Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 27, 2020; 12(9): 558-573
Published online Sep 27, 2020. doi: 10.4254/wjh.v12.i9.558
Biomarkers for hepatocellular cancer
Gurjot Singh, Eric M Yoshida, Sahaj Rathi, Vladimir Marquez, Peter Kim, Siegfried R Erb, Baljinder S Salh
Gurjot Singh, Department of Medicine, University of British Columbia, Vancouver V5Z 1M9, Canada
Eric M Yoshida, Sahaj Rathi, Vladimir Marquez, Siegfried R Erb, Baljinder S Salh, Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver V5Z 1M9, Canada
Peter Kim, Division of Oncological Surgery, Department of Medicine, University of British Columbia, Vancouver V5Z 1M9, Canada
Author contributions: All authors equally contributed to this paper.
Conflict-of-interest statement: All authors have no any conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Baljinder S Salh, FRCP, FRCP (C), MBChB, Associate Professor, Division of Gastroenterology, Department of Medicine, University of British Columbia, DHCC, 2775 Laurel Street, Vancouver V5Z 1M9, Canada. bill.salh@ubc.ca
Received: May 27, 2020
Peer-review started: May 27, 2020
First decision: June 15, 2020
Revised: July 6, 2020
Accepted: August 24, 2020
Article in press: August 24, 2020
Published online: September 27, 2020
Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. If diagnosed early, curative treatment options such as surgical resection, loco-regional therapies, and liver transplantation are available to patients, increasing their chances of survival and improving their quality of life. Unfortunately, most patients are diagnosed with late stage HCC where only palliative treatment is available. Therefore, biomarkers which could detect HCC early with a high degree of sensitivity and specificity, may play a crucial role in the diagnosis and management of the disease. This review will aim to provide an overview of the different biomarkers of HCC comprising those used in the diagnosis of HCC in at risk populations, as well as others with potential for prognosis, risk predisposition and prediction of response to therapeutic intervention.

Keywords: Biomarkers, Hepatocellular carcinoma, Liver cancer, Cancer, Review, Serum, Plasma, Scoring models, Algorithm, Genetic, Micro-RNA, miRNA, Diagnosis, Prognosis, Liquid biopsy.

Core Tip: The use of ultrasound with/without alpha-fetoprotein in the context of screening patients with chronic liver disease for the development of early stage hepatocellular carcinoma that is treatable, remains problematic. Consequently there has been considerable work done to examine biomarkers either individually, or in combination to address this deficiency. Whilst there are several promising targets (discussed in this manuscript) for this indication it appears that Gender, Age: Lens culinaris agglutinin-reactive of alpha-fetoprotein, Alpha-fetoprotein, and Des-γ-carboxy prothrombin, which has been established in Europe and Japan, and remains to be so in North America, may be clinically the best performer available.