The Application of Liquid Biopsy Techniques in High-Risk Population for Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of the digestive system and has a 5-year overall survival rate of 14.1%. Many HCC patients are diagnosed at an advanced stage, and thus early screening is essential for reducing the mortality of HCC. In addition to commonly used detection indicators such as serum alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) and abnormal prothrombin (protein induced by vitamin K absence II, PIVKA-II), liquid biopsy techniques have been demonstrated to have diagnostic value in HCC detection. Compared with invasive procedures, liquid biopsy can detect circulatory metabolites of malignant neoplasms. Liquid biopsy techniques can detect circulating tumor cells, circulating tumor DNA, circulating RNA and exosomes and have been used in the early screening, diagnosis and prognostic evaluation of HCC. This paper reviews the molecular biological characteristics and application of different liquid biopsy techniques, and aim to highlight promising biomarkers that may be feasible options for early-stage HCC evaluation to improve early screening in populations at high risk for HCC.

Liquid Biopsy in the Clinical Management of Cancers

“…A number of recent studies have demonstrated the potential of liquid biopsy for cancer screening, refinement of diagnosis, and early of cancer recurrences [43,61]. By detecting circulating tumor cells, nucleic acids, and exosomes, the method can be used for early cancer detection, diagnosis, and prognosis in various types of cancer [35,63,71,149]. Additionally, liquid biopsy can provide insights into cancer progression and treatment response by assessing cancer cachexia, muscle-derived microRNAs, and energy metabolism [16].…”

Advancements and Applications of Liquid Biopsies in Oncology: A Narrative Review

“…Liquid biopsy is potentially used for screening high-risk populations for early cancer detection. High-risk populations are more susceptible to cancer development due to previous cancer treatments, family history, genetic mutations, and exposure to carcinogens, which involves analyzing the circulatory metabolites of malignant neoplasm or other body fluids [ 29 ]. RNA-Seq analysis of platelet-derived RNA can detect both early- and late-stage NSCLC with an accuracy of around 80%, which involves sequencing the RNA molecules of platelets and analyzing gene expression patterns [ 28 ].…”

“…Somatic mutations, such as BRAF and RAS detection in ctDNA, improve treatment response and survival outcomes. ctDNA levels predict tumor response to immunotherapy and evaluate markers such as microsatellite instability (MSI) and tumor mutational burden (TMB) [ 29 ]. The presence of specific exosomal miRNAs, long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs) are biomarkers for diagnosing cancer, predicting prognosis, and assessing treatment response.…”