The potential of circulating tumor DNA to use as a molecular marker to screen and diagnose hepatocellular carcinoma: A systematic review

Abstract

Now a day's molecular characterization of individual patients' tumor cells is becoming instantly important for early detection and effective treatment of the disease. The idea of applying liquid biopsy technologies for early diagnosis of cancer through the specific and sensitive determination of circulating tumor DNA (ctDNA) among circulating free DNA (cfDNA) in plasma is a relatively recent approach with considerable promise, but also presented with great challenges. Ongoing advancement in the field has shown that ctDNA has huge potential to serve as a biomarker for early detection and precision treatment as well as prognosis of hepatocellular carcinoma (HCC). As ctDNA in HCC patients harbors the molecular characteristics of HCC tumor cells, ctDNA analysis in the blood of HCC patients might be an adequate and non-intrusive approach for locating tumors, disease prediction, and treatment. In the sight of this fact, this review tried to sum up and discuss the surveillance of HCC, the origins and molecular characteristics of molecular markers of hepatocellular carcinoma, the current status, and the potentials of ctDNA as a marker for HCC surveillance and early detection. Moreover, this review also describes the major tumor-specific genetic modifications in ctDNA, such as DNA methylation, microsatellite alterations, point mutations, chromosomal rearrangements. Finally, the challenges associated with the clinical use of ctDNA for HCC detection are also discussed.