ABSTRACT
Hepatocellular carcinoma (HCC) is one of the major malignant tumors that lead to death, and chronic hepatitis B virus (HBV) infection is an important risk factor for HCC. This article introduces the detailed mechanisms of HBV-related HCC, including HBV X protein, immune imbalance, and integration of HBV DNA into the host genome, with a focus on the pathological role and related mechanisms of HBV X protein in HCC. HBV X protein enhances carcinogenesis by promoting tumor cell proliferation, invasion, and metastasis, affecting angiogenesis, promoting cell apoptosis, and interfering with cell metabolism. In-depth studies on the biological functions of HBV X protein, immune imbalance, and HBV DNA integration will help to clarify the pathogenesis of liver cancer and promote the development of novel therapeutic targets for HBV-related HCC.