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The prognosis of hepatocellular carcinoma(HCC)stillremains dismal,although many advances in its clinicalstudy have been made.It is important for tumor control toidentify the factors that predispose patients to death.Withnew discoveries in cancer biology,the pathological andbiological prognostic factors of HCC have been studied quiteextensively.Analyzing molecular markers(biomarkers)withprognostic significance is a complementary method.A largenumber of molecular factors have been shown to associatewith the invasiveness of HCC,and have potential prognosticsignificance.One important aspect is the analysis ofmolecular markers for the cellular malignancy phenotype.These include alterations in DNA ploidy,cellularproliferation markers(PCNA,Ki-67,Mcm2,MIB1,MIA,andCSE1L/CAS protein),nuclear morphology,the p53 geneand its related molecule MDM2,other cell cycle regulators(cyclin A,cyclin D,cyclin E,cdc2,p27,p73),oncogenesand their receptors(such as res,c-myc,c-fms,HGF,c-met,and erb-B receptor family members),apoptosisrelated factors(Fas and FasL),as well as telomerassactivity.Another important aspect is the analysis ofmolecular markers involved in the process of cancerinvasion and metastasis.Adhesion molecules(E-cadherin,catenins,serum intercellular adhesion molecule-1,CD44variants),proteinases involved in the degradation ofextracellular matrix(MMP-2,MMP-9,uPA,uPAR,PAI),aswell as other molecules have been regarded as biomarkersfor the malignant phenotype of HCC,and are related toprognosis and therapeutic outcomes.Tumor angiogenesisis critical to both the growth and metastasis of cancersincluding HCC,and has drawn much attention in recentyears.Many angiogenesis-related markers,such as vascularendothelial growth factor(VEGF),basic fibroblast growthfactor(bFGF),platelet-derived endothelial cell growth factor(PD-ECGF),thrombospondin(TSP),angiogenin,pleiotrophin,and endostatin(ES)levels,as well asinratumor microvessel density(MVD)have been evaluatedand found to be of prognostic significance.Body fluid(particularly blood and urinary)testing for biomarkers iseasily accessible and useful in clinical patients.Theprognostic significance of circulating DNA in plasma orserum,and its genetic alterations in HCC are otherimportant trends.More attention should be paid to thesetwo areas in future.As the progress of the human genomeproject advances,so does a clearer understanding of tumorbiology,and more and more new prognostic markers withhigh sensitivity and specificity will be found and used in clinical assays.However,the combination of some items,i.e.,the pathological features and some biomarkersmentioned above,seems to be more practical for now.
The prognosis of hepatocellular carcinoma (HCC) stillremains dismal, although many advances in its clinical study have been made. It is important for tumor control to identify the factors that predispose patients to death. New discovery discoveries in cancer biology, the pathological and biologic prognostic factors of HCC have has been quite comprehensively studied. A significant number of molecular factors have been shown to associate with the invasiveness of HCC, and have potential prognosticsignificance. One important aspect is the analysis ofmolecular markers for the cellular malignancy phenotype These include alterations in DNA ploidy, cellularproliferation markers (PCNA, Ki-67, Mcm2, MIB1, MIA, andCSE1L / CAS protein), nuclear morphology, the p53 gene and its related molecule MDM2, other cell cycle regulators (cyclin A, cyclin D , cyclin E, cdc2, p27, p73), oncogenes and their receptors (such as res, c-myc, c-fms, HGF, c-met, and erb- ily members), apoptosisrelated factors (Fas and FasL), as well as telomerassactivity. Another important aspect is the analysis of molecular markers involved in the process of cancer invasion and metastasis. Adhesion molecules (E-cadherin, catenins, serum intercellular adhesion molecule- 1, CD44variants), proteinases involved in the degradation of extracellular matrix (MMP-2, MMP-9, uPA, uPAR, PAI), aswell as other molecules have been considered as biomarkers for the malignant phenotype of HCC, and are related to topognologic and therapeutic outcomes. Tumor angiogenesis is critical to both the growth and metastasis of cancers including HCC, and has drawn much attention in recent years. Many angiogenesis-related markers such as vascularendothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), platelet-derived endothelial cell growth factor PD-ECGF), thrombospondin (TSP), angiogenin, pleiotrophin, and endostatin (ES) levels, as well as inratumor microvessel densitygnificance.Body fluid (particularly blood and urinary) testing for biomarkers iseasily accessible and useful in clinical patients. The prognostic significance of circulating DNA in plasma orserum, and its genetic alterations in HCC are othotortant trends. More attention should be paid to thesetwo areas in future . The progress of the human genome project advances, so does a clearer understanding of tumor biology, and more and more new prognostic markers with high sensitivity and specificity will be found and used in clinical assays. Yet, the combination of some items, ie, the pathological features and some biomarkers payable above, seems to be more practical for now.