**5. Conclusion**

Hepatocellular carcinoma is a malignancy having multifactorial etiology and a very complex pathogenesis, that make difficult the clinical management of HCC patients. Similarly to the other kinds of cancer, HCC insurgence, progression and recurrence involve gene mutations, that might be different depending on the individual genotype profiling and tumor stage, and different signaling pathways, which often share some crucial molecules/steps and are subjected to additional post-transductional regulation. To overcome the complex network of signaling pathways and gene mutations underlying hepatic cancer, innovative diagnostic, prognostic and therapeutic strategies are needed. Nowadays, each existing biomarker used or proposed for HCC early diagnosis, staging and prognosis alone is poorly specific and the absolute positive and negative serological and/or immunohistochemical markers are still lacking. Even those markers selected for high sensitivity and specificity do not exhibit an universal diagnostic/prognostic value, also due to the individual genotype variability. The more promising approach for developing more specific diagnostic/prognostic tools might be to combine several positive or negative indicators in multiparametric platforms, that allow simultaneous detection of multiple serological or immunohistochemical markers for HCC. These platforms might be used to design "specific maps" for HCC early diagnosis, staging and prognosis, also taking into account the individual variability of each patient. Detecting expression patterns of combined biomarkers may also be a new method useful for identifying new and unique markers.

Moreover, since target-specific cancer therapy has remarkably improved the outcomes of patients and represents the frontline approach for cancer treatment, the development of such multiparametric platforms would also represent a high-performance technological tools useful for designing personalized therapies, adapted to the aggressiveness of each individual tumor. The final goal should be to discriminate, for each target-specific therapy and on the basis of the "biomarker profiling" of each patient, the "responder" to the "not responder", thus increasing the therapeutic effectiveness, improving patient outcomes, and resulting in saving healthcare costs. Thus, the discovery and validation of new HCC biomarkers useful for early diagnosis and prognosis, such as the NGF, and for target therapy and drug delivery, such as the CD44, as well as the deepening of knowledge on pathways actively involved in hepatocarcinogenesis, helpful for HCC staging and targetspecific cancer therapy, such as the WNT/β-catenin signaling, are essential steps to achieve this goal.
