Ouyang Wei, Wang Ming-Da, Wang Wan-Yin, Li Chao, Yao Lan-Qing, Zhu Hong, Yang Tian
Department of Medical Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Navy Medical University (Second Military Medical University), Shanghai, China.
J Oncol. 2023 Feb 9;2023:5449443. doi: 10.1155/2023/5449443. eCollection 2023.
Hepatocellular carcinoma (HCC) is a highly lethal and heterogeneous malignancy with multiple genetic alternations and complex signaling pathways. The complexity and multifactorial nature of HCC pose a tremendous challenge regarding its diagnosis and treatment. Emerging evidence has indicated an important regulatory role of epigenetic modifications in HCC initiation and progression. Epigenetic modifications are stably heritable gene expression traits caused by changing the accessibility of chromatin structure and genetic activity without alteration in the DNA sequence and have been gradually recognized as a hallmark of cancer. In addition, accumulating data suggest a potential value of altered hydroxymethylation in epigenetic modifications and therapeutics targeting the epigenetically mediated regulation. As such, probing the epigenetic field in the era of precision oncology is a valid avenue for promoting the accuracy of early diagnosis and improving the oncological prognosis of HCC patients. This review focuses on the diagnostic performance and clinical utility of 5-hydroxymethylated cytosine, the primary intermediate product of the demethylation process, for early HCC diagnosis and discusses the promising applications of epigenetic-based therapeutic regimens for HCC.
肝细胞癌（HCC）是一种具有高度致死性且异质性的恶性肿瘤，存在多种基因改变和复杂的信号通路。HCC的复杂性和多因素性质对其诊断和治疗构成了巨大挑战。新出现的证据表明表观遗传修饰在HCC的发生和发展中起重要调节作用。表观遗传修饰是由染色质结构可及性和基因活性改变引起的稳定可遗传的基因表达特征，而DNA序列不变，并且已逐渐被视为癌症的一个标志。此外，越来越多的数据表明羟甲基化改变在表观遗传修饰和靶向表观遗传介导调控的治疗中具有潜在价值。因此，在精准肿瘤学时代探索表观遗传领域是提高早期诊断准确性和改善HCC患者肿瘤预后的有效途径。本综述重点关注去甲基化过程的主要中间产物5-羟甲基化胞嘧啶在早期HCC诊断中的诊断性能和临床应用，并讨论基于表观遗传学的治疗方案在HCC中的应用前景。
