Hepatocellular carcinoma (HCC) is a major health problem with a high incidence and mortality all over the world. The current ability to increase the survival of patients with HCC relies upon clinical surveillance, which allows HCC precursors and malignant tumors to be recognized at an earlier stage making cure possible. In this paper we will report the main histopathological criteria to discriminate between HCC precursors and well differentiated HCC, with attention to the role of immunohistochemical markers.

Over time, many staging and scoring systems have been proposed for the classification and prognosis of patients with HCC. A complete system for HCC classification nowadays should include multifunctional and phenotypic characteristics of the tumor, the general health of the patient and the potential therapeutic approaches available. The second part of the paper is devoted to an overview of the current staging systems for HCC.

Genetic studies of tumor samples and the use of newer molecular approaches such as non coding RNA and genome-wide association studies, according to immunohistochemistry, proteomics and clinical criteria are highlighting the variability that exists among diverse HCC. Identification of new target pathways for the treatment of HCC by more personalized and targeted regimens are the main goals of the current translational medical research. The third part of the paper focuses on the molecular aspects of HCC.