Primary liver cancer (hepatocellular carcinoma, or HCC) is associated with liver cirrhosis 60-80% of the time. Liver
cancer is one of the most common malignancies in the world, with approximately 1,000,000 cases reported every year.
About 80% of people with primary liver cancer are male. Although two-thirds of people have advanced liver disease
when they seek medical help, one third of the patients have cancer that has not progressed beyond the liver. HCC may
metastasize to the lung, bones, kidney, and many other organs. Surgical resection, liver transplantation, chemotherapy
and radiation therapy are the foundation of current HCC therapies. However the outcomes are poor: the survival rate is
almost zero for metastatic HCC patients. Molecular mechanisms of HCC metastasis need to be understood better and
new therapies must be developed to selectively target to unique characteristics of HCC cell growth and metastasis. We
have developed the "in vivo microscopy" to study the mechanisms that govern liver tumor cell spread through the
microenvironment in vivo with real-time confocal near-infrared fluorescence imaging. A recently developed "in vivo
flow cytometer" and optical imaging are used to assess liver tumor cell spreading and the circulation kinetics of liver
tumor cells. A real- time quantitative monitoring of circulating liver tumor cells by the in vivo flow cytometer will be
useful to assess the effectiveness of the potential therapeutic interventions.