Liu Mengxiang, Wen Yanrong
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 211198, China.
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Heliyon. 2024 Sep 25;10(19):e38444. doi: 10.1016/j.heliyon.2024.e38444. eCollection 2024 Oct 15.
Liver cancer is a highly prevalent and lethal form of cancer worldwide. In the absence of early diagnosis, treatment options for this disease are severely restricted. Recent advancements in genomics and bioinformatics have facilitated the discovery of a multitude of novel biomarkers that accurately depict an individual's disease diagnosis, progression, and treatment response. Leveraging these breakthroughs, personalized medicine employs an individual's biomarker profile to enable early detection of liver cancer and inform decisions regarding treatment selection, dosage determination, and prognosis assessment. The current lack of readily applicable, timely, and economically viable tools for biomarker analysis has hindered the incorporation of personalized medicine into regular clinical procedures. Over the past decade, significant advancements have been achieved in the field of molecular point-of-care testing (POCT) and amplification techniques, leading to substantial improvements in the diagnosis of liver cancer and the implementation of precision medicine. Instrument-free PCR technology or plasma PCR technology can shorten the complex procedure of in vitro detection of nucleic acid-based biomarkers. Also, compared to traditional ELISA, various nanomaterials modified with monoclonal antibodies to target proteins for recognition, capture, and detection have improved the efficiency of protein-based biomarker detection. These advances have reduced the time and cost of clinical detection of early-stage hepatocellular carcinoma and improved the efficiency of timely diagnosis and survival of suspected patients while reducing unnecessary testing costs and procedures. This review aims to provide a comprehensive overview of the current and emerging biomarkers employed in the early detection of liver cancer, as well as the advancements in point-of-care molecular testing technology and platforms. The primary objective is to assess their potential in facilitating the implementation of personalized medicine. This review ultimately revealed that the diagnosis of early-stage hepatocellular carcinoma not only requires sensitive biomarkers, but its various modifications and changes during the progression of cirrhosis to early-stage hepatocellular carcinoma will be a greater focus of our attention in the future. The rapid development of POCT has facilitated the opportunity to readily detect liver cancer in the general population in the future, and the integration of multi-pathway multiplexing and intelligent algorithms has improved the sensitivity and accuracy of early liver cancer biomarker detection. It is expected that the integration of point-of-care technology will be instrumental in the widespread adoption of personalized medicine in the foreseeable future.
肝癌是全球一种高度流行且致命的癌症形式。在缺乏早期诊断的情况下,这种疾病的治疗选择受到严重限制。基因组学和生物信息学的最新进展促进了众多新型生物标志物的发现,这些生物标志物能准确描述个体的疾病诊断、进展和治疗反应。利用这些突破,个性化医疗利用个体的生物标志物谱来实现肝癌的早期检测,并为治疗选择、剂量确定和预后评估提供决策依据。目前缺乏易于应用、及时且经济可行的生物标志物分析工具,这阻碍了个性化医疗纳入常规临床程序。在过去十年中,分子即时检验(POCT)和扩增技术领域取得了重大进展,推动了肝癌诊断和精准医疗的实施取得实质性改善。无仪器PCR技术或血浆PCR技术可以缩短基于核酸的生物标志物体外检测的复杂程序。此外,与传统酶联免疫吸附测定(ELISA)相比,用单克隆抗体修饰以靶向蛋白质进行识别、捕获和检测的各种纳米材料提高了基于蛋白质的生物标志物检测效率。这些进展减少了早期肝细胞癌临床检测的时间和成本,提高了疑似患者及时诊断和生存的效率,同时降低了不必要的检测成本和程序。本综述旨在全面概述当前用于肝癌早期检测的生物标志物以及新兴生物标志物,以及即时分子检测技术和平台的进展。主要目的是评估它们在促进个性化医疗实施方面的潜力。本综述最终表明,早期肝细胞癌的诊断不仅需要敏感的生物标志物,而且其在从肝硬化进展到早期肝细胞癌过程中的各种修饰和变化将是我们未来更关注的焦点。POCT的快速发展为未来在普通人群中轻松检测肝癌提供了机会,多途径多重检测和智能算法的整合提高了早期肝癌生物标志物检测的灵敏度和准确性。预计即时检测技术的整合将在可预见的未来有助于个性化医疗的广泛应用。