Review Article
Molecular Classification of Hepatocellular Adenomas
Table 1
Genotype/phenotype classification of hepatocellular adenomas.
| | Group | % | Genetic alteration | Pathway dysregulated | mRNA markers | Protein markers | Clinical association | Histological phenotype |
| HNF1A-mutated
HCA | 30–45% | HNF1A | Tumor
suppressor
gene | Activation of glycolysis, fatty acid synthesis, and mTor pathway | Decrease
LFABP1
UGT2B7 | lack of
LFABP1 expression | Adenomatosis and association with MODY 3 diabetes (HNF1A germline mutation) | Diffuse
steatosis
|
| CTNNB1-mutated
HCA* | 10–15% | CTNNB1 | Oncogene | Activation of
Wnt/catenin pathway | Increase
GLUL
LGR5 | overexpression of
glutamine synthase
and nuclear
β-catenin | Risk of malignant transformation
Male | Cell atypia and cholestasis |
| Inflammatory
HCA* | 40–55% | IL6ST (65%) | Oncogene | Activation of JAK/STAT
pathway
(“oncogene-induced inflammation”) | Increase
SAA
CRP | SAA and CRP over-expression
| Obesity and high alcohol intake
Inflammatory syndrome | Inflammatory infiltrate
Sinusoidal dilatation
Dystrophic
arteries | | STAT3 (6%) | | GNAS (5%) | | Unknown (24%) |
| | Unclassified | 10% | Unknown |
|
|
50% of CTNNB1-mutated adenomas are also inflammatory.
|
