Hepatocellular carcinoma (HCC) is one of the most lethal cancers worldwide, representing also the main cause of death among cirrhotic patients. In contrast to most other solid tumors, the underlying cirrhotic liver disease in HCC patients greatly impairs tumor related prognosis, conferring this neoplasm a unique situation, in which accurate prognostic prediction is a relevant and unmet need.Although clinical staging systems have improved significantly and now comprise tumor characteristics, liver function and patient performance status, the integration of molecular data into these algorithms is still hypothetical.Molecular profiling of HCC has led to a better understanding of the physiopathology of this neoplasm and has allowed developing novel therapeutic approaches (e.g. molecular targeted therapies) for a tumor previously considered as therapy-refractory. Integrative analysis of different reported genomic datasets has revealed common subclasses between different studies, highlighting their biological relevance in HCC. Gene signatures derived from tumors and from the adjacent tissue have been able to differentiate subclasses with different outcomes and have been proposed as potential predictive markers in the clinical setting. Genomic characterization of surrounding non-tumor tissue might be of particular interest to identify patients at high risk of developing HCC and therefore to select those patients that would benefit of potential chemopreventive strategies.Epigenetic analyses (methylation and miRNA profiling) are adding up to the knowlegde derived from gene expression data and should not be forgotten in the molecular diagnosis of HCC. Integrative analyses of genetic and epigenetic information of the tumor and the surrounding tissue should be used to identify novel biomarkers and therapeutic targets in HCC, to improve existing treatment algorithms and to eventually design a more personalized medicine in this devastating disease.

中文翻译：

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肝细胞癌的诊断和预后分子标志物。

肝细胞癌（HCC）是全球最致命的癌症之一，也是肝硬化患者死亡的主要原因。与大多数其他实体瘤相比，HCC 患者的潜在肝硬化严重损害了肿瘤相关的预后，赋予这种肿瘤一种独特的情况，其中准确的预后预测是相关且未满足的需求。尽管临床分期系统已经显着改善，现在包括肿瘤特征、肝功能和患者体能状态，将分子数据整合到这些算法中仍然是假设性的。 HCC 的分子分析使人们更好地了解这种肿瘤的病理生理学，并允许开发新的治疗方法（例如 分子靶向治疗）用于先前被认为是治疗难治的肿瘤。对不同报告的基因组数据集的综合分析揭示了不同研究之间的共同子类，突出了它们在 HCC 中的生物学相关性。源自肿瘤和邻近组织的基因特征能够区分具有不同结果的亚类，并已被提议作为临床环境中的潜在预测标志物。周围非肿瘤组织的基因组特征可能对识别发生 HCC 的高风险患者特别感兴趣，因此可以选择那些将受益于潜在化学预防策略的患者。表观遗传分析（甲基化和 miRNA 分析）正在积累来自基因表达数据的知识，不应在 HCC 的分子诊断中被遗忘。应使用对肿瘤和周围组织的遗传和表观遗传信息的综合分析来确定 HCC 的新生物标志物和治疗靶点，改进现有的治疗算法，并最终设计出针对这种破坏性疾病的更加个性化的药物。