Labgaa Ismail, Villanueva Augusto, Dormond Olivier, Demartines Nicolas, Melloul Emmanuel
Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), CH-1011 Lausanne, Switzerland.
Division of Liver Diseases, Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Cancers (Basel). 2021 Feb 6;13(4):659. doi: 10.3390/cancers13040659.
Showing a steadily increasing cancer-related mortality, the epidemiological evolution of hepatocellular carcinoma (HCC) is concerning. Numerous strategies have attempted to prognosticate HCC but their performance is modest; this is partially due to the heterogeneous biology of this cancer. Current clinical guidelines endorse classifications and scores that use clinical variables, such as the Barcelona Clinic Liver Cancer (BCLC) classification. These algorithms are unlikely to fully recapitulate the genomic complexity of HCC. Integrating molecular readouts on a patient-basis, following a precision-medicine perspective, might be an option to refine prognostic systems. The limited access to HCC tissue samples is an important limitation to these approaches but it could be partially circumvented by using liquid biopsy. This concept consists of the molecular analysis of products derived from a solid tumor and released into biological fluids, mostly into the bloodstream. It offers an easy and minimally-invasive access to DNA, RNA, extracellular vesicles and cells that can be analyzed with next-generation sequencing (NGS) technologies. This review aims to investigate the potential contributions of liquid biopsy in HCC prognostication. The results identified prognostic values for each of the components of liquid biopsy, suggesting that this technology may help refine HCC prognostication.
肝细胞癌（HCC）的流行病学演变令人担忧，其与癌症相关的死亡率呈稳步上升趋势。许多策略都试图对HCC进行预后评估，但其效果并不理想；部分原因在于这种癌症生物学特性的异质性。当前的临床指南认可使用临床变量的分类和评分方法，如巴塞罗那临床肝癌（BCLC）分类。这些算法不太可能完全概括HCC的基因组复杂性。从精准医学的角度出发，在个体患者基础上整合分子检测结果，可能是优化预后系统的一种选择。获取HCC组织样本存在限制，这对这些方法来说是一个重要局限，但使用液体活检可以部分克服这一问题。这一概念是对源自实体瘤并释放到生物体液（主要是血液）中的产物进行分子分析。它提供了一种简便且微创的方式来获取可通过下一代测序（NGS）技术进行分析的DNA、RNA、细胞外囊泡和细胞。本综述旨在探讨液体活检在HCC预后评估中的潜在作用。结果确定了液体活检各组成部分的预后价值，表明该技术可能有助于优化HCC的预后评估。
