4.3 Review

Hepatocellular Carcinoma Chemoprevention with Generic Agents

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Letter Gastroenterology & Hepatology

Global prediction of primary liver cancer incidences and mortality in 2040

Chenxi Li et al.

JOURNAL OF HEPATOLOGY (2023)

Review Gastroenterology & Hepatology

Fibrosis Stage-specific Incidence of Hepatocellular Cancer After Hepatitis C Cure With Direct-acting Antivirals: A Systematic Review and Meta-analysis

Nicole J. Kim et al.

Summary: Pooled estimates from meta-analysis showed that the incidence of hepatocellular carcinoma (HCC) after sustained virologic response (SVR) in patients with cirrhosis was very high (2.99/100 person-years). However, this incidence may decline with longer time after SVR. In patients without cirrhosis, including those with F3 fibrosis, the incidence of HCC was lower than the thresholds for cost-effective HCC screening. There was little heterogeneity among studies in patients with F3 fibrosis, suggesting that HCC screening may not be warranted.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2023)

Review Energy & Fuels

Neoadjuvant Immunotherapy for Hepatocellular Carcinoma

Thomas U. Marron et al.

Summary: The treatment paradigm for hepatocellular carcinoma has recently improved with new combinations of targeted and immunotherapies. Studies have shown that perioperative immunotherapy can significantly improve outcomes for patients with resectable HCC.
Article Gastroenterology & Hepatology

Molecular Signature Predictive of Long-Term Liver Fibrosis Progression to Inform Antifibrotic Drug Development

Tongqi Qian et al.

Summary: This study developed a surrogate biomarker to predict liver fibrosis progression and evaluated the effectiveness of antifibrotic drugs. Results showed that a 20-gene surrogate biomarker could accurately predict fibrosis progression within 5 years. Furthermore, rational combination therapies based on epigallocatechin gallate were identified and validated for enhanced antifibrotic effect. This biomarker has potential clinical significance for the development of antifibrotics.

GASTROENTEROLOGY (2022)

Article Gastroenterology & Hepatology

HCC incidence after hepatitis C cure among patients with advanced fibrosis or cirrhosis: A meta-analysis

Ian Lockart et al.

Summary: HCV cure reduces the risk of HCC in patients with F3 fibrosis or cirrhosis. Incidence of HCC decreases over time after HCV cure and is influenced by factors such as age and prior decompensation.

HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Effect of diabetes medications and glycemic control on risk of hepatocellular cancer in patients with nonalcoholic fatty liver disease

Jennifer R. Kramer et al.

Summary: Patients with NAFLD and diabetes have a high risk of developing HCC. The study found that the use of metformin was associated with a reduced risk of developing HCC, while combination therapy was associated with an increased risk. Glycemic control can be a useful biomarker for stratifying HCC risk in these patients.

HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Aspirin use and risk of hepatocellular carcinoma in patients with chronic hepatitis B with or without cirrhosis

Heejoon Jang et al.

Summary: This study found that aspirin use is associated with reduced risks of HCC and liver-associated mortality in patients with chronic hepatitis B. However, this association is not evident in patients with cirrhosis.

HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Angiotensin-converting enzyme inhibitors prevent liver-related events in nonalcoholic fatty liver disease

Xinrong Zhang et al.

Summary: The use of ACEI is associated with a lower risk of liver cancer and cirrhosis complications in patients with NAFLD, especially among those with chronic kidney diseases (CKDs).

HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Estimating Global Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease in Overweight or Obese Adults

Jiaye Liu et al.

Summary: This study estimated the global prevalence of MAFLD in overweight and obese adults to be 50.7%. Male had a significantly higher MAFLD prevalence than female, and comorbidities such as type 2 diabetes and metabolic syndrome were found to have high prevalence rates.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

Review Biology

The clinical management of hepatocellular carcinoma worldwide: A concise review and comparison of current guidelines: 2022 update

Ningyuan Wen et al.

Summary: This review provides an updated summary of comprehensive guidelines on the clinical management of HCC worldwide. By comparing different guidelines and summarizing diagnostic and treatment algorithms, it helps target efforts to improve the clinical management of HCC. However, further studies are needed to enhance the management and outcomes of HCC.

BIOSCIENCE TRENDS (2022)

Article Gastroenterology & Hepatology

S-adenosylmethionine inhibits la ribonucleoprotein domain family member 1 in murine liver and human liver cancer cells

Komal Ramani et al.

Summary: Our study identified a SAMe-sensitive mechanism of LARP1 phosphorylation that may be involved in the progression from NASH to HCC.

HEPATOLOGY (2022)

Review Medicine, General & Internal

Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Janelle M. Guirguis-Blake et al.

Summary: Low-dose aspirin is effective in primary cardiovascular disease prevention, reducing the risk of major cardiovascular events. However, its effectiveness in preventing colorectal cancer is uncertain and it may increase the risk of major bleeding.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2022)

Article Gastroenterology & Hepatology

Aspirin Use and the Risk of Hepatocellular Carcinoma A Meta-analysis

Yikai Wang et al.

Summary: The use of aspirin is associated with a lower risk of liver cancer. Aspirin reduces the risk of HCC in Asian and Western populations, as well as after hepatitis B and C virus infections. It also has protective effects on people with chronic liver disease and the general population.

JOURNAL OF CLINICAL GASTROENTEROLOGY (2022)

Article Gastroenterology & Hepatology

Metformin treatment rescues CD8+T-cell response to immune checkpoint inhibitor therapy in mice with NAFLD

Simon Wabitsch et al.

Summary: Non-alcoholic steatohepatitis (NASH) negatively affects the efficacy of immune checkpoint inhibitor (ICI) therapy in hepatocellular carcinoma (HCC). This study reveals that NASH alters the metabolism, function, and motility of hepatic CD8+ T cells, leading to reduced responsiveness to anti-PD-1 treatment. The efficacy can be rescued by metformin treatment.

JOURNAL OF HEPATOLOGY (2022)

Review Gastroenterology & Hepatology

BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update

Maria Reig et al.

Summary: There have been significant advances in the treatment strategies for hepatocellular carcinoma since the last update in 2018. However, some interventions still lack sufficient data for clinical incorporation, and personalized clinical management requires consideration of multiple parameters.

JOURNAL OF HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Impact of metformin use on risk and mortality of hepatocellular carcinoma in diabetes mellitus

Qiaomei Li et al.

Summary: The use of metformin in diabetic patients is significantly associated with reduced risk and all-cause mortality of HCC.

CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY (2022)

Article Gastroenterology & Hepatology

A Meta-Analysis of Statin Use and Risk of Hepatocellular Carcinoma

Yikai Wang et al.

Summary: This meta-analysis study found that the use of statins is closely associated with a lower risk of liver cancer. Statin users, both in Asian and Western populations, have a reduced risk of developing hepatocellular carcinoma. Statins also have protective effects after hepatitis B and hepatitis C virus infections. In addition, statins are beneficial for individuals with chronic liver disease and the general population. Lipophilic statins have a significant preventive effect on hepatocellular carcinoma, while hydrophilic statins do not show a clear effect.

CANADIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Perioperative nivolumab monotherapy versus nivolumab plus ipilimumab in resectable hepatocellular carcinoma: a randomised, open-label, phase 2 trial

Ahmed Omar Kaseb et al.

Summary: This study aimed to evaluate the safety and tolerability of perioperative immunotherapy in patients with resectable hepatocellular carcinoma. The findings suggest that nivolumab alone or in combination with ipilimumab is safe and feasible in this patient population, supporting further studies of immunotherapy in the perioperative setting for hepatocellular carcinoma.

LANCET GASTROENTEROLOGY & HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Neoadjuvant cemiplimab for resectable hepatocellular carcinoma: a single-arm, open-label, phase 2 trial

Thomas U. Marron et al.

Summary: This study evaluated the clinical activity of neoadjuvant cemiplimab in patients with resectable hepatocellular carcinoma. The results showed that treatment with cemiplimab resulted in significant tumor necrosis and partial response in some patients. Adverse events were common but severe adverse events were rare. These findings contribute to further understanding the clinical benefit of preoperative PD-1 blockade in patients with hepatocellular carcinoma.

LANCET GASTROENTEROLOGY & HEPATOLOGY (2022)

Editorial Material Medicine, General & Internal

Aspirin use is associated with reduced risk for hepatocellular carcinoma

Ronald L. Koretz

ANNALS OF INTERNAL MEDICINE (2022)

Article Cell Biology

Changing global epidemiology of liver cancer from 2010 to 2019: NASH is the fastest growing cause of liver cancer

Daniel Q. Huang et al.

Summary: Liver cancer epidemiology is changing due to factors such as increasing alcohol consumption, rising obesity rates, and advancements in hepatitis B and C treatment. The Global Burden of Disease study estimated global and regional trends in liver cancer burden, revealing a 25% increase in liver cancer deaths between 2010 and 2019. Non-alcoholic steatohepatitis (NASH) and alcohol were found to have the fastest growing death rates, while hepatitis B and C showed declines. Urgent measures are needed globally to address metabolic risk factors and slow the growing burden of NASH-associated liver cancer, particularly in the Americas.

CELL METABOLISM (2022)

Review Endocrinology & Metabolism

The burden and risks of emerging complications of diabetes mellitus

Dunya Tomic et al.

Summary: The traditional complications of diabetes mellitus have been well-known, but emerging evidence suggests the existence of a different set of complications. Cancer and dementia have become the leading causes of death in people with diabetes, replacing vascular disease. Additionally, diabetes has been linked to a range of comorbidities, including cognitive decline, functional disability, affective disorders, obstructive sleep apnoea, and liver disease. There is currently no comprehensive review summarizing the burden and risks of these emerging complications.

NATURE REVIEWS ENDOCRINOLOGY (2022)

Article Cell Biology

Molecular signatures of long-term hepatocellular carcinoma risk in nonalcoholic fatty liver disease

Naoto Fujiwara et al.

Summary: This study analyzed multiple cohorts of NAFLD patients globally to define and validate signatures predictive of long-term HCC risk in NAFLD patients. These signatures can accurately predict the risk of developing HCC in patients and provide assistance for clinical treatment.

SCIENCE TRANSLATIONAL MEDICINE (2022)

Article Medicine, Research & Experimental

Hepatocellular carcinoma chemoprevention by targeting the angiotensin-converting enzyme and EGFR transactivation

Emilie Crouchet et al.

Summary: This study developed a simple human cell-based system that successfully predicted liver disease progression and HCC risk, and identified captopril as a potential drug for HCC chemoprevention. The results showed that captopril effectively reduced liver fibrosis and prevented the development of HCC in preclinical models. Mechanistic data revealed that captopril suppressed several signaling pathways related to fibrogenesis, inflammation, and carcinogenesis, including the EGFR pathway. Clinical data demonstrated that captopril could reverse the high-risk status of HCC in liver tissues with advanced fibrosis.

JCI INSIGHT (2022)

Article Medicine, General & Internal

Risk of Hepatocellular Carcinoma With Tenofovir vs Entecavir Treatment for Chronic Hepatitis B Virus A Reconstructed Individual Patient Data Meta-analysis

Darren Jun Hao Tan et al.

Summary: This study conducted a reconstructed individual patient data meta-analysis to provide robust estimates for the comparative hepatocellular carcinoma (HCC) risk between patients receiving tenofovir or entecavir. The results showed that tenofovir was associated with decreased HCC incidence compared with entecavir. However, there was no significant difference in the analysis of clinical cohort studies. The mean time to HCC development was slightly longer for patients receiving tenofovir compared to those receiving entecavir in administrative database studies.

JAMA NETWORK OPEN (2022)

Review Biochemistry & Molecular Biology

The Emerging Role of Branched-Chain Amino Acids in Liver Diseases

Emily Kwun Kwan Lo et al.

Summary: Branched-chain amino acids (BCAAs) are related to chronic liver diseases, but BCAA supplementation has positive effects on cirrhosis and hepatocellular carcinoma (HCC) patients. This review aims to clarify the contradictory claims and study the role of BCAAs in liver health.

BIOMEDICINES (2022)

Article Gastroenterology & Hepatology

Associations between six dietary habits and risk of hepatocellular carcinoma: A Mendelian randomization study

Yunyang Deng et al.

Summary: This study used Mendelian randomization to explore the potential causal associations between dietary habits and hepatocellular carcinoma (HCC) risk in an East Asian population. The findings showed potential causal associations between six dietary habits and HCC risk, providing evidence for the impact of dietary habits on HCC in clinical practice.

HEPATOLOGY COMMUNICATIONS (2022)

Review Oncology

Neoadjuvant Immunotherapy for Hepatocellular Carcinoma

Thomas U. Marron et al.

Summary: The treatment paradigm for hepatocellular carcinoma has improved with the introduction of new combinations of targeted and immunotherapies. However, the majority of patients who undergo surgical resection develop recurrent HCC and there is currently no perioperative therapy that significantly improves survival. Recent studies suggest that neoadjuvant immunotherapy may be a promising approach for patients with resectable HCC.

JOURNAL OF HEPATOCELLULAR CARCINOMA (2022)

Article Gastroenterology & Hepatology

Atorvastatin favorably modulates a clinical hepatocellular carcinoma risk gene signature

Myung-Ho Kim et al.

Summary: The study found that lipophilic statins, especially atorvastatin, can more significantly suppress the activation of YAP and AKT pathways, which are associated with liver cancer development. Atorvastatin also attenuates a high-risk clinical prognostic liver signature in models of hepatitis C and nonalcoholic fatty liver disease. These findings suggest that atorvastatin is the most potent statin in reducing the risk of liver cancer in patients with viral and metabolic liver diseases.

HEPATOLOGY COMMUNICATIONS (2022)

Article Gastroenterology & Hepatology

Targeting clinical epigenetic reprogramming for chemoprevention of metabolic and viral hepatocellular carcinoma

Frank Juhling et al.

Summary: The study found that patients with chronic viral hepatitis and NASH share similar epigenetic and transcriptional modifications driving cancer risk. Chromatin readers were identified as targets to revert liver gene transcription in patients, reducing the risk of HCC. Proof-of-concept studies in a NASH-HCC mouse model showed that inhibiting chromatin reader bromodomain 4 can inhibit liver disease progression and hepatocarcinogenesis.
Review Oncology

Serum Vitamin D Levels and Risk of Liver Cancer: A Systematic Review and Dose-Response Meta-Analysis of Cohort Studies

Yonggui Zhang et al.

Summary: This systematic review and dose-response meta-analysis found that individuals with higher serum vitamin D levels had a significantly lower risk of liver cancer, with a linear association between vitamin D levels and the risk. This suggests an inverse relationship between serum vitamin D levels and the risk of liver cancer.

NUTRITION AND CANCER-AN INTERNATIONAL JOURNAL (2021)

Article Gastroenterology & Hepatology

Do renin-angiotensin system inhibitors reduce risk for hepatocellular carcinoma?: A nationwide nested case-control study

Kwang Min Kim et al.

Summary: This study did not find a significant overall association between RASi use and HCC development, but lower incidence of HCC was observed in some subgroups, indicating a possible beneficial effect at higher cumulative RASi doses.

CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY (2021)

Review Medicine, General & Internal

Stratification of Hepatocellular Carcinoma Risk Following HCV Eradication or HBV Control

Pierre Nahon et al.

Summary: The incidence of hepatocellular carcinoma has decreased in patients infected with HCV and HBV thanks to antiviral drugs, but those with advanced fibrosis or cirrhosis still face risk. Predictors of cancer in virus-free patients include comorbidities, liver inflammation, and non-invasive test results, allowing for stratification and surveillance. International guidelines recommend lifelong monitoring with ultrasound, and further research into more effective surveillance tools is needed for personalized management.

JOURNAL OF CLINICAL MEDICINE (2021)

Article Medicine, General & Internal

Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease

Arun J. Sanyal et al.

Summary: In this study involving patients with nonalcoholic fatty liver disease, advanced fibrosis stages F3 and F4 were associated with increased risks of liver-related complications and death over a median of 4 years of follow-up. Advanced fibrosis was also related to an increased incidence of liver decompensation events.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Review Oncology

Aspirin in Hepatocellular Carcinoma

Emanuela Ricciotti et al.

Summary: Aspirin shows promise as a preventative agent for cancer, particularly in individuals at high risk of colorectal cancer due to Lynch syndrome and in reducing the risk of sporadic colorectal cancer. Additionally, it has been shown to have a beneficial effect as a chemopreventive or adjuvant therapeutic agent in hepatocellular carcinoma (HCC).

CANCER RESEARCH (2021)

Article Gastroenterology & Hepatology

Cancer Risk in Patients With Biopsy-Confirmed Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study

Tracey G. Simon et al.

Summary: The study found that cancer incidence is significantly increased in patients with NAFLD, primarily driven by HCC, while the contribution of extrahepatic cancers is modest. The incidence rate of HCC increases with categories of simple steatosis, nonfibrotic NASH, noncirrhotic fibrosis, and cirrhosis, with additional risk from diabetes.

HEPATOLOGY (2021)

Article Gastroenterology & Hepatology

State-Level HCC Incidence and Association With Obesity and Physical Activity in the United States

Yi-Te Lee et al.

Summary: This study identified wide state-level racial/ethnic disparities in HCC incidence, with over half of the states experiencing increasing rates. Additionally, there were moderate correlations between HCC incidence trends and state-level obesity as well as lack of physical activity, suggesting interventions targeting these factors may help curb rising HCC incidence.

HEPATOLOGY (2021)

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Cancer statistics for the year 2020: An overview

Jacques Ferlay et al.

Summary: The study briefly reviews the methods and data sources used in compiling the IARC GLOBOCAN cancer statistics for 2020 and summarizes the main results. It estimated that there were nearly 19.3 million new cancer cases and almost 10 million cancer deaths worldwide in 2020, with the most commonly diagnosed cancers being female breast cancer and lung cancer, and the most common causes of cancer death being lung cancer and liver cancer.

INTERNATIONAL JOURNAL OF CANCER (2021)

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The Mortality and Overall Survival Trends of Primary Liver Cancer in the United States

Yi-Te Lee et al.

Summary: In the United States, the mortality rates of primary liver cancer have started to decline, but continue to increase in American Indian and Alaska Native populations, individuals aged 65 years or older, and in 33 states. The detection rate of localized HCC has increased, leading to improved overall survival rates for HCC over the past few decades.

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE (2021)

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Thymosin alpha-1 therapy improves postoperative survival after curative resection for solitary hepatitis B virus-related hepatocellular carcinoma A propensity score matching analysis

He Linye et al.

Summary: Thymosin alpha-1 (T alpha 1) as an adjuvant therapy improves the prognosis of solitary HBV-related HCC patients after curative liver resection, showing better recurrence-free survival (RFS) and overall survival (OS) rates.

MEDICINE (2021)

Review Gastroenterology & Hepatology

Systematic review with meta-analysis: The effects of non-steroidal anti-inflammatory drugs and anti-platelet therapy on the incidence and recurrence of hepatocellular carcinoma

Regina Zi Hwei Tan et al.

Summary: The use of aspirin is supported in at-risk individuals to reduce the incidence of HCC and liver-related mortality, while NSAID treatment was associated with lower HCC recurrence following treatment.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS (2021)

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Novel deep learning-based transcriptome data analysis for drug-drug interaction prediction with an application in diabetes

Qichao Luo et al.

Summary: A novel deep learning model was developed for predicting DDI using transcriptome data from the L1000 database, demonstrating superior performance and accelerating the discovery of new DDIs to support safer and more effective drug co-prescription in future clinical research.

BMC BIOINFORMATICS (2021)

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Circulating Fatty Acids Associated with Advanced Liver Fibrosis and Hepatocellular Carcinoma in South Texas Hispanics

Jingjing Jiao et al.

Summary: The study showed that low plasma concentrations of VLC n-3 PUFAs and VLC SFAs were strongly associated with advanced liver fibrosis and HCC in the Hispanic population of South Texas, with genetic factors also playing a role in the low concentrations of these FAs.

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Thiazolidinediones, alpha-glucosidase inhibitors, meglitinides, sulfonylureas, and hepatocellular carcinoma risk: A meta-analysis

Ashwini Arvind et al.

Summary: This study found that thiazolidinediones may reduce the incidence of HCC in Asians with type 2 diabetes, while alpha-glucosidase inhibitors and sulfonylureas may slightly increase the risk of HCC. Future research should investigate whether these drugs should be avoided in patients with chronic liver disease.

METABOLISM-CLINICAL AND EXPERIMENTAL (2021)

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A human liver cell-based system modeling a clinical prognostic liver signature for therapeutic discovery

Emilie Crouchet et al.

Summary: The lack of suitable models for clinical translation hampers drug and target discovery for advanced liver disease. The authors present a human liver cell-based system modeling a clinical prognostic signature, proposing nizatidine for treatment of advanced liver fibrosis and hepatocellular carcinoma prevention. This research identifies urgently needed targets and therapeutics for treatment of advanced liver disease and cancer prevention.

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Association of dietary fat intake and hepatocellular carcinoma among US adults

Iman Moussa et al.

Summary: This study found an inverse association between monounsaturated fatty acid intake and hepatocellular carcinoma (HCC) risk, and a direct association between total polyunsaturated fatty acid intake and HCC risk. Omega-6 PUFA intake was directly associated with HCC risk, while long-chain omega-3 PUFA intake was inversely associated with HCC risk. No significant association was observed for saturated fat and HCC risk.

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Efficacy and safety of ravidasvir plus sofosbuvir in patients with chronic hepatitis C infection without cirrhosis or with compensated cirrhosis (STORM-C-1): interim analysis of a two-stage, open-label, multicentre, single arm, phase 2/3 trial

Hideki Ishikawa et al.

Summary: In low-income and middle-income countries, there is an urgent need for affordable direct-acting antivirals to treat hepatitis C virus (HCV) infection. The combination of ravidasvir and sofosbuvir has shown efficacy and safety in patients with chronic HCV genotype 4 infection. The STORM-C-1 trial confirmed the effectiveness and tolerability of ravidasvir plus sofosbuvir in a diverse adult population with chronic HCV infection, providing a potential tool for large-scale implementation to eliminate HCV as a cause of morbidity and mortality.

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Ram C. Shankaraiah et al.

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Peter R. Galle et al.

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Mice lacking liver-specific β-catenin develop steatohepatitis and fibrosis after iron overload

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lncRNA HULC promotes the growth of hepatocellular carcinoma cells via stabilizing COX-2 protein

Haojun Xiong et al.

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Thomas F. Baumert et al.

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Sahil Mittal et al.

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Angiotensin receptor blockers improve survival outcomes after radiofrequency ablation in hepatocarcinoma patients

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Branched-Chain Amino Acids Prevent Hepatocarcinogenesis and Prolong Survival of Patients With Cirrhosis

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