Hepatocellular carcinoma and hepatitis B surface protein

The tumorigenesis of hepatitis B virus(HBV)-associated hepatocellular carcinoma(HCC) has been widely studied. HBV envelope proteins are important for the structure and life cycle of HBV, and these proteins are useful for judging the natural disease course and guiding treatment. Truncated and mutated pre S/S are produced by integrated viral sequences that are defective for replication. The pre S/S mutants are considered "precursor lesions" of HCC. Different pre S/S mutants induce various mechanisms of tumorigenesis, such as transactivation of transcription factors and an immune inflammatory response, thereby contributing to HCC. The pre S2 mutants and type Ⅱ "Ground Glass" hepatocytes represent novel biomarkers of HBVassociated HCC. The pre S mutants may induce the unfolded protein response and endoplasmic reticulum stress-dependent and stress-independent pathways. Treatments to inhibit hepatitis B surface antigen(HBs Ag) and damage secondary to HBs Ag or the pre S/S mutants include antivirals and antioxidants, such as silymarin, resveratrol, and glycyrrhizin acid. Methods for the prevention and treatment of HCC should be comprehensive.