Molecular bases for the development of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)

hepatocellular carcinoma (HCC) is the most common histological form of prim ary liver cancer, the tumor cells having retained features of hepatocytic d ifferentiation. It is important to emphasize the heterogenity of the histol ogical background on which the tumor develops. Most HCCs complicate the evo lution of an active or inactive cirrhosis.(1-4) However, some tumors occur on livers with minimal histological changes,(5) the prevalence of such case s varies from one geographical region to the other, being much higher in th e southern half of Africa (around 40% of HCCs) than in Asia, America and Eu rope, where at least 90% of HCCs are associated in the cirrhosis. This hete rogeneity is probably a reflection of different environmental and molecular studies have indeed clearly demonstrated the prime importance of environme ntal factors to the development of primary liver cancers in humans. Chronic hepatitis B (HBV) and C (HCV) infections are major risk factors. This revi ew will mainly analyse the impact of chronic HBV infection but it is import ant to emphasize the potential synergistic effects between HBV and HCV, as well as between viral infections and other environmental factors, such as a lcohol, chemical carcinogens (see review by Dr Wogan) and other, still poor ly defined, hormonal factors which may account for the higher incidence of the tumor in man. Finally the review by Dr Buendia highlights the emerging issue of liver-cancer genetics. (C) 2000 Academic Press.