Published online Jun 26, 2019. doi: 10.12998/wjcc.v7.i12.1367
Peer-review started: February 20, 2019
First decision: March 11, 2019
Revised: April 7, 2019
Accepted: May 2, 2019
Article in press: May 3, 2019
Published online: June 26, 2019
Hepatocellular carcinoma (HCC) is the 5th most frequently diagnosed cancer in the world, according to the World Health Organization. The incidence of HCC is between 3/100000 and 78.1/100000, with a high incidence reported in areas with viral hepatitis B and hepatitis C, thus affecting Asia and Africa predominantly. Several international clinical guidelines address HCC diagnosis and are structured according to the geographical area involved. All of these clinical guidelines, however, share a foundation of diagnosis by ultrasound surveillance and contrast imaging techniques, particularly computed tomography, magnetic resonance imaging, and sometimes contrast-enhanced ultrasound. The primary objective of this review was to systematically summarize the recent published studies on the clinical utility of serum biomarkers in the early diagnosis of HCC and for the prognosis of this disease.
Core tip: Hepatocellular carcinoma (HCC) is an important cause of morbidity and mortality worldwide. Current HCC screening and diagnostic guidelines are based on imaging techniques-ultrasonography for screening, and dynamic contrast-enhanced computed tomography, magnetic resonance, and ultrasound for diagnosis. The use of biomarkers is promising but the diverse aetiology and complex pathophysiological mechanisms of HCC make it difficult to find an ideal combination. This review systematically summarizes the existing data on the role of biomarkers in early diagnosis and prognosis of HCC, to promote efforts to find alternatives to the imaging investigations which are expensive and not always accepted by patients.