Macrotrabecular-Massive Hepatocellular Carcinoma: Light and Shadow in Current Knowledge
Anna Sessa, Sebastien Mulé, Raffaele Brustia, Hélène Regnault, Athena Galletto Pregliasco, Rami Rhaiem, Vincent Leroy, Danièle Sommacale, Alain Luciani, Julien Caldéraro, Giuliana Amaddeo
Abstract
The subject of this narrative review is macrotrabecular-massive hepatocellular carcinoma (MTM-HCC). Despite their rarity, these tumours are of general interest because of their epidemiological and clinical features and for representing a distinct model of the interaction between the angiogenetic system and neoplastic cells. The MTM-HCC subtype is associated with various adverse biological and pathological parameters (the Alfa-foetoprotein (AFP) serum level, tumour size, vascular invasion, and satellite nodules) and is a key determinant of patient prognosis, with a strong and independent predictive value for early and overall tumour recurrence. Gene expression profiling has demonstrated that angiogenesis activation is a hallmark feature of MTM-HCC, with overexpression of both angiopoietin 2 (ANGPT2) and vascular endothelial growth factor A (VEGFA).