الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma is the commonest primary cancer of the liver and the incidence is increasing as HCC has risen to become the fifth commonest malignancy worldwide and the third leading cause of cancer related death beside that HCC carries a very bad prognosis as the 5-year survival rate less than 5% in all HCC cases.
Hepatocarcinogenesis is multistep process and this process may be induced by any risk factors that predispose to HCC. Hepatocarcinogenesis may be mediated by multiple mechanisms but eventually all the mechanisms of HCC pathogenesis can create conditions that increases the chance of generating hepatocytes population containing critical combinations of structurally and functionally aberrant genes.
There’s multiple risk factors for HCC and these risk factors can be classified into 1- Environmental risk factors as chronic hepatitis B and hepatitis C virus 2- Metabolic risk factors as diabetes mellitus and non-alcoholic fatty liver disease 3- Hereditary risk factors as haemochromatosis and others.
Some of the HCC risk factors could lead to dysregulation of important molecular cellular signaling pathways. This dysregulation may lead to malignant transformation by inducing alteration in many important genes as genes coding for proteins that control the cell cycle, cell growth, inflammatory response and others.
There are multiple regulatory pathways dysregulated in HCC, for example: TGF-β signaling pathway, Wnt/β-catenin signaling pathway, Toll like receptor signaling pathway, Notch signaling pathway, IGF signaling pathway, HGF signaling pathway and others.
The curative options for earlier stages of HCC are surgical resection followed by liver transplantation. However only 12% of patients are eligible for surgical intervention because most HCC patients are diagnosed at a late stage. So numerous experimental strategies are aiming to trigger the dysregulated signaling pathway in HCC for early diagnosis and a wide range of curative non surgical treatment.
Conclusion
There are multiple mechanisms underlying the hepatocarcinogenesis and by awaring these mechanisms, early diagnosis for HCC could be possible.
Understanding the signaling pathways dysregulated in high risk groups for HCC may provide new diagnostic and therapeutic modalities.