Mechanisms of ferroptosis in primary hepatocellular carcinoma and progress of artificial intelligence-based predictive modeling in hepatocellular carcinoma.

Ferroptosis, an iron-dependent form of programmed cell death, has garnered significant attention in tumor research in recent years. Its core characteristics include aberrant accumulation of lipid peroxides and impairment of antioxidant defense mechanisms, such as dysfunction of glutathione peroxidase 4. These features are closely intertwined with the initiation, progression, and therapeutic resistance of hepatocellular carcinoma (HCC). This review presents a systematic overview of the fundamental molecular mechanisms underlying ferroptosis, encompassing iron metabolism, lipid metabolism, and the antioxidant system. Furthermore, it summarizes the potential applications of targeting ferroptosis in liver cancer treatment, including the mechanisms of action of anticancer agents (e.g., sorafenib) and relevant ferroptosis-related enzymes. Against the backdrop of the growing potential of artificial intelligence (AI) in liver cancer research, various AI-based predictive models for liver cancer are being increasingly developed. On the one hand, this review examines the mechanisms of ferroptosis in HCC to explore novel early detection markers for liver cancer, to provide new insights for the development of AI-based early diagnostic models. On the other hand, it synthesizes the current research progress of existing liver cancer predictive models while summarizing key challenges that AI predictive models may encounter in the diagnosis and treatment of HCC.