Background: The introduction of transgenic technology has made it possible to study the steps of carcinogenesis and directly establish the link between viral subgenomic fragments and specific types of cancer. Research directed at hepatitis B virus (HBV)‐related carcinogenesis has benefited from this technology. We present a detailed pathological evaluation of the sequential steps of hepatocarcinogenesis in a hepatitis B ‘x’ (HBx) transgenic mouse model. In this model, the transgene incorporates the region encoding amino acids 58–154 of the HBV X protein and the murine c‐myc gene. This model demonstrated changes in the liver from birth with foci of multicentric dysplasia evolving into nodules and overt hepatocellular carcinoma between 20 and 28 weeks.

Methods and Results: The hepatocytes were mitotically active and showed increased proliferative capacity soon after birth, with exponential increase thereafter. This was accompanied by a high rate of apoptosis, which later declined as the tumors developed. Other functional and immunophenotypic characteristics included a high c‐myc expression in the neoplastic lesions, no alteration in p53 expression, and no alteration in the expression of hepatic enzymes except for diffuse expression of succinic dehydrogenase.

Conclusion: The entire process illustrates the disturbances of cell growth and death because of the collaborative influence of HBx and c‐myc genes that result in the development of hepatocellular carcinoma after a prolonged latent period.

© 2003 Blackwell Publishing Asia Pty Ltd