液体活检在肝细胞癌早期检测、预后评估及治疗监测中的作用
Role of Liquid Biopsy for Early Detection, Prognosis, and Therapeutic Monitoring of Hepatocellular Carcinoma.
作者信息
Alrumaihi Faris
机构信息
Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
出版信息
Diagnostics (Basel). 2025 Jun 28;15(13):1655. doi: 10.3390/diagnostics15131655.
The global prevalence of hepatocellular carcinoma (HCC) is getting worse, leading to an urgent need for improved diagnostic and prognostic strategies. Liquid biopsy, which analyzes circulating tumor cells (CTCs), cell-free DNA (cfDNA), cell-free RNA (cfRNA), and extracellular vesicles (EVs), has emerged as a minimally invasive and promising alternative to traditional tissue biopsy. These biomarkers can be detected using sensitive molecular techniques such as digital PCR, quantitative PCR, methylation-specific assays, immunoaffinity-based CTC isolation, nanoparticle tracking analysis, ELISA, next-generation sequencing, whole-genome sequencing, and whole-exome sequencing. Despite several advantages, liquid biopsy still has challenges like sensitivity, cost-effectiveness, and clinical accessibility. Reports highlight the significance of multi-analyte liquid biopsy panels in enhancing diagnostic sensitivity and specificity. This approach offers a more comprehensive molecular profile of HCC, early detection, and tracking therapeutic treatment, particularly in those cases where single-analyte assays and imaging fail. The technological advancement in the isolation and analysis of CTC, cell-free nucleic acids, and EVs is increasing our understanding of extracting genetic information from HCC tumors and discovering mechanisms of therapeutic resistance. Furthermore, crucial information on tumor-specific transcriptomic and genomic changes can be obtained using cfRNA and cfDNA released into the peripheral blood by tumor cells. This review provides an overview of current liquid biopsy strategies in HCC and their use for early detection, prognosis, and monitoring the effectiveness of HCC therapy.
肝细胞癌(HCC)的全球患病率正在恶化,这导致迫切需要改进诊断和预后策略。液体活检通过分析循环肿瘤细胞(CTC)、游离DNA(cfDNA)、游离RNA(cfRNA)和细胞外囊泡(EV),已成为一种微创且有前景的传统组织活检替代方法。这些生物标志物可以使用敏感的分子技术进行检测,如数字PCR、定量PCR、甲基化特异性检测、基于免疫亲和的CTC分离、纳米颗粒跟踪分析、ELISA、下一代测序、全基因组测序和全外显子组测序。尽管有几个优点,但液体活检仍然存在灵敏度、成本效益和临床可及性等挑战。报告强调了多分析物液体活检面板在提高诊断灵敏度和特异性方面的重要性。这种方法提供了更全面的HCC分子图谱、早期检测和跟踪治疗,特别是在单分析物检测和成像失败的情况下。CTC、游离核酸和EV的分离和分析技术进步正在加深我们对从HCC肿瘤中提取遗传信息和发现治疗耐药机制的理解。此外,使用肿瘤细胞释放到外周血中的cfRNA和cfDNA可以获得有关肿瘤特异性转录组和基因组变化的关键信息。本综述概述了目前HCC中的液体活检策略及其在早期检测、预后和监测HCC治疗效果方面的应用。