Clinical and histopathological variation in hepatocellular carcinoma.

OBJECTIVES To assess clinical and histopathological variation in hepatocellular carcinoma from different endemic zones and to relate such variation to current putative pathogenic mechanisms of carcinogenesis. METHODS Review of pertinent English language articles with emphasis on regional differences as they relate to our objectives. RESULTS Clinical presentation of hepatocellular carcinoma is variable in different endemic zones. Such different features may depend on the interaction of different etiological initiators and, probably, promoters that can lead to different genetic aberrations. Similarly, there also may be histopathological variation. However, it is difficult to clearly delineate such differences, in part, because of lack of uniformity in reporting interpretation of histological data in the literature. And, the ethnic origin of patients is not always noted in middle and low endemic zones of hepatocellular carcinoma. CONCLUSIONS Distinction in clinical and histopathological variation in hepatocellular carcinoma may benefit from delineating the ethnic origin of subjects included in studies and from adoption of clear uniform terminology for benign, indeterminate, and malignant lesions.