Published online Oct 7, 2016. doi: 10.3748/wjg.v22.i37.8271
Peer-review started: April 27, 2016
First decision: June 20, 2016
Revised: July 18, 2016
Accepted: August 5, 2016
Article in press: August 5, 2016
Published online: October 7, 2016
Chronic hepatitis B virus (HBV) infected patients have an almost 100-fold increased risk to develop hepatocellular carcinoma (HCC). HCC is the fifth most common and third most deadly cancer worldwide. Up to 50% of newly diagnosed HCC cases are attributed to HBV infection. Early detection improves survival and can be achieved through regular screening. Six-monthly abdominal ultrasound, either alone or in combination with alpha-fetoprotein serum levels, has been widely endorsed for this purpose. Both techniques however yield limited diagnostic accuracy, which is not improved when they are combined. Alternative circulating or histological markers to predict or diagnose HCC are therefore urgently needed. Recent advances in systems biology technologies have enabled the identification of several new putative circulating biomarkers. Although results from studies assessing combinations of these biomarkers are promising, evidence for their clinical utility remains low. In addition, most of the studies conducted so far show limitations in design. Attention must be paid for instance to different ethnicities and different etiologies when studying biomarkers for hepatocellular carcinoma. This review provides an overview on the current understandings and recent progress in the field of diagnostic and predictive circulating biomarkers for hepatocellular carcinoma in chronically infected HBV patients and discusses the future prospects.
Core tip: Regular screening for hepatocellular carcinoma (HCC) in patients at risk improves their survival rates. Currently available screening methods include abdominal ultrasound and alpha-fetoprotein serum levels, but both methods lack diagnostic accuracy. Recent technological advances have enabled the identification of new predictive and diagnostic hepatitis B virus (HBV)-associated HCC biomarkers. Nevertheless, most of the studies conducted so far show design limitations. This review provides an overview on the current understanding and future prospects of circulating predictive and diagnostic biomarkers for HBV-associated HCC.