Published online Nov 7, 2018. doi: 10.3748/wjg.v24.i41.4643
Peer-review started: July 5, 2018
First decision: August 25, 2018
Revised: September 4, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: November 7, 2018
Autophagy is a “self-degradative” process and is involved in the maintenance of cellular homeostasis and the control of cellular components by facilitating the clearance or turnover of long-lived or misfolded proteins, protein aggregates, and damaged organelles. Autophagy plays a dual role in cancer, including in tumor progression and tumor promotion, suggesting that autophagy acts as a double-edged sword in cancer cells. Liver cancer is one of the greatest leading causes of cancer death worldwide due to its high recurrence rate and poor prognosis. Especially in China, liver cancer has become one of the most common cancers due to the high infection rate of hepatitis virus. In primary liver cancer, hepatocellular carcinoma (HCC) is the most common type. Considering the perniciousness and complexity of HCC, it is essential to elucidate the function of autophagy in HCC. In this review, we summarize the physiological function of autophagy in cancer, analyze the role of autophagy in tumorigenesis and metastasis, discuss the therapeutic strategies targeting autophagy and the mechanisms of drug-resistance in HCC, and provide potential methods to circumvent resistance and combined anticancer strategies for HCC patients.
Core tip: Liver cancer seriously threatens human health, due to its high recurrence rate and poor prognosis. Hepatocellular carcinoma is the most common type of primary liver cancer. Autophagy plays a dual role in cancer. Basic autophagy exerts a tumor suppression function by maintaining genomic stability in normal cells. When cancer occurs, activated autophagy benefits cancer cell survival and promotes cancer development. However, the mechanism and function of autophagy in human cancers, especially liver cancer, have not been clarified. We summarize the physiological function of autophagy and its role in tumorigenesis, metastasis, targeted therapy and drug-resistance in hepatocellular carcinoma.