TNF and hepatocellular carcinoma: The mechanism of HCC pathophysiology begins with an inflammatory process mediated by Kupffer cells in the liver or macrophages (46, 47), both of which have immunostimulatory activity, secreting pro-inflammatory cytokines (interleukin 6-IL6 and TNF-α-tumor necrosis factor) and immunosuppressive cytokines (interleukin 10-IL-10) (46, 47).