENEOPLASTIC LESIONS IN HUMAN HEPATOCARCINOGENESIS. THE EARLY STAGES OF HEPATOCARCINOGENESIS IN HUMAN CHRONIC LIVER DISEASES ARE CHARACTERIZED BY THE EMERGENCE OF PRENEOPLASTIC LESIONS OF WHICH SOME WILL EVENTUALLY DEVELOP INTO HEPATOCELLULAR CARCINOMA (HCC). BASIC STUDIES ON THE GENETIC AND EPIGENETIC ALTERATIONS OF THESE PRENEOPLASTIC LESIONS MAY EVENTUALLY LEAD TO NEW THERAPEUTIC STRATEGIES. CLINICOPATHOLOGICAL STUDIES ARE ALSO IMPORTANT IN ORDER TO DETERMINE OPTIMAL MANAGEMENT OF PATIENTS WITH A PRENEOPLASTIC LESION. THIS ARTICLE AIMS TO PROVIDE A COMPREHENSIVE REVIEW OF THE CURRENT CONCEPTS OF PRENEOPLASTIC LESION IN CHRONIC LIVER DISEASES. THE MICROSCOPICAL SMALL-CELL DYSPLASTIC FOCUS IS THE SMALLEST MORPHOLOGICALLY RECOGNIZABLE PRECURSOR LESION OF HCC AND THEREFORE IS A LOGICAL TARGET OF STUDY TO ELUCIDATE THE EARLIEST EVENTS IN HEPATOCARCINOGENESIS. IN CONTRAST, LARGE-CELL DYSPLASIA IS NOT A PRECURSOR LESION, BUT APPEARS TO BE OF CLINICAL VALUE BECAUSE OF ITS GOOD PREDICTIVE VALUE FOR DEVELOPMENT OF HCC. DYSPLASTIC NODULES (DNS) ARE MACROSCOPICALLY RECOGNIZABLE PRECURSOR LESIONS OF HCC AND HIGH-GRADE DNS (HGDNS) HAVE A RISK OF MALIGNANT TRANSFORMATION. DETECTION OF DNS AND CORRECT DIFFERENTIATION FROM SMALL HCC (<2 CM) IS SOMETIMES DIFFICULT, ESPECIALLY WHEN ONLY IMAGING TECHNIQUES ARE USED. ADDITIONAL CLINICOPATHOLOGICAL STUDIES ON IDENTIFICATION AND OPTIMAL TREATMENT OF DNS ARE NECESSARY. MOLECULAR STUDIES ON HGDNS AND SMALL HCCS MAY YIELD MUCH INFORMATION ON THE GENETIC MECHANISMS INVOLVED IN THE TRANSITION FROM SEVERE DYSPLASIA TO EARLY MALIGNANCY. IN CONTRAST, CURRENTLY AVAILABLE DATA INDICATE THAT (LARGE) REGENERATIVE NODULES DO NOT REPRESENT A DISTINCT STEP IN HEPATOCARCINOGENESIS. ANIMAL MODELS WILL BE HELPFUL IN THE FURTHER UNRAVELLING OF HUMAN HCC DEVELOPMENT, PROVIDED THAT STUDIES ARE PERFORMED ON MODELS THAT ARE GOOD REPRESENTATIVES OF HUMAN HEPATOCARCINOGENESIS. WE PROPOSE THREE CRITERIA BY WHICH GOOD MIMICKERS CAN BE IDENTIFIED. 2005 11 915 27 CHRONIC HEPATITIS B VIRUS AND HEPATITIS C VIRUS INFECTIONS AND CANCER: SYNERGY BETWEEN VIRAL AND HOST FACTORS. HEPATITIS B VIRUS (HBV) OR HEPATITIS C VIRUS (HCV) INFECTIONS REPRESENT MAJOR CAUSES OF CHRONIC LIVER DISEASE AND HEPATOCELLULAR CARCINOMA. DESPITE INDUCING SHARED PATHOLOGICAL EVENTS LEADING TO ONCOGENIC TRANSFORMATION, THESE TWO VIRUSES PRESENT PROFOUND DIFFERENCES IN THEIR MOLECULAR FEATURES, LIFE CYCLE AND INTERPLAY WITH HOST FACTORS, WHICH SIGNIFICANTLY DIFFERENTIATE THE PROGNOSTIC AND THERAPEUTIC APPROACH TO THE RELATED DISEASES. IN THE PRESENT REVIEW, WE REPORT THE MAIN MECHANISMS INVOLVED IN THE MULTISTEP PROCESS LEADING FROM HCV/HBV INFECTION AND CANCER DEVELOPMENT, DISCUSSING SIDE-BY-SIDE THE ANALOGIES AND DIFFERENCES BETWEEN THE TWO VIRUSES. SUCH EVENTS CAN BE BROADLY CATEGORIZED INTO (A) DIRECT ONCOGENIC EFFECTS, INVOLVING INTEGRATION IN THE HOST GENOME (IN THE CASE OF HBV) AND CHROMOSOMAL INSTABILITY, INTERFERENCE WITH ONCOSUPPRESSOR PATHWAYS, INDUCTION OF OXIDATIVE STRESS, PROMOTION OF ANGIOGENESIS, EPITHELIAL-MESENCHYMAL TRANSITION, ALTERATIONS IN THE EPIGENETIC ASSET AND INTERACTION WITH NON-CODING RNAS; AND (B) INDIRECT ACTIVITIES MOSTLY MEDIATED BY HOST EVENTS, INCLUDING CHRONIC INFLAMMATION SUSTAINED BY PECULIAR CYTOKINE NETWORKS (SUCH AS INTERLEUKIN-6 AND LYMPHOTOXINS), METABOLIC DYSFUNCTIONS PROMOTED BY STEATOHEPATITIS, INTERPLAY WITH GUT MICROBIOTA AND FIBROTIC EVENTS (MAINLY IN HCV INFECTION). THIS SCENARIO SUGGESTS THAT THE INTEGRATED STUDY OF VIRAL AND HOST FACTORS MAY LEAD TO THE SUCCESSFUL DEVELOPMENT OF NOVEL BIOMARKERS AND TARGETS FOR THERAPY. 2015 12 2538 22 EPIGENETICS IN HEPATOCELLULAR CARCINOMA: AN UPDATE AND FUTURE THERAPY PERSPECTIVES. HEPATOCELLULAR CARCINOMA (HCC), THE PREDOMINANT FORM OF ADULT LIVER MALIGNANCIES, IS A GLOBAL HEALTH CONCERN. ITS DISMAL PROGNOSIS HAS PROMPTED RECENT SIGNIFICANT ADVANCES IN THE UNDERSTANDING OF ITS ETIOLOGY AND PATHOGENESIS. THE DEREGULATION OF EPIGENETIC MECHANISMS, WHICH MAINTAIN HERITABLE GENE EXPRESSION CHANGES AND CHROMATIN ORGANIZATION, IS IMPLICATED IN THE DEVELOPMENT OF MULTIPLE CANCERS, INCLUDING HCC. THIS REVIEW SUMMARIZES THE CURRENT KNOWLEDGE OF EPIGENETIC MECHANISMS IN THE PATHOGENESIS OF HCC, WITH AN EMPHASIS ON HCC MEDIATED BY CHRONIC HEPATITIS B VIRUS INFECTION. THIS REVIEW ALSO DISCUSSES THE ENCOURAGING OUTCOMES AND LESSONS LEARNT FROM EPIGENETIC THERAPIES FOR HEMATOLOGICAL AND OTHER SOLID CANCERS, AND HIGHLIGHTS THE FUTURE POTENTIAL OF SIMILAR THERAPIES IN THE TREATMENT OF HCC. 2014 13 5233 25 PROFIBROTIC SIGNALING AND HCC RISK DURING CHRONIC VIRAL HEPATITIS: BIOMARKER DEVELOPMENT. DESPITE BREAKTHROUGHS IN ANTIVIRAL THERAPIES, CHRONIC VIRAL HEPATITIS B AND C ARE STILL THE MAJOR CAUSES OF LIVER FIBROSIS AND HEPATOCELLULAR CARCINOMA (HCC). IMPORTANTLY, EVEN IN PATIENTS WITH CONTROLLED INFECTION OR VIRAL CURE, THE CANCER RISK CANNOT BE FULLY ELIMINATED, HIGHLIGHTING A PERSISTING ONCOGENIC PRESSURE IMPOSED BY EPIGENETIC IMPRINTING AND ADVANCED LIVER DISEASE. RELIABLE AND MINIMALLY INVASIVE BIOMARKERS FOR EARLY FIBROSIS AND FOR RESIDUAL HCC RISK IN HCV-CURED PATIENTS ARE URGENTLY NEEDED. CHRONIC INFECTION WITH HBV AND/OR HCV DYSREGULATES ONCOGENIC AND PROFIBROGENIC SIGNALING WITHIN THE HOST, ALSO DISPLAYED IN THE SECRETION OF SOLUBLE FACTORS TO THE BLOOD. THE STUDY OF VIRUS-DYSREGULATED SIGNALING PATHWAYS MAY, THEREFORE, CONTRIBUTE TO THE IDENTIFICATION OF RELIABLE MINIMALLY INVASIVE BIOMARKERS FOR THE DETECTION OF PATIENTS AT EARLY-STAGE LIVER DISEASE POTENTIALLY COMPLEMENTING EXISTING NONINVASIVE METHODS IN CLINICS. WITH A FOCUS ON VIRUS-INDUCED SIGNALING EVENTS, THIS REVIEW PROVIDES AN OVERVIEW OF CANDIDATE BLOOD BIOMARKERS FOR LIVER DISEASE AND HCC RISK ASSOCIATED WITH CHRONIC VIRAL HEPATITIS AND EPIGENETIC VIRAL FOOTPRINTS. 2021 14 2182 22 EPIGENETIC MECHANISMS REGULATING THE DEVELOPMENT OF HEPATOCELLULAR CARCINOMA AND THEIR PROMISE FOR THERAPEUTICS. HEPATOCELLULAR CARCINOMA (HCC) IS ONE OF THE MOST COMMON CANCERS AROUND THE GLOBE AND THIRD MOST FATAL MALIGNANCY. CHRONIC LIVER DISORDERS SUCH AS CHRONIC HEPATITIS AND LIVER CIRRHOSIS OFTEN LEAD TO THE DEVELOPMENT OF HCC. ACCUMULATION OF GENETIC AND EPIGENETIC ALTERATIONS ARE INVOLVED IN THE DEVELOPMENT OF HCC. GENETIC RESEARCH SPARKED BY RECENT DEVELOPMENTS IN NEXT GENERATION SEQUENCING HAS IDENTIFIED THE FREQUENCY OF GENETIC ALTERATIONS THAT OCCUR IN HCC AND HAS LED TO THE IDENTIFICATION OF GENETIC HOTSPOTS. EMERGING EVIDENCE SUGGESTS THAT EPIGENETIC ABERRATIONS ARE STRONGLY ASSOCIATED WITH THE INITIATION AND DEVELOPMENT OF HCC. VARIOUS IMPORTANT GENES ENCODING TUMOR SUPPRESSORS INCLUDING P16, RASSF1A, DLC-1, RUNX3 AND SOCS-1 ARE TARGETS OF EPIGENETIC DYSREGULATION DURING THE DEVELOPMENT OF HCC. THE PRESENT REVIEW DISCUSSES THE IMPORTANCE OF EPIGENETIC REGULATIONS INCLUDING DNA METHYLATION, HISTONE MODIFICATION AND MICRORNA MEDIATED REGULATION OF GENE EXPRESSION DURING TUMORIGENESIS AND THEIR USE AS DISEASE BIOMARKERS. FURTHERMORE, THESE EPIGENETIC ALTERATIONS HAVE BEEN DISCUSSED IN RELATIONSHIP WITH PROMISING THERAPEUTIC PERSPECTIVES FOR HCC AND RELATED CANCERS. 2017 15 6092 22 THE EFFECTS OF EPIGENETIC MODIFICATION ON THE OCCURRENCE AND PROGRESSION OF LIVER DISEASES AND THE INVOLVED MECHANISM. INTRODUCTION: EPIGENETIC MODIFICATION IS A TYPE OF GENE EXPRESSION AND REGULATION THAT DOES NOT INVOLVE CHANGES IN DNA SEQUENCES. AN INCREASING NUMBER OF STUDIES HAVE PROVEN THAT EPIGENETIC MODIFICATIONS PLAY AN IMPORTANT ROLE IN THE OCCURRENCE AND PROGRESSION OF LIVER DISEASES THROUGH THE GENE REGULATION AND PROTEIN EXPRESSIONS OF HEPATOCELLULAR LIPID METABOLISM, INFLAMMATORY REACTION, CELL PROLIFERATION, AND ACTIVATION, ETC.AREAS COVERED: IN THIS STUDY, WE ELABORATED AND ANALYZED THE UNDERLYING FUNCTIONAL MECHANISM OF EPIGENETIC MODIFICATION IN ALCOHOLIC LIVER DISEASE (ALD), NONALCOHOLIC FATTY LIVER DISEASE (NAFLD), LIVER FIBROSIS (LF), VIRAL HEPATITIS, HEPATOCELLULAR CARCINOMA (HCC), AND RESEARCH PROGRESS OF RECENT YEARS.EXPERT OPINION: THE FURTHER UNDERSTANDING OF EPIGENETIC MECHANISMS THAT CAN REGULATE GENE EXPRESSION AND CELL PHENOTYPE LEADS TO NEW INSIGHTS IN EPIGENETIC CONTROL OF CHRONIC LIVER DISEASE. CURRENTLY, HEPATOLOGISTS ARE EXPLORING THE ROLE OF DNA METHYLATION, HISTONE/CHROMATIN MODIFICATION, AND NON-CODING RNA IN SPECIFIC LIVER PATHOLOGY. THESE FINDINGS HAVE LED TO ADVANCES IN DIRECT EPIGENETIC BIOMARKER TESTING OF PATIENT TISSUE OR BODY FLUID SPECIMENS, AS WELL AS QUANTITATIVE ANALYSIS. BASED ON THESE FINDINGS, DRUG VALIDATION OF SOME TARGETS INVOLVED IN THE EPIGENETIC MECHANISM OF LIVER DISEASE IS GRADUALLY BEING CARRIED OUT CLINICALLY. 2020 16 3277 22 HEPATOCYTE PLOIDY AND PATHOLOGICAL MUTATIONS IN HEPATOCELLULAR CARCINOMA: IMPACT ON ONCOGENESIS AND THERAPEUTICS. HEPATOCELLULAR CARCINOMA (HCC) OCCURS IN THE CHRONIC LIVER INFLAMMATION SUCH AS VIRAL HEPATITIS, ALCOHOLIC AND NON-ALCOHOLIC STEATOHEPATITIS. WHILE ANTI-VIRAL TREATMENT HAS BEEN SIGNIFICANTLY IMPROVED, THE PREVALENCE OF HCC REMAINS HIGH AND TREATMENT IS STILL CHALLENGING. THE CONTINUATION OF HEPATOCYTE DEATH, INFLAMMATION, AND FIBROSIS LEADS TO THE ACCUMULATION OF GENE ALTERATIONS, WHICH MAY TRIGGER CARCINOGENESIS. HEPATOCYTES ARE A UNIQUE CELL TYPE HAVING MORE THAN ONE COMPLETE SET OF 23 CHROMOSOMES, TERMED POLYPLOIDY. DUE TO GENE REDUNDANCY, HEPATOCYTES MAY TOLERATE LETHAL MUTATIONS. NEXT GENERATION SEQUENCING TECHNOLOGY HAS REVEALED GENE ALTERATIONS IN HCC RELATED TO TELOMERE MAINTENANCE, WNT/BETA-CATENIN PATHWAY, P53 CELL-CYCLE PATHWAY, EPIGENETIC MODIFIERS, OXIDATIVE STRESS PATHWAY, PI3K/AKT/MTOR, AND RAS/RAF/MAPK PATHWAY WITH OR WITHOUT A CHROMOSOMAL INSTABILITY. SOME TYPE OF DRIVER GENE MUTATIONS ACCUMULATES IN HEPATOCYTES AND BREAKS THE ORCHESTRATION OF EXCESSIVE COPIES OF CHROMOSOMES, WHICH MAY LEAD TO UNFAVORABLE GENE EXPRESSIONS AND FUEL TUMORIGENESIS. RECENTLY, MOLECULAR TARGETED DRUGS, DEVELOPED WITH THE AIM OF INTERFERING WITH THESE SIGNALING PATHWAYS, ARE BEING USED FOR HCC PATIENTS IN THE CLINICS. THEREFORE, A DEEPER UNDERSTANDING OF HEPATOCYTE PLOIDY AND GENETIC OR EPIGENETIC ALTERATIONS IS INDISPENSABLE FOR THE ESTABLISHMENT OF NOVEL THERAPEUTIC STRATEGIES AGAINST HCC. 2020 17 3927 24 LIVER ABNORMALITIES AFTER ELIMINATION OF HCV INFECTION: PERSISTENT EPIGENETIC AND IMMUNOLOGICAL PERTURBATIONS POST-CURE. CHRONIC HEPATITIS C (CHC) IS A MAJOR CAUSE OF HEPATOCELLULAR CARCINOMA (HCC) WORLDWIDE. WHILE DIRECTLY ACTING ANTIVIRAL (DAA) DRUGS ARE NOW ABLE TO CURE VIRTUALLY ALL HEPATITIS C VIRUS (HCV) INFECTIONS, EVEN IN SUBJECTS WITH ADVANCED LIVER DISEASE, WHAT HAPPENS TO THE LIVER AND PROGRESSION OF THE DISEASE AFTER DAA-INDUCED CURE OF VIREMIA IS ONLY BEGINNING TO EMERGE. SEVERAL LARGE-SCALE CLINICAL STUDIES IN DIFFERENT PATIENT POPULATIONS HAVE SHOWN THAT PATIENTS WITH ADVANCED LIVER DISEASE MAINTAIN A RISK FOR DEVELOPING HCC EVEN WHEN THE ORIGINAL INSTIGATOR, THE VIRUS, IS ELIMINATED BY DAAS. HERE WE REVIEW EMERGING STUDIES DERIVED FROM MULTIPLE, COMPLEMENTARY EXPERIMENTAL SYSTEMS INVOLVING PATIENT LIVER TISSUES, HUMAN LIVER CELL CULTURES, HUMAN LIVER SLICE CULTURES, AND ANIMAL MODELS, SHOWING THAT HCV INFECTION INDUCES EPIGENETIC, SIGNALING, AND GENE EXPRESSION CHANGES IN THE LIVER ASSOCIATED WITH ALTERED HEPATIC INNATE IMMUNITY AND LIVER CANCER RISK. OF CRITICAL IMPORTANCE IS THE FACT THAT THESE VIRUS-INDUCED ABNORMALITIES PERSIST AFTER DAA CURE OF HCV. THESE NASCENT FINDINGS PORTEND THE DISCOVERY OF PATHWAYS INVOLVED IN POST-HCV IMMUNOPATHOGENESIS, WHICH MAY BE CLINICALLY ACTIONABLE TARGETS FOR MORE COMPREHENSIVE CARE OF DAA-CURED INDIVIDUALS. 2021 18 4449 25 MOLECULAR MECHANISM OF HEPATITIS B VIRUS-INDUCED HEPATOCARCINOGENESIS. HEPATITIS B VIRUS (HBV) INFECTION IS A GLOBAL PUBLIC HEALTH PROBLEM WITH APPROXIMATELY 2 BILLION PEOPLE THAT HAVE BEEN EXPOSED TO THE VIRUS. HBV IS A MEMBER OF A FAMILY OF SMALL, ENVELOPED DNA VIRUSES CALLED HEPADNAVIRUSES, AND HAS A PREFERENTIAL TROPISM FOR HEPATOCYTES OF MAMMALS AND BIRDS. EPIDEMIOLOGICAL STUDIES HAVE PROVED A STRONG CORRELATION BETWEEN CHRONIC HEPATITIS B VIRUS INFECTION AND THE DEVELOPMENT OF HEPATOCELLULAR CARCINOMA (HCC). HCC IS THE FIFTH MOST COMMON MALIGNANCY WITH ABOUT 700000 NEW CASES EACH YEAR, AND MORE THAN 50% OF THEM ARISE IN HBV CARRIERS. A LARGE NUMBER OF STUDIES DESCRIBE THE WAY IN WHICH HBV CAN CONTRIBUTE TO HCC DEVELOPMENT. MULTIPLE MECHANISMS HAVE BEEN PROPOSED, INCLUDING THE ACCUMULATION OF GENETIC DAMAGE DUE TO IMMUNE-MEDIATED HEPATIC INFLAMMATION AND THE INDUCTION OF OXIDATIVE STRESS. THERE IS EVIDENCE OF THE DIRECT EFFECTS OF THE VIRAL PROTEINS HBX AND HBS ON THE CELL BIOLOGY. INTEGRATION OF HBV-DNA INTO THE HUMAN GENOME IS CONSIDERED AN EARLY EVENT IN THE CARCINOGENIC PROCESS AND CAN INDUCE, THROUGH INSERTIONAL MUTAGENESIS, THE ALTERATION OF GENE EXPRESSION AND CHROMOSOMAL INSTABILITY. HBV HAS ALSO EPIGENETIC EFFECTS THROUGH THE MODIFICATION OF THE GENOMIC METHYLATION STATUS. FURTHERMORE, THE VIRUS PLAYS AN IMPORTANT ROLE IN THE REGULATION OF MICRORNA EXPRESSION. THIS REVIEW WILL SUMMARIZE THE MANY MECHANISMS INVOLVED IN HBV-RELATED LIVER CARCINOGENESIS. 2014 19 5761 31 SOMATIC MUTATIONS, VIRAL INTEGRATION AND EPIGENETIC MODIFICATION IN THE EVOLUTION OF HEPATITIS B VIRUS-INDUCED HEPATOCELLULAR CARCINOMA. LIVER CANCER IN MEN IS THE SECOND LEADING CAUSE OF CANCER DEATH AND HEPATOCELLULAR CARCINOMA (HCC) ACCOUNTS FOR 70%-85% OF THE TOTAL LIVER CANCER WORLDWIDE. CHRONIC INFECTION WITH HEPATITIS B VIRUS (HBV) IS THE MAJOR CAUSE OF HCC. CHRONIC, INTERMITTENTLY ACTIVE INFLAMMATION PROVIDES "FERTILE FIELD" FOR "MUTATION, SELECTION, AND ADAPTATION" OF HBV AND THE INFECTED HEPATOCYTES, A LONG-TERM EVOLUTIONARY PROCESS DURING HBV-INDUCED CARCINOGENESIS. HBV MUTATIONS, WHICH ARE POSITIVELY SELECTED BY INSUFFICIENT IMMUNITY, CAN PROMOTE AND PREDICT THE OCCURRENCE OF HCC. RECENTLY, ADVANCED SEQUENCING TECHNOLOGIES INCLUDING WHOLE GENOME SEQUENCING, EXOME SEQUENCING, AND RNA SEQUENCING PROVIDE OPPORTUNITIES TO BETTER UNDER-STAND THE INSIGHT OF HOW SOMATIC MUTATIONS, STRUCTURE VARIATIONS, HBV INTEGRATIONS, AND EPIGENETIC MODIFICATIONS CONTRIBUTE TO HCC DEVELOPMENT. GENOMIC VARIATIONS OF HCC CAUSED BY VARIOUS ETIOLOGICAL FACTORS MAY BE DIFFERENT, BUT THE COMMON DRIVER MUTATIONS ARE IMPORTANT TO ELUCIDATE THE HCC EVOLUTIONARY PROCESS. GENOME-WIDE ANALYSES OF HBV INTEGRATIONS ARE HELPFUL IN CLARIFYING THE TARGETED GENES OF HBV IN CARCINOGENESIS AND DISEASE PROGRESSION. RNA SEQUENCING CAN IDENTIFY KEY MOLECULES WHOSE EXPRESSIONS ARE EPIGENETICALLY MODIFIED DURING HCC EVOLUTION. IN THIS REVIEW, WE SUMMARIZED THE CURRENT FINDINGS OF NEXT GENERATION SEQUENCINGS FOR HBV-HCC AND PROPOSED A THEORY FRAMEWORK OF CANCER EVOLUTION AND DEVELOPMENT BASED ON THE CURRENT KNOWLEDGE OF HBV-INDUCED HCC TO CHARACTERIZE AND INTERPRET EVOLUTIONARY MECHANISMS OF HCC AND POSSIBLE OTHER CANCERS. UNDERSTANDING THE KEY VIRAL AND GENOMIC VARIATIONS INVOLVED IN HCC EVOLUTION IS ESSENTIAL FOR GENERATING EFFECTIVE DIAGNOSTIC, PROGNOSTIC, AND PREDICTIVE BIOMARKERS AS WELL AS THERAPEUTIC TARGETS FOR THE INTERVENTIONS OF HBV-HCC. 2014 20 4454 27 MOLECULAR MECHANISMS DRIVING PROGRESSION OF LIVER CIRRHOSIS TOWARDS HEPATOCELLULAR CARCINOMA IN CHRONIC HEPATITIS B AND C INFECTIONS: A REVIEW. ALMOST ALL PATIENTS WITH HEPATOCELLULAR CARCINOMA (HCC), A MAJOR TYPE OF PRIMARY LIVER CANCER, ALSO HAVE LIVER CIRRHOSIS, THE SEVERITY OF WHICH HAMPERS EFFECTIVE TREATMENT FOR HCC DESPITE RECENT PROGRESS IN THE EFFICACY OF ANTICANCER DRUGS FOR ADVANCED STAGES OF HCC. HERE, WE REVIEW RECENT KNOWLEDGE CONCERNING THE MOLECULAR MECHANISMS OF LIVER CIRRHOSIS AND ITS PROGRESSION TO HCC FROM GENETIC AND EPIGENOMIC POINTS OF VIEW. BECAUSE ~70% OF PATIENTS WITH HCC HAVE HEPATITIS B VIRUS (HBV) AND/OR HEPATITIS C VIRUS (HCV) INFECTION, WE FOCUSED ON HBV- AND HCV-ASSOCIATED HCC. THE LITERATURE SUGGESTS THAT GENETIC AND EPIGENETIC FACTORS, SUCH AS MICRORNAS, PLAY A ROLE IN LIVER CIRRHOSIS AND ITS PROGRESSION TO HCC, AND THAT HBV- AND HCV-ENCODED PROTEINS APPEAR TO BE INVOLVED IN HEPATOCARCINOGENESIS. FURTHER STUDIES ARE NEEDED TO ELUCIDATE THE MECHANISMS, INCLUDING IMMUNE CHECKPOINTS AND MOLECULAR TARGETS OF KINASE INHIBITORS, ASSOCIATED WITH LIVER CIRRHOSIS AND ITS PROGRESSION TO HCC. 2019