Abstract
Hepatocellular carcinoma (HCC) is one of the most common cancers and a leading cause of death worldwide. Due to latent liver disease, late diagnosis, and nonresponse to systemic treatments, surgical resection and/or biopsy specimens are still generally considered as the gold standard by clinicians for clinical decision-making until now. Since the conventional tissue biopsy is invasive and contains small tissue samples, it is unable to represent tumor heterogeneity or monitor dynamic tumor progression. Therefore, it is imperative to find a new less invasive or noninvasive diagnostic strategy to detect HCC at an early stage and to monitor HCC recurrence. Over the past years, a new diagnostic concept known as “liquid biopsy” has emerged with substantial attention. Liquid biopsy is noninvasive and allows repeated analyses to monitor tumor recurrence, metastasis or treatment responses in real time. With the advanced development of new molecular techniques, HCC circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) detection have achieved interesting and encouraging results. In this review, we focus on the clinical applications of CTCs and ctDNA as key components of liquid biopsy in HCC patients.
Highlights
The biological basis of liquid biopsyCirculating tumor cells (CTCs) In the 1860s, CTCs were discovered using a microscope to examine the peripheral blood [9]
We focus on the clinical applications of CTCs and circulating tumor DNA (ctDNA) as crucial components of the liquid biopsy in the Hepatocellular carcinoma (HCC) diagnosis, prognosis and therapy
CTCs are cancer cells that circulate in the bloodstream after being naturally shed from the original or metastatic tumors, which can lead to a new fatal metastasis and can be vividly described as “seeds” of the tumors (Fig. 1)
Summary
Hepatocellular carcinoma (HCC) is one of the most common cancers and a leading cause of death worldwide. Surgical resection or liver transplantation remains the primary therapy for HCC patients. The 5-year survival rate of early HCC (BCLC stage A) is high (50–75%), the prognosis of HCC is still limited due to 50–70% recurrence rate after radical surgical resection or ablation [2]. Excellent progress has been made using liquid biopsy as blood-based biomarkers in HCC. These novel biomarkers are believed to have great potential and could provide more detailed individualized decision-making during HCC management, including early detection, prediction of treatment and prognostic outcome. We focus on the clinical applications of CTCs and ctDNA as crucial components of the liquid biopsy in the HCC diagnosis, prognosis and therapy
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