Pathophysiology of HCC

Histopathological features that lead to the initiation and progression of HCC are poorly understood. Tissue microenvironment plays a major role in this process. Interaction of a variety of cell types in the tumor stroma with extracellular matrix components lead to the acquisition of an abnormal phenotype that promotes tumor formation. It has also been demonstrated that hypoxia enhances progression, and metastasis of HCC. Activation of epithelial-mesenchymal transition, oxidative stress, and inflammation also play major roles in tumor progression. Furthermore, cells with ‘stem-like’ features, termed cancer stem cells, are also present in the liver during HCC that promote tumor growth.