Lactylation: the malignant playbook of hepatocellular carcinoma cells and their roadmap to therapy resistance

Hepatocellular carcinoma (HCC) is a significant global health issue, characterized by a high mortality rate closely linked to treatment resistance and late-stage diagnosis. Lactylation, a distinctive post-translational modification linking cellular metabolism and epigenetics, has recently attracted significant attention due to its potential role in HCC. This review aims to systematically elucidate how lactylation facilitates the malignant progression of HCC through many mechanisms, including regulation of cell proliferation, invasion and metastasis, immune response, and stem cell properties. It examines its role in immunotherapy and resistance to targeted therapy in greater depth. The essay succinctly evaluates the therapeutic promise and translational challenges of targeting lactylation, offering a resource for future study.