Liquid biopsy in hepatocellular carcinoma: circulating tumor cells and circulating tumor DNA

Qianwei Ye, Sunbin Ling, Shusen Zheng, Xiao Xu, Qianwei Ye, Sunbin Ling, Shusen Zheng, Xiao Xu

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.

Keywords: Circulating tumor DNA; Circulating tumor cells (CTCs); Clinical application; Hepatocellular carcinoma; Liquid biopsy.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CTCs and ctDNA in the peripheral blood. CTCs and ctDNA are the essential elements and are widely believed to be the cornerstones of the liquid biopsy. CTCs are cancer cells that circulate in the bloodstream after being naturally shed from the original or metastatic tumors, they are “seeds” of tumors and can lead to a new fatal metastasis; ctDNA is derived from apoptotic and necrotic tumor cells that release their fragmented DNA into the circulation and contain genetic defects identical to the original tumor cells
Fig. 2
Fig. 2
Phantom drawing of clinical applications of liquid biopsy in HCC patients. Monitoring the response and relapse of HCC patients using liquid biopsy, the levels of ctDNA and CTCs correlate well with HCC progression as well as various therapies, including surgical resection, TACE, radiofrequency ablation (RFA) and targeted molecular therapy

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Source: PubMed

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