**2. Epidemiology and etiology**

HCC has a multifactorial etiology, and its incidence and prevalence varies by country [7]. Although the incidence of HCC is different in different geographies, the incidence increases with age [8]. It is more common in men than in

women (male:female ratio; ranging between 2:1 and 4:1 in various countries). Cirrhosis, viral hepatitis, alcohol, aflatoxin, metabolic diseases, metabolic syndrome characterized by fatty liver are the main causes of HCC etiology. Although the activation of the WNT/B-catenin pathway is one of the main events in HCC, the effects of viral antigens on the nucleus, mutations, and DNA instability constitute the pathogenesis of HCC [9]. There are also molecular studies showing that activation of the JAK/STAT pathway also contributes to the development of SH-HCC [1, 10].
