Cirrhosis: A Questioned Risk Factor for Hepatocellular Carcinoma

Trends Cancer. 2021 Jan;7(1):29-36. doi: 10.1016/j.trecan.2020.08.005. Epub 2020 Sep 8.

Abstract

The liver is one of the major metabolic organs in the body, susceptible to injury caused by various factors. In response to injury, sophisticated mechanisms are engaged to repair and regenerate the damaged liver, preventing its failure. When the damage is chronic, regeneration goes awry, impairing liver function and causing cirrhosis. Hence, cirrhosis may rather be a protective response to injury, where wound-healing processes are set to primarily repair the damaged liver. Although cirrhosis is clinically considered a risk factor for hepatocellular carcinoma (HCC), comprehensive population-based studies demonstrate a very modest incidence, refuting the idea that cirrhosis progresses to HCC. Here, we discuss and shed light on the provocative question of whether cirrhosis predisposes to HCC.

Keywords: cirrhosis; fibrosis; hepatic progenitor cells; hepatic stellate cells; hepatocellular carcinoma; immunosurveillance; myofibroblasts; regeneration; regenerative nodules.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Carcinogenesis / genetics
  • Carcinogenesis / pathology
  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / genetics
  • Carcinoma, Hepatocellular / pathology
  • Disease Models, Animal
  • Disease Progression
  • Genetic Predisposition to Disease
  • Humans
  • Liver / pathology*
  • Liver Cirrhosis / epidemiology*
  • Liver Cirrhosis / genetics
  • Liver Cirrhosis / pathology
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / genetics
  • Liver Neoplasms / pathology
  • Liver Regeneration / genetics*
  • Mice
  • Mice, Transgenic
  • Protective Factors
  • Risk Factors