The Current Role of Circulating Cell-Free DNA in the Management of Hepatocellular Carcinoma.

IF 4.5 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2025-03-20 DOI:10.3390/cancers17061042
Alkistis Papatheodoridi, Vasileios Lekakis, Antonios Chatzigeorgiou, George Papatheodoridis
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Abstract

Circulating cell-free DNA (cfDNA) has emerged as a compelling candidate of liquid biopsy markers for the diagnosis and prognosis of several cancers. We systematically reviewed data on the role of cfDNA markers in the diagnosis, prognosis and treatment of hepatocellular carcinoma (HCC). Early studies suggested that levels of circulating cfDNA, mitochondrial DNA and cfDNA integrity are higher in patients with HCC than chronic liver diseases. In subsequent studies, methylation changes in circulating tumor DNA (ctDNA) as well as cfDNA fragmentation patterns and circulating nucleosomes were found to offer high sensitivity (>60%) and excellent specificity (>90%) for HCC diagnosis. The predictive role of cfDNA markers and ctDNA has been assessed in a few studies including untreated patients with HCC providing promising results for prediction of survival. However, port-hepatectomy detection of cfDNA/ctDNA markers or copy number variation indicators of cfDNA seem to reflect minimum residual disease and thus a high risk for HCC recurrence. The same markers can be useful for prediction after transarterial chemoembolization, radiofrequency ablation, radiotherapy and even systemic therapies. In conclusion, cfDNA markers can be useful in HCC surveillance, improving early diagnosis rates, as well as for monitoring treatment effectiveness and minimal residual disease post-treatment.

循环游离DNA在肝细胞癌治疗中的作用。
循环无细胞DNA (cfDNA)已成为几种癌症诊断和预后的液体活检标志物的有力候选。我们系统地回顾了cfDNA标记物在肝细胞癌(HCC)的诊断、预后和治疗中的作用。早期研究表明,HCC患者的循环cfDNA、线粒体DNA和cfDNA完整性水平高于慢性肝病患者。在随后的研究中,循环肿瘤DNA (ctDNA)以及cfDNA片段模式和循环核小体的甲基化变化被发现为HCC诊断提供了高灵敏度(>60%)和极好的特异性(>90%)。cfDNA标记物和ctDNA的预测作用已经在一些研究中进行了评估,包括未经治疗的HCC患者,为预测生存提供了有希望的结果。然而,肝切除检测cfDNA/ctDNA标记物或cfDNA拷贝数变异指标似乎反映了最小的残留病变,因此HCC复发的风险很高。同样的标记物可以用于经动脉化疗栓塞、射频消融、放疗甚至全身治疗后的预测。总之,cfDNA标志物可用于HCC监测,提高早期诊断率,以及监测治疗效果和治疗后最小残留疾病。
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
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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