Published online Oct 7, 2015. doi: 10.3748/wjg.v21.i37.10584
Peer-review started: March 27, 2015
First decision: April 24, 2015
Revised: May 8, 2015
Accepted: September 2, 2015
Article in press: September 2, 2015
Published online: October 7, 2015
Hepatocellular carcinoma (HCC) is a primary cancer of the liver that is predominant in developing countries and is responsible for nearly 600000 deaths each year worldwide. Similar to many other tumors, the development of HCC must be understood as a multistep process involving the accumulation of genetic and epigenetic alterations in regulatory genes, leading to the activation of oncogenes and the inactivation or loss of tumor suppressor genes. Extensive research over the past decade has identified a number of molecular biomarkers, including aberrant expression of HCC-related genes and microRNAs. The challenge facing HCC research and clinical care at this time is to address the heterogeneity and complexity of these genetic and epigenetic alterations and to use this information to direct rational diagnosis and treatment strategies. The multikinase inhibitor sorafenib was the first molecularly targeted drug for HCC to show some extent of survival benefits in patients with advanced tumors. Although the results obtained using sorafenib support the importance of molecular therapies in the treatment of HCC, there is still room for improvement. In addition, no molecular markers for drug sensitivity, recurrence and prognosis are currently clinically available. In this review, we provide an overview of recently published articles addressing HCC-related genes and microRNAs to update what is currently known regarding genetic and epigenetic aspects of the pathogenesis of HCC and propose novel promising candidates for use as diagnostic and therapeutic targets in HCC.
Core tip: Despite the large number of studies dedicated to the molecular diagnosis of hepatocellular carcinoma (HCC), highly sensitive biomarkers of the initiation and progression of HCC still need to be identified. At the same time, the development of novel molecular targeting agents that can surpass the effect of the multikinase inhibitor sorafenib is much-anticipated. This review aimed to update our knowledge of genetic and epigenetic aspects of HCC by providing an overview of novel HCC-related genes and microRNAs as candidates for use as diagnostic and therapeutic targets in HCC.