New evidence on the link between alcohol consumption and aggressive liver cancer

Although excessive alcohol consumption is a well-known risk factor for liver cancer, the precise mechanisms by which alcohol contributes to the development of alcoholic hepatocellular carcinoma (A-HCC) remain unclear.

This review, published in the journal of Hepatology, provides a comprehensive summary of the pathogenesis, heterogeneity, preclinical approaches, epigenetic and genetic profiles of A-HCC. Compared to other types of liver cancer, A-HCC is often diagnosed at later stages, when the disease is more advanced. This is due in part to the lack of available screening tools for individuals with alcoholic liver disease (ALD).

“A-HCC is a serious public health problem,” says Yaojie Fu, lead author of the review. “Our work highlights the importance of understanding how alcohol and its metabolites contribute to this aggressive form of liver cancer. By exploring the unique characteristics of A-HCC, we hope to develop better diagnostic tools and treatment options."

There is a strong association between alcohol consumption and the risk of A-HCC. People who drink a lot of alcohol are at a much higher risk of developing this aggressive form of liver cancer. However, the exact reasons why alcohol contributes to the development of A-HCC are not fully understood.

Compared with hepatocellular carcinoma (HCC) of other etiologies, A-HCC is often diagnosed at a later stage, when the disease is more advanced. This may be explained by the lack of available screening methods for individuals with ALD. In this regard, the authors suggested that HCC screening and surveillance among patients with alcoholic cirrhosis, as well as more precise risk stratification methods, are critical for early intervention in A-HCC.

Ethanol and its metabolites, epigenetic modifications, various types of metabolic changes, immunosuppressive tumor microenvironment (TME) and oncogenic signaling pathways contribute to the development of alcohol-induced hepatocellular carcinoma (A-HCC).
Source: Fu, Yaojie, Maccioni, Luca, Wang, Xin Wei, Greten, Tim F, Gao, Bin.

In this review, the authors also discussed the potential role of genetics in the development of A-HCC. Single nucleotide polymorphisms (SNPs) of certain specific genes may alter the risk of alcoholic cirrhosis and susceptibility to A-HCC. However, more research is needed to decipher the potential mechanisms by which SNPs influence the progression of A-HCC.

Moreover, the review also highlights the molecular mechanisms and heterogeneity of A-HCC. The development of better preclinical models is critical for a better understanding of the characteristics, as well as for the prevention and personalized therapy of A-HCC in clinical practice.