Primary liver cancer is one of the most life-threatening malignant tumors

and is the sixth leading cancer by incidence worldwide. Hepatocellular carcinoma (HCC) is the most common pathological type of primary liver cancer. The development of HCC is a complex process involving the interaction of environmental carcinogenic factors such as virus

alcohol

and chemicals with host genetic factors. Many chronic liver diseases (CLDs) such as hepatitis B and C and alcoholic and nonalcoholic fatty liver diseases may develop into HCC. The development of HCC in various liver diseases has etiology-specific mechanisms and synergistic effects

and the progression of these CLDs to liver cirrhosis is an independent risk factor for HCC. On the basis of genetic changes

oxidative damage

in⁃flammation

and matrix fibrosis and with the interaction of various cells as well as the participation of cell growth fac⁃tors

chemokines

transcriptional factors

and a variety of signaling pathways

hepatocytes gradually acquire the char⁃acteristics of rapid proliferation

immune escape

angiogenesis

and invasion and metastasis

eventually forming HCC. The in-depth study of the pathogenesis of HCC is not only important for identifying therapeutic targets to im⁃prove the survival and prognosis of patients with HCC

but is also significant for the prevention and treatment of the disease by preventing the risk factors of HCC.