A hepatocellularis carcinoma (HCC) igen rossz prognózisú daganat, azonban diagnosztikája és kezelése területén az utóbbi években jelentős előrehaladás történt. Mindehhez hozzájárult a HCC molekuláris patogenezisének mélyebb megismerése. A cirrhosis talaján kialakult HCC praemalignus elváltozásai a nagy regeneratív nodulus, az alacsony („low”) és magas („high”) fokozatú diszplasztikus nodulus. Mikroszkóposan a WHO trabecularis (micro-, macrotrabecularis), acinaris (pseudoglandularis,), scirrhosus és szolid formát különít el, speciális altípusként a világos sejtes, fibrolamellaris és kevert cholangiohepatocellularis szöveti forma ismert. Ezen szövettani típusok prognosztikai jelentősége vitatott. A fibrolamellaris, fiatalokban előforduló, nem cirrhoticus HCC-t jobb prognózisúnak tartják, bár valószínű, hogy ez annak a következménye, hogy ezen típust cirrhosis nem kíséri. A diagnózist segíthetik egyes, a szérumban és a daganatban is kimutatható tumormarkerek, így a jól ismert alfa-fetoprotein (AFP) mellett a glipikán-3 és a survivin, az újabban leírt agrin és claudinok, valamint a májsejteredetet bizonyító hepatocytaspecifikus antigén (HSA). Újabban az úgynevezett mikro-RNS-ek diagnosztikus jelentősége, elsősorban a májsejtspecifikus mir-122-é is felmerült. A HCC molekuláris osztályozása, a kezelés irányait is megszabó barcelonai beosztás (BCLC) mellett, kulcsfontosságú molekuláris eltérések alapján csoportosítja a HCC-t. Számos olyan molekuláris alteráció észlelhető, amely minden HCC-ben megfigyelhető, míg egyes eltérések csak bizonyos tumorokban detektálhatók.
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