Hepatocellular Carcinoma (HCC) is a major worldwide public health concern. Despite recent advances, there has been little success in improving the survival of HCC patients. It is the fifth most common cancer and the third leading cause of cancer deaths worldwide. In Middle Eastern countries, the prevalence of this cancer is low compared to Sub-Saharan Africa and some other Far East countries, but it is still a major concern among men, especially in Egypt and Saudi Arabia. The symptoms are hepatic mass, abdominal pain and, in advanced stages, jaundice, cachexia, and liver failure. The major risk factors for HCC are chronic hepatitis B virus (HBV) infection, chronic hepatitis C virus (HCV) infection, prolonged dietary aflatoxin exposure, alcoholic cirrhosis, and cirrhosis due to other causes.
The most commonly offered therapy is transcatheter arterial chemoembolization (TACE). It is performed by an interventional radiologist who selectively cannulates the feeding artery to the tumor and delivers high local doses of chemotherapy. In early stages, the patients will be suitable for potentially curative treatments: surgical resection, liver transplantation, and percutaneous ablation.
HCC results from interactions between individual genomic background and environmental factors, showing a polygenic pattern. The malignant phenotype is heterogeneous, and is produced by the disruption of a number of genes that function in different regulatory pathways, producing several molecular variants of HCC. Comparative genomic hybridization and SNP arrays have identified chromosomal aberrations, including gains in chromosomes 1q, 6p, 8q, 17q, and 20q; and losses in 4q, 8p, 13q, 16q, and 17p.