Department of internal medicine, Hematology/Oncology division, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Anatomy, Cell Biology and Physiology, American University of Beirut Medical Center, Beirut, Lebanon.
Expert Rev Mol Diagn. 2022 May;22(5):507-518. doi: 10.1080/14737159.2022.2094706. Epub 2022 Jun 29.
The diagnosis of hepatocellular carcinoma (HCC) is made at a relatively advanced stage resulting in poor prognosis. Alpha-fetoprotein and liver ultrasound have limited accuracy as biomarkers in HCC. Liver biopsy provides information on tumor biology; however, it is invasive and holds high threat of tumor seeding. Thus, more accurate and less invasive approaches are needed.
Highly sensitive liquid biopsy assays have made possible the detection and analysis of cells or organelles such as circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), and tumor-derived exosomes. Here, we focus on CTCs and ctDNA components of liquid biopsy and their clinical application as diagnostic, prognostic, and predictive biomarkers in HCC. Unlike tissue biopsy, liquid biopsy involves attaining a sample at several time frames in an easy and a non-invasive manner. They have been efficacious in detecting and classifying cancer, in predicting treatment response, in monitoring disease relapse and in identifying mechanisms of resistance to targeted therapies.
Although interesting and highly promising, liquid biopsy techniques still have many obstacles to overcome before their wide spread clinical application sees the light. It is expected that these techniques will be incorporated into traditional methodologies for better diagnostic, predictive and prognostic results.
肝细胞癌（HCC）的诊断通常在相对晚期进行，导致预后不良。甲胎蛋白和肝脏超声作为 HCC 的生物标志物的准确性有限。肝活检可提供肿瘤生物学信息；然而，它具有侵袭性且存在很高的肿瘤播种风险。因此，需要更准确和微创的方法。
高灵敏度的液体活检检测已使得循环肿瘤细胞（CTC）、循环肿瘤 DNA（ctDNA）和肿瘤来源的外泌体等细胞或细胞器的检测和分析成为可能。在这里，我们重点关注液体活检中的 CTC 和 ctDNA 成分及其在 HCC 中的诊断、预后和预测生物标志物中的临床应用。与组织活检不同，液体活检可以通过简单且微创的方式在多个时间点获得样本。它们在检测和分类癌症、预测治疗反应、监测疾病复发以及识别靶向治疗耐药机制方面非常有效。
虽然很有趣且极具前景，但液体活检技术在广泛应用于临床之前仍有许多障碍需要克服。预计这些技术将被纳入传统方法中，以获得更好的诊断、预测和预后结果。
