Liquid Biopsy in Hepatocellular Carcinoma: Challenges, Advances, and Clinical Implications.

IF 14 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Molecular Hepatology Pub Date : 2024-11-28 DOI:10.3350/cmh.2024.0541

Jaeho Park, Yi-Te Lee, Vatche G Agopian, Jessica S Liu, Ekaterina K Koltsova, Sungyong You, Yazhen Zhu, Hsian-Rong Tseng, Ju Dong Yang

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引用次数: 0

Abstract

Hepatocellular carcinoma (HCC) is an aggressive primary liver malignancy often diagnosed at an advanced stage, resulting in a poor prognosis. Accurate risk stratification and early detection of HCC are critical unmet needs for improving outcomes. Several blood-based biomarkers and imaging tests are available for early detection, prediction, and monitoring of HCC. However, serum protein biomarkers such as alpha-fetoprotein have shown relatively low sensitivity, leading to inaccurate performance. Imaging studies also face limitations related to suboptimal accuracy, high cost, and limited implementation. Recently, liquid biopsy techniques have gained attention for addressing these unmet needs. Liquid biopsy is non-invasive and provides more objective readouts, requiring less reliance on healthcare professional's skills compared to imaging. Circulating tumor cells, cell-free DNA, and extracellular vesicles are targeted in liquid biopsies as novel biomarkers for HCC. Despite their potential, there are debates regarding the role of these novel biomarkers in the HCC care continuum. This review article aims to discuss the technical challenges, recent technical advancements, advantages and disadvantages of these liquid biopsies, as well as their current clinical application and future directions of liquid biopsy in HCC.

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肝细胞癌中的液体活检：挑战、进展和临床意义。

肝细胞癌（HCC）是一种侵袭性原发性肝脏恶性肿瘤，通常在晚期才被诊断出来，因此预后较差。准确的风险分层和早期检测是改善预后的关键需求。目前有几种基于血液的生物标记物和成像检测可用于早期检测、预测和监测 HCC。然而，甲胎蛋白等血清蛋白生物标志物的灵敏度相对较低，导致检测结果不准确。成像研究也面临着准确性不佳、成本高昂和实施受限等限制。最近，液体活检技术因能满足这些未满足的需求而备受关注。与影像学相比，液体活检是非侵入性的，能提供更客观的读数，对医护人员技能的依赖性也更低。循环肿瘤细胞、无细胞 DNA 和细胞外囊泡是液体活检的目标，可作为 HCC 的新型生物标记物。尽管这些新型生物标记物潜力巨大，但关于它们在 HCC 治疗过程中的作用仍存在争议。这篇综述文章旨在讨论这些液体活检的技术挑战、最新技术进展、优缺点、目前的临床应用以及液体活检在 HCC 中的未来发展方向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Molecular Hepatology Medicine-Hepatology

CiteScore

15.60

自引率

9.00%

发文量

审稿时长

10 weeks

期刊介绍： Clinical and Molecular Hepatology is an internationally recognized, peer-reviewed, open-access journal published quarterly in English. Its mission is to disseminate cutting-edge knowledge, trends, and insights into hepatobiliary diseases, fostering an inclusive academic platform for robust debate and discussion among clinical practitioners, translational researchers, and basic scientists. With a multidisciplinary approach, the journal strives to enhance public health, particularly in the resource-limited Asia-Pacific region, which faces significant challenges such as high prevalence of B viral infection and hepatocellular carcinoma. Furthermore, Clinical and Molecular Hepatology prioritizes epidemiological studies of hepatobiliary diseases across diverse regions including East Asia, North Asia, Southeast Asia, Central Asia, South Asia, Southwest Asia, Pacific, Africa, Central Europe, Eastern Europe, Central America, and South America. The journal publishes a wide range of content, including original research papers, meta-analyses, letters to the editor, case reports, reviews, guidelines, editorials, and liver images and pathology, encompassing all facets of hepatology.