Published online Sep 15, 2021. doi: 10.4251/wjgo.v13.i9.1144
Peer-review started: May 8, 2021
First decision: June 16, 2021
Revised: June 29, 2021
Accepted: July 29, 2021
Article in press: July 29, 2021
Published online: September 15, 2021
Processing time: 125 Days and 11.8 Hours
Hepatocellular carcinoma (HCC) is one of the most prevalent cancers worldwide, accounting for approximately 75%-85% of primary liver cancers. Metabolic alterations have been labeled as an emerging hallmark of tumors. Specially, the last decades have registered a significant improvement in our understanding of the role of metabolism in driving the carcinogenesis and progression of HCC. In this paper, we provide a review of recent studies that investigated the metabolic traits of HCC with a specific focus on three common metabolic alterations involving glycolysis, lipid metabolism, and glutamine addiction which have been gaining much attention in the field of HCC. Next, we describe some representative diagnostic markers or tools, and promising treatment agents that are proposed on the basis of the aforementioned metabolic alterations for HCC. Finally, we present some challenges and directions that may promisingly speed up the process of developing objective diagnostic markers and therapeutic options underlying HCC. Specifically, we recommend future investigations to carefully take into account the influence of heterogeneity, control for study-specific confounds, and invite the validation of existing biomarkers.
Core Tip: Metabolic activities play a crucial role in promoting tumor transformation and progression. In the current review, we present a summary of recent advances investigating the metabolic traits of hepatocellular carcinoma (HCC) with a specific focus on three common metabolic alterations involving glycolysis, lipid metabolism, and glutamine addiction, and describe some representative diagnostic markers or tools, and promising treatment agents. Moreover, challenges related to the existence of great heterogeneity in HCC, the ignorance of study-related confounders, and a lack of validation of proposed markers are discussed.