Gonvers Stéphanie, Tabrizian Parissa, Melloul Emmanuel, Dormond Olivier, Schwartz Myron, Demartines Nicolas, Labgaa Ismail
Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.
Recanati Miller Transplant Institute, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States.
Front Oncol. 2022 Aug 11;12:940473. doi: 10.3389/fonc.2022.940473. eCollection 2022.
Liver transplant (LT) is the most favorable treatment option for patients with early stage hepatocellular carcinoma (HCC). Numerous attempts have been pursued to establish eligibility criteria and select HCC patients for LT, leading to various systems that essentially integrate clinico-morphological variables. Lacking of sufficient granularity to recapitulate the biological complexity of the disease, all these alternatives display substantial limitations and are thus undeniably imperfect. Liquid biopsy, defined as the molecular analysis of circulating analytes released by a cancer into the bloodstream, was revealed as an incomparable tool in the management of cancers, including HCC. It appears as an ideal candidate to refine selection criteria of LT in HCC. The present comprehensive review analyzed the available literature on this topic. Data in the field, however, remain scarce with only 17 studies. Although rare, these studies provided important and encouraging findings highlighting notable prognostic values and supporting the contribution of liquid biopsy in this specific clinical scenario. These results underpinned the critical and urgent need to intensify and accelerate research on liquid biopsy, in order to determine whether and how liquid biopsy may be integrated in the decision-making of LT in HCC.
肝移植（LT）是早期肝细胞癌（HCC）患者最有利的治疗选择。人们已经进行了大量尝试来制定入选标准并选择适合肝移植的HCC患者，从而产生了各种基本上整合了临床形态学变量的系统。由于缺乏足够的精细度来概括疾病的生物学复杂性，所有这些方法都存在很大局限性，因此不可否认是不完美的。液体活检被定义为对癌症释放到血液中的循环分析物进行分子分析，它已被证明是癌症管理（包括HCC）中一种无与伦比的工具。它似乎是完善HCC肝移植选择标准的理想候选方法。本综述分析了关于该主题的现有文献。然而，该领域的数据仍然稀缺，仅有17项研究。尽管这些研究很少，但它们提供了重要且令人鼓舞的发现，突出了显著的预后价值，并支持了液体活检在这一特定临床场景中的作用。这些结果强调了加强和加速液体活检研究的迫切需求，以便确定液体活检是否以及如何能够纳入HCC肝移植的决策过程。
