Platelets, Microenvironment and Hepatocellular Carcinoma

Liver cancer is the fifth most frequent cancer globally, ranks second among the causes of death from all cancer and hepatocellular carcinoma (HCC) is the most common type of cancer of the liver. The increasing risk of HCC is attributed tochronic hepatitis Cinfection and subsequent cirrhosis, fatty liver disease and alcoholrelated cirrhosis. A vast majority of HCC develops with fibrosis and in the background of cirrhosis. Surveillance of cirrhotic patients is a critical approach to detect early-stage HCC which is generally asymptomatic, and so many patients tend to be diagnosed at intermediate or late-stage of tumor. 

There are no treatment options to reverse the development of advanced HCC, and patients with untreated advanced tumors have an overall survival rate of 7 months, whereas with the use of the only FDA approved systemic therapy, multikinase inhibitor Sorafenib, overall survival rate increased up to 10 months. The needto find new markers in early-stage diagnosis of HCC and generate new approaches for therapies underlies the importance of better understanding tumor formation. In this review we focus on the importance of tumor microenvironment and stress the microenvironmental role of platelets in HCC.