Agrawal H, Goswami B, Gupta N, Singh N. Liquid biopsy in hepatobiliary and pancreatic cancers: A paradigm shift in early detection, prognostic stratification, and perioperative monitoring. World J Meta-Anal 2025; 13(2): 107997 [DOI: 10.13105/wjma.v13.i2.107997]
Corresponding Author of This Article
Nikhil Gupta, FACS, FRCS (Gen Surg), Professor, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, BKS Marg, Delhi 110001, India. nikhil_ms26@yahoo.co.in
Research Domain of This Article
Biochemistry & Molecular Biology
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Himanshu Agrawal, Nilanjana Singh, Department of Surgery, University College of Medical Sciences (University of Delhi), GTB Hospital, Delhi 110095, India
Binita Goswami, Department of Biochemistry, Maulana Azad Medical College, New Delhi 110002, India
Nikhil Gupta, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi 110001, India
Author contributions: Agrawal H and Gupta N contributed to research conception and design; Agrawal H and Singh N contributed to data acquisition; Gupta N, Agrawal H, and Singh N contributed to data analysis and interpretation; Singh N and Agrawal H contributed to drafting of the manuscript; Gupta N, Agrawal H, and Goswami B contributed to critical revision of the manuscript; Gupta N and Goswami B contributed to supervision; Gupta N, Agrawal H, Singh N, and Goswami B contributed to approval of the final manuscript.
Conflict-of-interest statement: All authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikhil Gupta, FACS, FRCS (Gen Surg), Professor, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, BKS Marg, Delhi 110001, India. nikhil_ms26@yahoo.co.in
Received: April 2, 2025 Revised: April 10, 2025 Accepted: May 8, 2025 Published online: June 18, 2025 Processing time: 75 Days and 12.6 Hours
Abstract
BACKGROUND
Hepatobiliary and pancreatic cancers are among the most lethal malignancies due to late-stage diagnosis and limited treatment options. Liquid biopsy has emerged as a minimally invasive tool for early cancer detection, prognosis, and therapeutic monitoring.
AIM
To concise the available data on liquid biopsy and establish its role in hepatobiliary surgeries.
METHODS
This systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. A comprehensive literature search was performed using PubMed, Scopus, Web of Science, and EMBASE for studies published up to March 2025. Studies assessing the role of circulating tumor DNA, circulating tumor cells, exosomes, and other liquid biopsy markers in hepatobiliary and pancreatic cancers were included. The risk of bias was evaluated using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias Tool for clinical trials.
RESULTS
Liquid biopsy demonstrated significant potential for early cancer detection, perioperative risk stratification, intraoperative surgical decision-making, and postoperative monitoring of minimal residual disease. However, challenges remain regarding standardization, sensitivity, and clinical validation.
CONCLUSION
Liquid biopsy represents a paradigm shift in hepatobiliary and pancreatic cancer management. Advancements in next-generation sequencing and artificial intelligence may enhance its clinical utility. Further large-scale studies are needed to establish standardized protocols for routine implementation.
Core Tip: Liquid biopsy is a minimally invasive technique that detects circulating tumor DNA, circulating tumor cells, and other biomarkers in bodily fluids. It offers real-time monitoring of tumor dynamics, treatment response, and minimal residual disease. Unlike traditional tissue biopsies, liquid biopsy allows for repeated sampling, providing insights into tumor heterogeneity and evolution. It has applications in early cancer detection, prognosis, and guiding targeted therapies. Despite its advantages, challenges such as standardization, sensitivity, and specificity remain. Further research and technological advancements are needed to enhance its clinical utility.
