Clinical Application Value of Circulating Cell-free DNA in Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and a leading cause of cancer-related deaths. Due to late diagnosis, early intrahepatic metastasis and nonresponse to systemic treatments, surgical resection and/or biopsy specimens remain the gold standard for disease staging, grading and clinical decision-making. Since only a small amount of tissue was obtained in a needle biopsy, the conventional tissue biopsy is unable to represent tumor heterogeneity in HCC. For this reason, it is imperative to find a new non-invasive and easily available diagnostic tool to detect HCC at an early stage and to monitor HCC recurrence. The past decade has witnessed considerable evolution in the development of liquid biopsy technologies with the emergence of next-generation sequencing. As a liquid biopsy approach, molecular analysis of cell-free DNA (cfDNA), characterized by noninvasiveness and real-time analysis, may accurately represent the tumor burden and comprehensively reflect genetic profile of HCC. Therefore, cfDNA may be used clinically as a predictive biomarker in early diagnosis, outcome assessment, and even molecular typing. In this review, we provide an update on the recent advances made in clinical applications of cfDNA in HCC.

Diagnostic Value of Multislice Spiral Computed Tomography Combined with Serum AFP, TSGF, and GP73 Assay in the Diagnosis of Primary Liver Cancer

“…The serum levels of GP73 increase with the severity of liver inflammatory responses, but not significantly. The combination of AFP, TSGF, and GP73 contributes to a higher diagnostic efficiency for PLC [ 11 ]. Accordingly, this study was conducted to explore the diagnostic value of MSCT plus serum AFP, TSGF, and GP73 levels in PLC.…”

Liquid Biopsy Using Cell-Free or Circulating Tumor DNA in the Management of Hepatocellular Carcinoma

“… 3 Other challenges include the difficulty in detecting ctDNA mutations in early stage cancers with lower tumor burden, 74 complex variants of gene fusions, 75 lack of HCC-specific mutation hotspots for detection by NGS panels of insufficient broadness, and unavailability of matching effective therapies for druggable targets. 74 , 75 , 76 The lack of standardization in liquid biopsy procedures (eg, blood collection volume, the types of tubes for blood collection, and sample storage and shipping logistics) resulting from the varying practice for ctDNA profiling in different health care centers also hinders its use in clinical routine practice. 77 …”

Leveraging Blood-Based Diagnostics to Predict Tumor Biology and Extend the Application and Personalization of Radiotherapy in Liver Cancers

“…The advent of next generation sequencing has provided new opportunities for utilizing liquid biopsies for diagnostic purposes [88] (Table 2, V). A promising biomarker in this context is circulating cell-free DNA (cfDNA), which are fragments of 150 to 200 base pairs of double-stranded DNA segments that have a short half-life.…”