Yan Qi, Sun Yuan-Song, An Ran, Liu Fang, Fang Qi, Wang Zhen, Xu Tao, Chen Lijian, Du Jian
School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui 230032, China.
Department of Emergency Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui 230032, China.
Genes Dis. 2022 Apr 22;10(5):1857-1869. doi: 10.1016/j.gendis.2022.04.003. eCollection 2023 Sep.
Hepatocellular carcinoma (HCC) has a very high incidence and fatality rate, and in most cases, it is already at an advanced stage when diagnosed. Therefore, early prevention and detection of HCC are two of the most effective strategies. However, the methods recommended in the practice guidelines for the detection of HCC cannot guarantee high sensitivity and specificity except for the liver biopsy, which is known as the "gold standard". In this review, we divided the detection of HCC into pre-treatment diagnosis and post-treatment monitoring, and found that in addition to the traditional imaging detection and liver biopsy, alpha fetoprotein (AFP), lens culinaris-agglutinin-reactive fraction of AFP (AFP-L3), protein induced by vitamin K absence or antagonist-II (PIVKA-II) and other biomarkers are excellent biomarkers for HCC, especially when they are combined together. Most notably, the emerging liquid biopsy shows great promise in detecting HCC. In addition, lactic dehydrogenase (LDH), suppressor of cytokine signaling (SOCS) and other relevant biomarkers may become promising biomarkers for HCC post-treatment monitoring. Through the detailed introduction of the diagnostic technology of HCC, we can have a detailed understanding of its development process and then obtain some enlightenment from the diagnosis, to improve the diagnostic rate of HCC and reduce its mortality.
肝细胞癌(HCC)的发病率和死亡率都非常高,并且在大多数情况下,确诊时已处于晚期。因此,早期预防和检测是最有效的两种策略。然而,除了被称为“金标准”的肝活检外,HCC检测实践指南中推荐的方法无法保证高灵敏度和特异性。在本综述中,我们将HCC的检测分为治疗前诊断和治疗后监测,发现除了传统的影像学检测和肝活检外,甲胎蛋白(AFP)、甲胎蛋白的刀豆凝集素反应性部分(AFP-L3)、维生素K缺乏或拮抗剂-II诱导蛋白(PIVKA-II)等生物标志物是HCC的优秀生物标志物,尤其是当它们联合使用时。最值得注意的是,新兴的液体活检在检测HCC方面显示出巨大的潜力。此外,乳酸脱氢酶(LDH)、细胞因子信号抑制因子(SOCS)等相关生物标志物可能成为HCC治疗后监测的有前景的生物标志物。通过对HCC诊断技术的详细介绍,我们可以深入了解其发展过程,进而从诊断中获得一些启示,以提高HCC的诊断率并降低其死亡率。