1 2792 111 FAT10 IS AN EPIGENETIC MARKER FOR LIVER PRENEOPLASIA IN A DRUG-PRIMED MOUSE MODEL OF TUMORIGENESIS. THERE IS CLINICAL EVIDENCE THAT CHRONIC LIVER DISEASES IN WHICH MDBS (MALLORY DENK BODIES) FORM PROGRESS TO HEPATOCELLULAR CARCINOMA. THE PRESENT STUDY PROVIDES EVIDENCE THAT LINKS MDB FORMATION INDUCED BY CHRONIC DRUG INJURY, WITH PRENEOPLASIA AND LATER TO THE FORMATION OF TUMORS, WHICH DEVELOP LONG AFTER DRUG WITHDRAWAL. EVIDENCE INDICATED THAT THIS LINK WAS DUE TO AN EPIGENETIC CELLULAR MEMORY INDUCED BY CHRONIC DRUG INGESTION. MICROARRAY ANALYSIS SHOWED THAT THE EXPRESSIONS OF MANY MARKERS OF PRENEOPLASIA (UBD, ALPHA FETOPROTEIN, KLF6 AND GLUTATHIONE-S-TRANSFERASE MU2) WERE INCREASED TOGETHER WHEN THE DRUG DDC WAS REFED. THESE CHANGES WERE SUPPRESSED BY S-ADENOSYLMETHIONINE FEEDING, INDICATING THAT THE DRUG WAS AFFECTING DNA AND HISTONES METHYLATION IN AN EPIGENETIC MANNER. THE LINK BETWEEN MDB FORMATION AND NEOPLASIA FORMATION WAS LIKELY DUE TO THE OVER EXPRESSION OF UBD (ALSO CALLED FAT10), WHICH IS UP REGULATED IN 90% OF HUMAN HEPATOCELLULAR CARCINOMAS. IMMUNOHISTOCHEMICAL STAINING OF DRUG-PRIMED MOUSE LIVERS SHOWED THAT FAT10 POSITIVE LIVER CELLS PERSISTED UP TO 4 MONTHS AFTER DRUG WITHDRAWAL AND THEY WERE STILL FOUND IN THE LIVERS OF MICE, 14 MONTHS AFTER DRUG WITHDRAWAL. THE REFEEDING OF DDC INCREASED THE PERCENT OF FAT10 HEPATOCYTES. 2008 2 6361 59 THE ROLE OF INNATE IMMUNITY IN THE PATHOGENESIS OF PRENEOPLASIA IN DRUG-INDUCED CHRONIC HEPATITIS BASED ON A MOUSE MODEL. INNATE IMMUNITY FACTORS SUCH AS CONVERSION OF THE 26S PROTEASOME TO FORM THE IMMUNOPROTEASOME AND THE TOLL-LIKE RECEPTOR SIGNALING PATHWAYS ARE ACTIVATED IN CHRONIC HEPATITIS INDUCED BY THE CARCINOGENIC DRUG DDC. OVER TIME, PRENEOPLASTIC HEPATOCYTE PHENOTYPES APPEAR IN THE LIVER PARENCHYMA. THESE CHANGED HEPATOCYTES EXPAND IN NUMBER BECAUSE THEY HAVE A GROWTH ADVANTAGE OVER NORMAL HEPATOCYTES WHEN RESPONDING TO CHRONIC LIVER INJURY. THE CHANGED HEPATOCYTES CAN BE IDENTIFIED USING IMMUNOFLUORESCENT ANTIBODIES TO PRENEOPLASTIC CELLS E.G. FAT10/UBD, A2 MACROGLOBULIN, GLUTATHIONE TRANSPEPTIDASE, ALPHA FETOPROTEIN, GLYCIPAN 3, FAS, AND GAMMA GLUTAMYL TRANSPEPTIDASE. THE FORMATION OF THE PRENEOPLASTIC CELLS OCCURS CONCOMITANT WITH ACTIVATION OF THE TOLL-LIKE RECEPTOR SIGNALING PATHWAYS AND THE TRANSFORMATION OF THE 26S PROTEASOME TO FORM THE IMMUNOPROTEASOME. THIS TRANSFORMATION IS IN RESPONSE TO INTERFERON STIMULATING RESPONSE ELEMENT ON THE PROMOTER OF THE FAT10/UBD GENE. NFKAPPAB, ERK, P38 AND JNK ARE ALSO UP REGULATED. SPECIFIC INHIBITORS BLOCK THESE RESPONSES IN VITRO IN A MOUSE TUMOR CELL LINE EXPOSED TO INTERFERON GAMMA. MALLORY-DENK BODIES FORM IN THESE PRENEOPLASTIC CELLS, BECAUSE OF THE DEPLETION OF THE 26S PROTEASOME DUE TO FORMATION OF THE IMMUNOPROTEASOME. THUS, MDB FORMING CELLS ARE ALSO MARKERS OF THE PRENEOPLASTIC HEPATOCYTES. THE UBD POSITIVE PRENEOPLASTIC CELLS REGRESS WHEN THE LIVER INJURY INDUCED CHRONIC HEPATITIS SUBSIDES. WHEN THE DRUG DDC IS REFED TO MICE AND CHRONIC HEPATITIS IS ACTIVATED, THE PRENEOPLASTIC CELL POPULATION EXPANDS AND MALLORY-DENK BODIES RAPIDLY REFORM. THIS RESPONSE IS REMEMBERED BY THE PRENEOPLASTIC CELLS FOR AT LEAST FOUR MONTHS INDICATING THAT AN EPIGENETIC CELLULAR MEMORY HAS FORMED IN THE PRENEOPLASTIC CELLS. THIS PROLIFERATIVE RESPONSE IS PREVENTED BY FEEDING METHYL DONORS SUCH AS S-ADENOSYLMETHIONINE OR BETAINE. DRUG FEEDING REDUCES THE METHYLATION OF H(3) K4, 9, AND 27 AND THIS RESPONSE IS PREVENTED BY FEEDING THE METHYL DONORS. AFTER 8 TO 15MONTHS OF DRUG WITHDRAWAL IN MICE THE PRENEOPLASTIC LIVER CELLS PERSIST AS SINGLE OR SMALL CLUSTERS OF CELLS IN THE LIVER LOBULES. MULTIPLE LIVER TUMORS FORM, SOME OF WHICH ARE HEPATOCELLULAR CARCINOMAS. THE TUMORS IMMUNOSTAIN POSITIVELY FOR THE SAME PRENEOPLASTIC MARKERS AS THE PRENEOPLASTIC CELLS. SIMILAR CELLS ARE IDENTIFIED IN HUMAN CIRRHOSIS AND HEPATOCELLULAR CARCINOMA INDICATING THE RELEVANCE OF THE DRUG MODEL DESCRIBED HERE TO THE PRENEOPLASTIC CHANGES ASSOCIATED WITH HUMAN CHRONIC HEPATITIS AND HEPATOCELLULAR CARCINOMA. 2011 3 5181 20 PREMALIGNANT LESIONS IN GASTRIC CANCER. DESPITE A PLATEAU IN INCIDENCE, GASTRIC CANCER IS ONE OF THE MOST COMMON CANCERS WORLDWIDE AND CAUSES CONSIDERABLE MORBIDITY AND MORTALITY. PREMALIGNANT GASTRIC LESIONS ARE WELL KNOWN RISK FACTORS FOR THE DEVELOPMENT OF INTESTINAL-TYPE GASTRIC ADENOCARCINOMAS. IN THIS MULTISTEP MODEL OF GASTRIC CARCINOGENESIS, HELICOBACTER PYLORI CAUSES CHRONIC ACTIVE INFLAMMATION OF THE GASTRIC MUCOSA, WHICH SLOWLY PROGRESSES THROUGH THE PREMALIGNANT STAGES OF ATROPHIC GASTRITIS, INTESTINAL METAPLASIA, AND ADENOMA/DYSPLASIA TO GASTRIC CARCINOMA. THIS PROGRESSION IS PARALLELED BY A STEPWISE ACCUMULATION OF MULTIPLE GENETIC AND EPIGENETIC ABNORMALITIES. DETECTION, TREATMENT, AND MOLECULAR ANALYSES OF PREMALIGNANT LESIONS MAY THUS PROVIDE A BASIS FOR GASTRIC CANCER PREVENTION. THIS REVIEW DESCRIBES AN OVERVIEW OF CURRENT KNOWLEDGE ON PREMALIGNANT GASTRIC LESIONS. IT ALSO REVIEWS THE ISSUE OF SURVEILLANCE OF PATIENTS WITH PREMALIGNANT LESIONS IN ORDER TO IMPROVE THE SURVIVAL OF PATIENTS WITH GASTRIC CANCER. 2010 4 3232 17 HELICOBACTER PYLORI-INDUCED SIGNALING PATHWAYS CONTRIBUTE TO INTESTINAL METAPLASIA AND GASTRIC CARCINOGENESIS. HELICOBACTER PYLORI (H. PYLORI) INDUCES CHRONIC GASTRIC INFLAMMATION, ATROPHIC GASTRITIS, INTESTINAL METAPLASIA, AND CANCER. ALTHOUGH THE RISK OF GASTRIC CANCER INCREASES EXPONENTIALLY WITH THE EXTENT OF ATROPHIC GASTRITIS, THE PRECISE MECHANISMS OF GASTRIC CARCINOGENESIS HAVE NOT BEEN FULLY ELUCIDATED. H. PYLORI INDUCES GENETIC AND EPIGENETIC CHANGES IN GASTRIC EPITHELIAL CELLS THROUGH ACTIVATING INTRACELLULAR SIGNALING PATHWAYS IN A CAGPAI-DEPENDENT MANNER. H. PYLORI EVENTUALLY INDUCES GASTRIC CANCER WITH CHROMOSOMAL INSTABILITY (CIN) OR MICROSATELLITE INSTABILITY (MSI), WHICH ARE CLASSIFIED AS TWO MAJOR SUBTYPES OF GASTRIC CANCER. ELUCIDATION OF THE PRECISE MECHANISMS OF GASTRIC CARCINOGENESIS WILL ALSO BE IMPORTANT FOR CANCER THERAPY. 2015 5 6824 27 [GENETIC ALTERATIONS IN PRENEOPLASTIC AND NEOPLASTIC INJURIES OF THE GALLBLADDER]. THIS ARTICLE AIMS TO REVIEW THE MOST RELEVANT MORPHOLOGICAL AND MOLECULAR ASPECTS INVOLVED IN GALLBLADDER (GB) CANCER. IN CHILE, GALLBLADDER CANCER IS THE MAIN CAUSE OF DEATH DUE TO CANCER, AMONG WOMEN OLDER THAN 40 YEARS. HOWEVER, THERE IS ALMOST NONE INFORMATION ABOUT THE MORPHOLOGICAL CHANGES AND THE GENETIC ALTERATIONS INVOLVED IN THE BEGINNING AND DEVELOPMENT OF THIS NEOPLASIA. TWO CARCINOGENIC WAYS HAVE BEEN DESCRIBED. THE SEQUENCE ADENOMA-CARCINOMA IS ACCEPTED TO BE LESS FREQUENT AND IMPORTANT. THE MOST IMPORTANT IS THE SEQUENCE WHERE A METAPLASIA EVOLVES TO DISPLASIA THAT PROGRESSES TO CARCINOMA IN SITU AND FINALLY IT BECOMES INVASIVE. THIS PROGRESS REQUIRES 10 TO 15 YEARS APPROXIMATELY. DURING THIS TIME, A CONTINUE PROGRESSION OF INJURIES HAVE BEEN DESCRIBED. MOLECULAR RESEARCH STUDIES SHOW GENETIC ANOMALIES IN SOME GENES WHICH ARE TEMPORARY EVENTS IN PRENEOPLASTIC INJURIES OF THE GALLBLADDER. SOME OF THEM EVEN EXIST BEFORE THE FIRST MORPHOLOGICAL CHANGES, WHILE THE EXPRESSION OF TUMOR SUPPRESSOR GENES LIKE P53, ADHESION MOLECULES AND ONCOGENES, AMONG OTHERS, CAN BE RELATED TO LATE GB CARCINOGENESIS. THE K-RAS GENE SEEMS TO PLAY A ROLE IN THIS NEOPLASIA, MAINLY IN THOSE THAT PRESENT AN ABNORMAL BILIOPANCREATIC UNION. THE MICROSATELITAL INSTABILITY HAS BEEN FOUND IN A SMALL SUBSET OF PRENEOPLASTIC AND NEOPLASTIC LESIONS. THE EXISTENCE OF METHYLATION IN THE PROMOTOR GENE AREAS HAS BEEN RELATED TO THE CELLULAR PROLIFERATION, INVASION AND METASTASIS AND ALSO IN CASES OF CHRONIC CHOLECYSTITIS, SUGGESTING THAT THIS EPIGENETIC PHENOMENON REPRESENTS A CRUCIAL EARLY EVENT IN GB CARCINOGENESIS. 2010 6 4134 27 MECHANISMS OF HUMAN HEPATOCARCINOGENESIS. THE MAJOR RISK FACTORS AND ETIOLOGICAL AGENTS RESPONSIBLE FOR DEVELOPMENT OF HEPATOCELLULAR CARCINOMA IN HUMANS HAVE BEEN IDENTIFIED AND CHARACTERIZED. AMONG THESE ARE CHRONIC INFECTION WITH HEPATITIS B VIRUS OR HEPATITIS C VIRUS, EXPOSURE TO AFLATOXIN B1, AND CIRRHOSIS OF ANY ETIOLOGY (INCLUDING ALCOHOLIC CIRRHOSIS AND CIRRHOSIS ASSOCIATED WITH GENETIC LIVER DISEASES). BOTH CHRONIC HEPATITIS AND CIRRHOSIS REPRESENT MAJOR PRENEOPLASTIC CONDITIONS OF THE LIVER AS THE MAJORITY OF HEPATOCELLULAR CARCINOMAS ARISE IN THESE PATHOLOGICAL SETTINGS. HEPATOCARCINOGENESIS REPRESENTS A LINEAR AND PROGRESSIVE PROCESS IN WHICH SUCCESSIVELY MORE ABERRANT MONOCLONAL POPULATIONS OF HEPATOCYTES EVOLVE. REGENERATIVE HEPATOCYTES IN FOCAL LESIONS IN THE INFLAMED LIVER (CHRONIC HEPATITIS OR CIRRHOSIS) GIVE RISE TO HYPERPLASTIC HEPATOCYTE NODULES, AND THESE PROGRESS TO DYSPLASTIC NODULES, WHICH ARE THOUGHT TO BE THE DIRECT PRECURSOR OF HEPATOCELLULAR CARCINOMA. IN MOST CASES, THE NEOPLASTIC TRANSFORMATION OF HEPATOCYTES RESULTS FROM ACCUMULATION OF GENETIC DAMAGE DURING THE REPETITIVE CELLULAR PROLIFERATION THAT OCCURS IN THE INJURED LIVER IN RESPONSE TO PARACRINE GROWTH FACTOR AND CYTOKINE STIMULATION. HEPATOCELLULAR CARCINOMAS EXHIBIT NUMEROUS GENETIC ABNORMALITIES (INCLUDING CHROMOSOMAL DELETIONS, REARRANGEMENTS, ANEUPLOIDY, GENE AMPLIFICATIONS, AND MUTATIONS), AS WELL AS EPIGENETIC ALTERATIONS (INCLUDING MODULATION OF DNA METHYLATION). THESE GENETIC AND EPIGENETIC ALTERATIONS COMBINE TO ACTIVATE POSITIVE MEDIATORS OF CELLULAR PROLIFERATION (INCLUDING CELLULAR PROTO-ONCOGENES AND THEIR MITOGENIC SIGNALING PATHWAYS) AND INACTIVATE NEGATIVE MEDIATORS OF CELLULAR PROLIFERATION (INCLUDING TUMOR SUPPRESSOR GENES), RESULTING IN CELLS WITH AUTONOMOUS GROWTH POTENTIAL. HOWEVER, HEPATOCELLULAR CARCINOMAS EXHIBIT A HIGH DEGREE OF GENETIC HETEROGENEITY, SUGGESTING THAT MULTIPLE MOLECULAR PATHWAYS MAY BE INVOLVED IN THE GENESIS OF SUBSETS OF HEPATOCELLULAR NEOPLASMS. CONTINUED INVESTIGATION OF THE MECHANISMS OF HEPATOCARCINOGENESIS WILL REFINE OUR CURRENT UNDERSTANDING OF THE MOLECULAR AND CELLULAR BASIS FOR NEOPLASTIC TRANSFORMATION IN LIVER, ENABLING THE DEVELOPMENT OF EFFECTIVE STRATEGIES FOR PREVENTION AND/OR MORE EFFECTIVE TREATMENT OF HEPATOCELLULAR CARCINOMA. 2003 7 5338 31 QUANTITATIVE EVALUATION OF RASSF1A METHYLATION IN THE NON-LESIONAL, REGENERATIVE AND NEOPLASTIC LIVER. BACKGROUND: EPIGENETIC CHANGES DURING AGEING AND THEIR RELATIONSHIP WITH CANCER ARE UNDER THE FOCUS OF INTENSE RESEARCH. RASSF1A AND NORE1A ARE NOVEL GENES ACTING IN CONCERT IN THE PROAPOPTOTIC PATHWAY OF THE RAS SIGNALLING. WHILE NORE1A HAS NOT BEEN PREVIOUSLY INVESTIGATED IN THE HUMAN LIVER, RECENT REPORTS HAVE SUGGESTED THAT RASSF1A IS FREQUENTLY EPIGENETICALLY METHYLATED NOT ONLY IN HCC BUT ALSO IN THE CIRRHOTIC LIVER. METHODS: TO ADDRESS WHETHER EPIGENETIC CHANGES TAKE PLACE IN CONNECTION TO AGE AND/OR TO THE UNDERLYING DISEASE, WE INVESTIGATED RASSF1A AND NORE1A GENE PROMOTER METHYLATION BY CONVENTIONAL METHYLATION SPECIFIC PCR AND REAL-TIME MSP IN A SERIES OF HEPATITIC AND NON-HEPATITIC LIVERS HARBORING REGENERATIVE/HYPERPLASTIC (CIRRHOSIS/FOCAL NODULAR HYPERPLASIA), DYSPLASTIC (LARGE REGENERATIVE, LOW AND HIGH GRADE DYSPLASTIC NODULES) AND NEOPLASTIC (HEPATOCELLULAR ADENOMA AND CARCINOMA) GROWTHS. RESULTS: IN THE HEPATITIC LIVER (CHRONIC HEPATITIC/CIRRHOSIS, HEPATOCELLULAR NODULES AND HCC) WE FOUND WIDESPREAD RASSF1A GENE PROMOTER METHYLATION WITH A METHYLATION INDEX THAT INCREASED FROM REGENERATIVE CONDITIONS (CIRRHOSIS) TO HEPATOCELLULAR NODULES (P < 0.01) TO HCC (P < 0.001). IN THE NON-HEPATITIC LIVER A CONSISTENT PATTERN OF GENE METHYLATION WAS ALSO FOUND IN BOTH LESIONAL (FOCAL NODULAR HYPERPLASIA AND HEPATOCELLULAR ADENOMA) AND NON-LESIONAL TISSUE. SPECIFICALLY, HEPATOCELLULAR ADENOMAS (HA) SHOWED A METHYLATION INDEX SIGNIFICANTLY HIGHER THAN THAT DETECTED IN FOCAL NODULAR HYPERPLASIA (FNH) (P < 0.01) AND IN NON-LESIONAL TISSUE (P < 0.001). IN NON-LESIONAL LIVER ALSO THE METHYLATION INDEX GRADUALLY INCREASED BY AGEING (P = 0.002), SUGGESTING A PROGRESSIVE SPREADING OF METHYLATED CELLS OVER TIME. AS OPPOSED TO RASSF1A GENE PROMOTER METHYLATION, NORE1A GENE WAS NEVER FOUND EPIGENETICALLY ALTERATED IN BOTH HEPATITIC AND NON-HEPATITIC LIVER. CONCLUSION: WE HAVE SHOWN THAT IN NON-LESIONAL, REGENERATIVE AND NEOPLASTIC LIVER THE RASSF1A GENE IS INCREASINGLY METHYLATED, THAT THIS CONDITION TAKES PLACE AS AN AGE-RELATED PHENOMENON AND THAT THE EARLY SETTING AND SPREADING OVER TIME OF AN EPIGENETICALLY METHYLATED HEPATOCYTE SUBPOPULATION, MIGHT BE RELATED TO LIVER TUMORIGENESIS. 2006 8 4477 25 MOLECULAR PATHOGENESIS OF HUMAN HEPATOCELLULAR CARCINOMA. HEPATOCARCINOGENESIS IS A SLOW PROCESS DURING WHICH GENOMIC CHANGES PROGRESSIVELY ALTER THE HEPATOCELLULAR PHENOTYPE TO PRODUCE CELLULAR INTERMEDIATES THAT EVOLVE INTO HEPATOCELLULAR CARCINOMA. DURING THE LONG PRENEOPLASTIC STAGE, IN WHICH THE LIVER IS OFTEN THE SITE OF CHRONIC HEPATITIS, CIRRHOSIS, OR BOTH, HEPATOCYTE CYCLING IS ACCELERATED BY UPREGULATION OF MITOGENIC PATHWAYS, IN PART THROUGH EPIGENETIC MECHANISMS. THIS LEADS TO THE PRODUCTION OF MONOCLONAL POPULATIONS OF ABERRANT AND DYSPLASTIC HEPATOCYTES THAT HAVE TELOMERE EROSION AND TELOMERASE RE-EXPRESSION, SOMETIMES MICROSATELLITE INSTABILITY, AND OCCASIONALLY STRUCTURAL ABERRATIONS IN GENES AND CHROMOSOMES. DEVELOPMENT OF DYSPLASTIC HEPATOCYTES IN FOCI AND NODULES AND EMERGENCE OF HEPATOCELLULAR CARCINOMA ARE ASSOCIATED WITH THE ACCUMULATION OF IRREVERSIBLE STRUCTURAL ALTERATIONS IN GENES AND CHROMOSOMES, BUT THE GENOMIC BASIS OF THE MALIGNANT PHENOTYPE IS HETEROGENEOUS. THE MALIGNANT HEPATOCYTE PHENOTYPE MAY BE PRODUCED BY THE DISRUPTION OF A NUMBER OF GENES THAT FUNCTION IN DIFFERENT REGULATORY PATHWAYS, PRODUCING SEVERAL MOLECULAR VARIANTS OF HEPATOCELLULAR CARCINOMA. NEW STRATEGIES SHOULD ENABLE THESE VARIANTS TO BE CHARACTERIZED. 2002 9 6310 56 THE REGULATION OF NON-CODING RNA EXPRESSION IN THE LIVER OF MICE FED DDC. MALLORY-DENK BODIES (MDBS) ARE FOUND IN THE LIVER OF PATIENTS WITH ALCOHOLIC AND CHRONIC NONALCOHOLIC LIVER DISEASE, AND HEPATOCELLULAR CARCINOMA (HCC). DIETHYL 1,4-DIHYDRO-2,4,6,-TRIMETHYL-3,5-PYRIDINEDICARBOXYLATE (DDC) IS USED AS A MODEL TO INDUCE THE FORMATION OF MDBS IN MOUSE LIVER. PREVIOUS STUDIES IN THIS LABORATORY SHOWED THAT DDC INDUCED EPIGENETIC MODIFICATIONS IN DNA AND HISTONES. THE COMBINATION OF THESE MODIFICATIONS CHANGES THE PHENOTYPE OF THE MDB FORMING HEPATOCYTES, AS INDICATED BY THE MARKER FAT10. THESE EPIGENETIC MODIFICATIONS ARE PARTIALLY PREVENTED BY ADDING TO THE DIET S-ADENOSYLMETHIONINE (SAME) OR BETAINE, BOTH METHYL DONORS. THE EXPRESSION OF THREE IMPRINTED NCRNA GENES WAS FOUND TO CHANGE IN MDB FORMING HEPATOCYTES, WHICH IS THE SUBJECT OF THIS REPORT. NCRNA EXPRESSION WAS QUANTITATED BY REAL-TIME PCR AND RNA FISH IN LIVER SECTIONS. MICROARRAY ANALYSIS SHOWED THAT THE EXPRESSION OF THREE NCRNAS WAS REGULATED BY DDC: UP REGULATION OF H19, ANTISENSE IGF2R (AIR), AND DOWN REGULATION OF GTL2 (ALSO CALLED MEG3). S-ADENOSYLMETHIONINE (SAME) FEEDING PREVENTED THESE CHANGES. BETAINE, ANOTHER METHYL GROUP DONOR, PREVENTED ONLY H19 AND AIR UP REGULATION INDUCED BY DDC, ON MICROARRAYS. THE RESULTS OF THE SAME AND BETAINE GROUPS WERE CONFIRMED BY REAL-TIME PCR, EXCEPT FOR AIR EXPRESSION. AFTER 1 MONTH OF DRUG WITHDRAWAL, THE EXPRESSION OF THE THREE NCRNAS TENDED TOWARD CONTROL LEVELS OF EXPRESSION. LIVER TUMORS THAT DEVELOPED ALSO SHOWED UP REGULATION OF H19 AND AIR. THE RNA FISH APPROACH SHOWED THAT THE MDB FORMING CELLS' PHENOTYPE CHANGED THE LEVEL OF EXPRESSION OF AIR, H19 AND GTL2, COMPARED TO THE SURROUNDING CELLS. FURTHERMORE, OVER EXPRESSION OF H19 AND AIR WAS DEMONSTRATED IN TUMORS FORMED IN MICE WITHDRAWN FOR 9 MONTHS. THE DYSREGULATION OF NCRNA IN MDB FORMING LIVER CELLS HAS BEEN OBSERVED FOR THE FIRST TIME IN DRUG-PRIMED MICE ASSOCIATED WITH LIVER PRENEOPLASTIC FOCI AND TUMORS. 2009 10 3267 21 HEPATOCELLULAR CARCINOMA AND POSSIBLE CHEMICAL AND BIOLOGICAL CAUSES: A REVIEW. THE DEVELOPMENT OF HEPATOCELLULAR CARCINOMA (HCC) IS A MULTISTEP PROCESS. IN HCC, PROGRESSIVE AND MORPHOLOGICALLY DISTINCT PRENEOPLASTIC LESIONS/ALTERATIONS ASSOCIATED WITH CHRONIC LIVER INJURY, INFLAMMATION, HEPATOCELLULAR DEGENERATION/REGENERATION, NECROSIS, AND SMALL-CELL DYSPLASIA CAN BE OBSERVED. THE INCIDENCE OF HCC EXHIBITS REGIONAL AND ETHNIC DIFFERENCES. SEVERAL CYTOTOXIC AND DNA-DAMAGING CHEMICALS ARE SUGGESTED TO BE THE UNDERLYING CAUSES OF HCC-FOR EXAMPLE, ACRYLAMIDE, PERFLUOROOCTANOIC ACID (PFOA), POLYCHLORINATED BIPHENYLS (PCBS), BENZO(A)PYRENE (BAP), PERFLUORINATED CHEMICALS (PFCS), VINYL CHLORIDE MONOMER (VCM), AND DIETARY CONTAMINANTS (AFLATOXINS, OCHRATOXINS). ALSO SUGGESTED ARE SUBSTANCES OF ABUSE (ALCOHOL) AND BIOLOGICAL AGENTS, SUCH AS HEPATITIS B AND C AND HUMAN IMMUNODEFICIENCY VIRUS 1 (HIV-1). THESE CAN ACT THROUGH GENETIC AND/OR EPIGENETIC MECHANISMS. THIS REVIEW WILL SHORTLY ADDRESS THE GENETIC AND EPIGENETIC MECHANISMS OF HCC AND FOCUS ON CYTOTOXIC AND DNA-DAMAGING CHEMICALS AND BIOLOGICAL AGENTS, EXPOSURE TO WHICH ARE SUGGESTED TO LEAD TO HCC INITIATION, PROMOTION, AND/OR PROGRESSION. 2017 11 6848 28 [MOLECULAR GENETIC AND EPIGENETIC MECHANISMS OF HEPATOCARCINOGENESIS]. HEPATOCELLULAR CARCINOMA (HCC) IS A MAJOR TYPE OF PRIMARY LIVER CANCER AND ONE OF THE MOST FREQUENT HUMAN MALIGNANT NEOPLASMS. COMMON RISK FACTORS OF HUMAN HCC INCLUDE CHRONIC HEPATITIS VIRUS (HBV AND HCV) INFECTION, DIETARY AFLATOXIN B1 (AFB1) INGESTION, CHRONIC ALCOHOL ABUSE, AND CIRRHOSIS ASSOCIATED WITH GENETIC LIVER DISEASES. HEPATOCARCINOGENESIS IS THE RESULT OF INTERACTION BETWEEN HEREDITARY AND ENVIRONMENTAL FACTORS. INHERITANCE DETERMINES INDIVIDUAL SUSCEPTIBILITY TO CANCER; ENVIRONMENT DETERMINES WHICH SUSCEPTIBLE INDIVIDUALS EXPRESS CANCER. STUDIES OF GENETIC AND EPIGENETIC MECHANISMS OF HEPATOCARCINOGENESIS SHOWED THAT HCC DEVELOPMENT IS A COMPLEX POLYGENE AND MULTIPATHWAY PROCESS; THE ACTIVATION OF PROTO-ONCOGENES AND THE INACTIVATION OF TUMOR SUPPRESSOR GENES INDUCED BY GENETIC AND EPIGENETIC ALTERATIONS ARE CORE BIOLOGICAL PROCESSES OF HEPATOCARCINOGENESIS; RB1, P53, AND WNT PATHWAYS ARE COMMONLY AFFECTED IN HCCS OF DIFFERENT ETIOLOGIES, WHICH MAY REFLECT COMMON PATHOLOGIC SEQUENCE OF HCC: CHRONIC LIVER INJURY, CIRRHOSIS, ATYPICAL HYPERPLASTIC NODULES, AND HCC OF EARLY STAGES. HEPATITIS VIRUS INFECTION-ASSOCIATED HCCS HAVE FREQUENT ALTERATIONS IN RB1 PATHWAY, INCLUDING METHYLATION OF P16INK4A AND RB1 GENES AND AMPLIFICATION OF CYCLIN D1. AFB1 EXPOSURE-ASSOCIATED HCCS HAVE FREQUENT ALTERATIONS IN P53 PATHWAY; THE G-->T MUTATION OF P53 GENE AT CODON 249 HAS BEEN IDENTIFIED AS A GENETIC HALLMARK OF HCC CAUSED BY AFB1. ALCOHOLISM-ASSOCIATED HCCS HAVE FREQUENT ALTERATIONS IN BOTH RB1 AND P53 PATHWAYS. THE ROLES OF SOME IMPORTANT GENES RELATED TO CELL APOPTOSIS, DNA REPAIR, DRUG METABOLISM, AND TUMOR METASTASIS IN HEPATOCARCINOGENESIS HAD BEEN DISCUSSED. 2005 12 5969 25 TERT PROMOTER MUTATIONS IN PRIMARY LIVER TUMORS. NEXT-GENERATION SEQUENCING HAS DRAWN THE GENETIC LANDSCAPE OF HEPATOCELLULAR CARCINOMA AND SEVERAL SIGNALING PATHWAYS ARE ALTERED AT THE DNA LEVEL IN TUMORS: WNT/BETA-CATENIN, CELL CYCLE REGULATOR, EPIGENETIC MODIFIER, HISTONE METHYLTRANSFERASE, OXIDATIVE STRESS, RAS/RAF/MAP KINASE AND AKT/MTOR PATHWAYS. HEPATOCARCINOGENESIS IS A MULTISTEP PROCESS STARTING WITH THE EXPOSURE TO DIFFERENT RISK FACTORS, FOLLOWED BY THE DEVELOPMENT OF A CHRONIC LIVER DISEASE AND CIRRHOSIS PRECEDE IN THE VAST MAJORITY OF THE CASES THE DEVELOPMENT OF HCC. SEVERAL LINES OF EVIDENCE HAVE UNDERLINED THE PIVOTAL ROLE OF TELOMERE MAINTENANCE IN BOTH CIRRHOSIS AND HCC PATHOGENESIS. TERT PROMOTER MUTATIONS WERE IDENTIFIED AS THE MOST FREQUENT GENETIC ALTERATIONS IN HEPATOCELLULAR CARCINOMA WITH AN OVERALL FREQUENCY AROUND 60%. MOREOVER, IN CIRRHOSIS, TERT PROMOTER MUTATIONS ARE OBSERVED AT THE EARLY STEPS OF HEPATOCARCINOGENESIS SINCE THEY ARE RECURRENTLY IDENTIFIED IN LOW-GRADE AND HIGH-GRADE DYSPLASTIC NODULES. IN CONTRAST, ACQUISITION OF GENOMIC DIVERSITY THROUGH MUTATIONS OF CLASSICAL ONCOGENES AND TUMOR SUPPRESSOR GENES (TP53, CTNNB1, ARID1A...) OCCURRED ONLY IN PROGRESSED HCC. IN NORMAL LIVER, A SUBSET OF HCC CAN DERIVED FROM THE MALIGNANT TRANSFORMATION OF HEPATOCELLULAR ADENOMA (HCA). IN HCA, CTNNB1 MUTATIONS PREDISPOSE TO TRANSFORMATION OF HCA IN HCC AND TERT PROMOTER MUTATIONS ARE REQUIRED IN MOST OF THE CASES AS A SECOND HIT FOR A FULL MALIGNANT TRANSFORMATION. ALL THESE FINDINGS HAVE REFINED OUR KNOWLEDGE OF HCC PATHOGENESIS AND HAVE POINTED TELOMERASE AS A TARGET FOR TAILORED THERAPY IN THE FUTURE. 2016 13 3134 29 GLOBAL DNA HYPOMETHYLATION IS AN EARLY EVENT IN HELICOBACTER PYLORI-RELATED GASTRIC CARCINOGENESIS. AIM: CANCER, PARTICULARLY GASTRIC CANCER (GC), IS PREVALENTLY AN EPIGENETIC PHENOMENON THAT IS DEPENDENT ON AN ALTERED DNA METHYLATION PATTERN. IN GASTRIC CARCINOGENESIS, MANY GENES SHOW ABERRANT METHYLATION; HOWEVER, NONE OF THEM MAY BE USED AS A BIOMARKER OF CANCER RISK AND PROGRESSION. THE AUTHORS AIMED TO EVALUATE THE GLOBAL DNA METHYLATION OF GASTRIC MUCOSA IN HELICOBACTER PYLORI (HP)-RELATED CHRONIC GASTRITIS, IN GC AND IN 10 PATIENTS WITH PRENEOPLASTIC LESIONS (IE, ATROPHY AND INTESTINAL METAPLASIA) FOLLOWED UP FOR 10 YEARS. METHODS: THE AUTHORS ANALYSED 93 DYSPEPTIC PATIENTS WHO UNDERWENT UPPER ENDOSCOPY, 41 SURGICAL GC SAMPLES AND 10 PATIENTS WITH PRENEOPLASTIC GASTRIC LESIONS FOLLOWED UP FOR 10 YEARS AFTER SUCCESSFUL HP ERADICATION THERAPY. GLOBAL DNA METHYLATION STATUS AND SURROGATE MARKERS OF CELL PROLIFERATION AND APOPTOSIS WERE EVALUATED BY IMMUNOHISTOCHEMISTRY USING THE ANTI-5-METHYLCYTOSINE (5-MC), ANTI-KI-67 AND ANTI-P53 (ANTI-APOPTOTIC MARKER)-SPECIFIC ANTIBODIES, RESPECTIVELY. RESULTS: GLOBAL DNA METHYLATION OF GASTRIC MUCOSA GRADUALLY DECREASED FROM NORMAL MUCOSA TO HP-POSITIVE GASTRITIS, HP-POSITIVE CHRONIC ATROPHIC GASTRITIS, INDEPENDENT OF CAG-A STATUS AND GC; HOWEVER, THE VARIATION WAS SIGNIFICANT (P<0.05) ONLY BETWEEN HP-NEGATIVE SUBJECTS AND HP-POSITIVE CHRONIC GASTRITIS. INTERESTINGLY, THE 5-MC IMMUNOSTAINING WAS ABSENT IN AREAS OF INTESTINAL METAPLASIA. IN THE 10 PATIENTS WITH PRENEOPLASTIC LESIONS, GLOBAL DNA METHYLATION DECREASED OVER TIME DESPITE THE ERADICATION OF HP INFECTION, BUT REACHED SIGNIFICANCE ONLY AT 10 YEARS VERSUS BASELINE. THE 5-MC IMMUNOSTAINING NEGATIVELY CORRELATED WITH KI-67 AND P53 EXPRESSION IN ALL GROUPS. CONCLUSION: GLOBAL DNA HYPOMETHYLATION IS AN EARLY MOLECULAR EVENT IN HP-RELATED GASTRIC CARCINOGENESIS. FURTHER STUDIES WITH MORE CASES AND A LONGER FOLLOW-UP ARE NEEDED TO ESTABLISH THE POTENTIAL GC PREDICTIVE ROLE OF DNA HYPOMETHYLATION. 2011 14 5211 29 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 15 4903 19 P16 PROMOTER HYPERMETHYLATION IN HUMAN HEPATOCELLULAR CARCINOMA WITH OR WITHOUT HEPATITIS VIRUS INFECTION. BACKGROUND: EPIGENETIC ALTERATION THROUGH METHYLATION IS ONE OF THE MOST IMPORTANT STEPS IN CARCINOGENESIS. HOWEVER, THE RELATION BETWEEN HEPATITIS VIRUS INFECTION AND EPIGENETIC ALTERATIONS IS POORLY UNDERSTOOD. METHODS: SIXTEEN PATIENTS WITHOUT HEPATITIS B VIRUS (HBV) AND HEPATITIS C VIRUS (HCV) AND 35 PATIENTS WITH HBV OR HCV WHO UNDERWENT LIVER RESECTION FOR HEPATOCELLULAR CARCINOMA (HCC) WERE STUDIED. MUTATION OF P53 WAS DETECTED BY DIRECT SEQUENCING. METHYLATION STATUS OF P16 WAS EVALUATED IN TUMOR AND NONCANCEROUS LIVER TISSUES BY METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION. RESULTS: IN HCC WITHOUT HBV AND HCV, P53 MUTATIONS WERE DETECTED IN 5 (31%) OF 16 HCCS. METHYLATION OF P16 PROMOTER WAS DETECTED IN 2 (25%) OF 8 MODERATELY DIFFERENTIATED HCCS, 6 (75%) OF 8 POORLY DIFFERENTIATED HCCS, AND NONE OF 16 NONCANCEROUS TISSUE SPECIMENS. IN HCC WITH HBV OR HCV, P53 MUTATIONS WERE DETECTED IN 8 (23%) OF 35 HCCS. METHYLATION OF P16 PROMOTER WAS DETECTED IN 2 (100%) OF 2 WELL-DIFFERENTIATED HCCS, 13 (76%) OF 17 MODERATELY DIFFERENTIATED HCCS, 12 (75%) OF 16 POORLY DIFFERENTIATED HCCS, AND 9 (26%) OF 35 NONCANCEROUS LIVER TISSUE SPECIMENS. CONCLUSIONS: OUR RESULTS SUGGEST THAT HEPATITIS VIRUSES MIGHT INDUCE METHYLATION OF P16 PROMOTER IN LIVER WITH CHRONIC INFLAMMATION, BEFORE APPEARANCE OF HCC. 2004 16 2938 15 GENETIC AND EPIGENETIC ALTERATIONS IN BARRETT'S ESOPHAGUS AND ESOPHAGEAL ADENOCARCINOMA. ESOPHAGEAL ADENOCARCINOMA (EAC) DEVELOPS FROM BARRETT'S ESOPHAGUS (BE), WHEREIN NORMAL SQUAMOUS EPITHELIA IS REPLACED BY SPECIALIZED INTESTINAL METAPLASIA IN RESPONSE TO CHRONIC GASTROESOPHAGEAL ACID REFLUX. BE CAN PROGRESS TO LOW- AND HIGH-GRADE DYSPLASIA, INTRAMUCOSAL, AND INVASIVE CARCINOMA. BOTH BE AND EAC ARE CHARACTERIZED BY LOSS OF HETEROZYGOSITY, ANEUPLOIDY, SPECIFIC GENETIC MUTATIONS, AND CLONAL DIVERSITY. GIVEN THE LIMITATIONS OF HISTOPATHOLOGY, GENOMIC AND EPIGENOMIC ANALYSES MAY IMPROVE THE PRECISION OF RISK STRATIFICATION. ASSAYS TO DETECT MOLECULAR ALTERATIONS ASSOCIATED WITH NEOPLASTIC PROGRESSION COULD BE USED TO IMPROVE THE PATHOLOGIC ASSESSMENT OF BE/EAC AND TO SELECT HIGH-RISK PATIENTS FOR MORE INTENSIVE SURVEILLANCE. 2015 17 3265 25 HEPATOCARCINOMA: GENETIC AND EPIGENETIC FEATURES. HCC IS THE THIRD LEADING CAUSE OF CANCER-RELATED DEATHS WORLDWIDE, ACCOUNTING FOR ABOUT 1 MILLION DEATHS ANNUALLY. THE INCIDENCE OF HCC IS HIGHEST IN ASIA AND AFRICA, WHERE THE ENDEMIC HIGH PREVALENCE OF HEPATITIS B AND HEPATITIS C STRONGLY PREDISPOSES TO THE DEVELOPMENT OF CHRONIC LIVER DISEASE AND SUBSEQUENT DEVELOPMENT OF HCC. PATIENTS WITH HCC GENERALLY PRESENT AT AN ADVANCED STAGE DUE TO COMPENSATED CIRRHOSIS DEFINED BY THE ABSENCE OF PATHOGNOMONIC SYMPTOMS, RESULTING IN DEATH WITHIN 6 TO 20 MONTHS, SUGGESTING AN URGENT NEED IN TREATMENT MODALITIES THAT WILL DRAMATICALLY DECREASE THE MORTALITY RATE OF HCC. THE MOLECULAR HEPATOCARCINOGENESIS IS, HOWEVER, A GRADUAL PROCESS DURING WHICH GENETIC ALTERATIONS PROGRESSIVELY ACCUMULATE AND LEAD TO HCC THROUGH INTERMEDIATE PRENEOPLASTIC STAGES. WITH THE ADVENT OF WHOLE GENOME SEQUENCING TOOLS, VARIOUS MUTATIONS ASSOCIATED WITH HCC HAVE BEEN IDENTI FI ED, WHICH HAVE ADVANCED OUR MOLECULAR UNDERSTANDING OF HCC. HOWEVER, THE FREQUENCY OF THESE MUTATIONS IS RARE, AND THESE GENETIC MUTATIONS ONLY PARTLY EXPLAIN THE ETIOLOGY OF THE DISEASE. BETTER UNDERSTANDING AND CHARACTERIZATION OF NOVEL GENETIC AND EPIGENETIC ALTERATIONS, WHICH ARE IMPORTANT TO HEPATOCARCINOGENESIS, MAY HELP UNDERSTAND THE MOLECULAR PATHOGENESIS OF HCC, AS WELL AS PROVIDING NOVEL THERAPEUTIC TARGETS FOR HCC TREATMENT. FURTHER CONSIDERATION SHOULD BE GIVEN TO DEVELOPING MORE EFFECTIVE MOLECULAR DIAGNOSTIC MARKERS AND TARGETED DRUG THERAPY. 2018 18 4476 20 MOLECULAR PATHOGENESIS OF HEPATOCELLULAR CARCINOMA. HEPATOCELLULAR CARCINOMA (HCC) IS THE FIFTH MOST COMMON CANCER AND THE THIRD LEADING CAUSE OF CANCER DEATH WORLDWIDE. HEPATOCARCINOGENESIS IS A MULTISTEP PROCESS EVOLVING FROM NORMAL THROUGH CHRONIC HEPATITIS/CIRRHOSIS AND DYSPLASTIC NODULES TO HCC. WITH ADVANCES IN MOLECULAR METHODS, THERE IS A GROWING UNDERSTANDING OF THE MOLECULAR MECHANISMS IN HEPATOCARCINOGENESIS. HEPATOCARCINOGENESIS IS STRONGLY LINKED TO INCREASES IN ALLELIC LOSSES, CHROMOSOMAL CHANGES, GENE MUTATIONS, EPIGENETIC ALTERATIONS AND ALTERATIONS IN MOLECULAR CELLULAR PATHWAYS. SOME OF THESE ALTERATIONS ARE ACCOMPANIED BY A STEPWISE INCREASE IN THE DIFFERENT PATHOLOGICAL DISEASE STAGES IN HEPATOCARCINOGENESIS. OVERALL, A DETAILED UNDERSTANDING OF THE UNDERLYING MOLECULAR MECHANISMS INVOLVED IN THE PROGRESSION OF HCC IS OF FUNDAMENTAL IMPORTANCE TO THE DEVELOPMENT OF EFFECTIVE PREVENTION AND TREATMENT REGIMES FOR HCC. 2008 19 1042 20 CLINICAL AND MOLECULAR BASIS OF HEPATOCELLULAR CARCINOMA AFTER HEPATITIS C VIRUS ERADICATION. HEPATOCELLULAR CARCINOMA (HCC) ARISES IN THE BACKGROUND OF CHRONIC LIVER DISEASES, INCLUDING HEPATITIS AND LIVER CIRRHOSIS CAUSED BY HEPATITIS C VIRUS (HCV) INFECTION. IT IS WELL KNOWN THAT HCV ERADICATION USING ANTIVIRAL DRUGS CAN EFFICIENTLY INHIBIT HEPATOCARCINOGENESIS. RECENT ADVANCES IN AND DEVELOPMENT OF DIRECT-ACTING ANTIVIRAL (DAA) DRUGS HAS REVOLUTIONIZED THE TREATMENT OF HCV INFECTION, AND THE VAST MAJORITY OF HCV PATIENTS CAN ACHIEVE HCV ERADICATION USING DAAS. HOWEVER, MOUNTING EVIDENCE CLEARLY INDICATES THAT HCC INEVITABLY OCCURS IN A SUBSET OF PATIENTS AFTER SUCCESSFUL VIRAL ERADICATION USING DAA THERAPY. CANCER IS A GENETIC DISEASE, AND THE ACCUMULATION OF GENETIC AND EPIGENETIC ABERRATIONS MAY CAUSE HEPATOCARCINOGENESIS IN CHRONICALLY DAMAGED LIVER, EVEN AFTER VIRUS ELIMINATION. IN THIS REVIEW, WE HIGHLIGHT HCC DEVELOPMENT AFTER HCV ERADICATION AND DISCUSS THE CURRENT UNDERSTANDING OF THE MOLECULAR MECHANISMS OF TUMORIGENESIS AFTER VIRUS ELIMINATION, FOCUSING ON THE GENETIC AND EPIGENETIC BACKGROUND OF CHRONICALLY DAMAGED LIVER TISSUES. 2022 20 824 30 CHARACTERIZATION OF COPY NUMBER ALTERATIONS IN A MOUSE MODEL OF FIBROSIS-ASSOCIATED HEPATOCELLULAR CARCINOMA REVEALS CONCORDANCE WITH HUMAN DISEASE. HEPATOCELLULAR CARCINOMA (HCC) IS A PREVALENT HUMAN CANCER WITH RISING INCIDENCE WORLDWIDE. HUMAN HCC IS FREQUENTLY ASSOCIATED WITH CHRONIC LIVER INFLAMMATION AND CIRRHOSIS, PATHOPHYSIOLOGICAL PROCESSES THAT ARE A CONSEQUENCE OF CHRONIC VIRAL INFECTION, DISTURBANCES IN METABOLISM, OR EXPOSURE TO CHEMICAL TOXICANTS. TO BETTER CHARACTERIZE THE PATHOGENESIS OF HCC, WE USED A HUMAN DISEASE-RELEVANT MOUSE MODEL OF FIBROSIS-ASSOCIATED HEPATOCARCINOGENESIS. IN THIS MODEL, MARKED LIVER TUMOR RESPONSE CAUSED BY THE PROMUTAGENIC CHEMICAL N-NITROSODIETHYLAMINE IN THE PRESENCE OF LIVER FIBROSIS WAS ASSOCIATED WITH EPIGENETIC EVENTS INDICATIVE OF GENOMIC INSTABILITY. THEREFORE, WE HYPOTHESIZED THAT DNA COPY NUMBER ALTERATIONS (CNAS), A FEATURE OF GENOMIC INSTABILITY AND A COMMON CHARACTERISTIC OF CANCER, ARE CONCORDANT BETWEEN HUMAN HCC AND MOUSE MODELS OF FIBROSIS-ASSOCIATED HEPATOCARCINOGENESIS. WE EVALUATED DNA CNAS AND CHANGES IN GENE EXPRESSION IN THE MOUSE LIVER (NORMAL, TUMOR, AND NONTUMOR FIBROTIC TISSUES). ADDITIONALLY, WE COMPARED OUR FINDINGS TO DNA CNAS IN HUMAN HCC CASES (TUMOR AND NONTUMOR CIRRHOTIC/FIBROTIC TISSUES) USING PUBLICLY AVAILABLE DATA FROM THE CANCER GENOME ATLAS (TCGA). WE OBSERVED THAT WHILE FIBROTIC LIVER TISSUE IS LARGELY DEVOID OF DNA CNAS, HIGHLY FREQUENTLY OCCURRING DNA CNAS ARE FOUND IN MOUSE TUMORS, WHICH IS INDICATIVE OF A PROFOUND INCREASE IN CHROMOSOMAL INSTABILITY IN HCC. THE CROSS-SPECIES GENE-LEVEL COMPARISON OF CNAS IDENTIFIED SHARED REGIONS OF CNAS BETWEEN HUMAN FIBROSIS- AND CIRRHOSIS-ASSOCIATED LIVER TUMORS AND MOUSE FIBROSIS-ASSOCIATED HCC. OUR RESULTS SUGGEST THAT CNAS MOST COMMONLY ARISE IN NEOPLASTIC TISSUE RATHER THAN IN FIBROTIC OR CIRRHOTIC LIVER, AND DEMONSTRATE THE UTILITY OF THIS MOUSE MODEL IN REPLICATING THE MOLECULAR FEATURES OF HUMAN HCC. 2016