Department of Internal Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York, USA.
Gut. 2020 Nov;69(11):2025-2034. doi: 10.1136/gutjnl-2019-320282. Epub 2020 Sep 3.
With increasing knowledge on molecular tumour information, precision oncology has revolutionised the medical field over the past years. Liquid biopsy entails the analysis of circulating tumour components, such as circulating tumour DNA, tumour cells or tumour-derived extracellular vesicles, and has thus come as a handy tool for personalised medicine in many cancer entities. Clinical applications under investigation include early cancer detection, prediction of treatment response and molecular monitoring of the disease, for example, to comprehend resistance patterns and clonal tumour evolution. In fact, several tests for blood-based mutation profiling are already commercially available and have entered the clinical field.In the context of hepatocellular carcinoma, where access to tissue specimens remains mostly limited to patients with early stage tumours, liquid biopsy approaches might be particularly helpful. A variety of translational liquid biopsy studies have been carried out to address clinical needs, such as early hepatocellular carcinoma detection and prediction of treatment response. To this regard, methylation profiling of circulating tumour DNA has evolved as a promising surveillance tool for early hepatocellular carcinoma detection in populations at risk, which might soon transform the way surveillance programmes are implemented. This review summarises recent developments in the liquid biopsy oncological space and, in more detail, the potential implications in the clinical management of hepatocellular carcinoma. It further outlines technical peculiarities across liquid biopsy technologies, which might be helpful for interpretation by non-experts.
随着对分子肿瘤信息的了解不断增加，精准肿瘤学在过去几年中彻底改变了医学领域。液体活检涉及对循环肿瘤成分的分析，例如循环肿瘤 DNA、肿瘤细胞或肿瘤来源的细胞外囊泡，因此成为许多癌症实体中个性化医学的便捷工具。正在研究的临床应用包括早期癌症检测、治疗反应预测和疾病的分子监测，例如，了解耐药模式和克隆肿瘤演变。事实上，已经有几种基于血液的突变分析测试可用于商业用途，并已进入临床领域。在肝癌中，组织标本的获取主要限于早期肿瘤患者，因此液体活检方法可能特别有帮助。已经进行了各种转化液体活检研究，以满足临床需求，例如早期肝癌检测和治疗反应预测。在这方面，循环肿瘤 DNA 的甲基化分析已成为高危人群早期肝癌检测的有前途的监测工具，这可能很快会改变监测计划的实施方式。这篇综述总结了液体活检肿瘤学领域的最新进展，并更详细地介绍了其在肝癌临床管理中的潜在影响。它还概述了液体活检技术的技术特点，这可能有助于非专家进行解释。
