What can be learned from molecular diagnostic techniques and genetic signatures?

Liver cancer is a disease characterized by a long latency during which hepatocytes pass through a continual process of damage and regeneration leading to accumulation of genetic aberrations. Although several genes and signalling pathways involved in cell proliferation and differentiation have been implicated in hepatocellular carcinoma (HCC), widespread gaps still exist in our understanding of the molecular mechanisms of hepatocarcinogenesis. Microarray technology is a widely applied tool for studying the pathogenesis of HCC and the identification of genes, which could translate into novel diagnostic tools and therapeutic targets. Many studies have reported unique gene expression profiles in HCC that can identify transition from mild to moderate liver fibrosis and can recognize, at an early stage, dysplastic nodules likely to transform into hepatocellular tumours. This review highlights recent contributions of the microarray technology in advancing our knowledge of the molecular alterations observed at different stages of hepatocellular carcinogenesis. In the future, specific gene expression profiles can possibly predict micro-metastasis or early recurrence after resection of HCC for a better patient outcome.