Hepatocellular Carcinoma: Advances in biomarkers for HCC

Hepatocellular carcinoma is a common cancer worldwide and has a high mortality. Many patientspresent in the late stages and the outcome of treatment for these patients is poor. Biomarkerscould theoretically help to detect the disease at an earlier stage before symptoms occurand improve the treatment outcomes. The first biomarker found was alpha-fetoprotein (AFP) and it iscurrently used as part of the HCC surveillance recommended in many countries. However AFP isnot very accurate and 30-40% of HCCs may be missed. Currently there are other biomarkers underinvestigation. Most of the more common biomarkers studied are serum/blood tests and include AFP-L3,PIVKA-II, Glypican-2, VEGF and the non-coding RNAs, such as long non-coding RNA and microRNA,and metabolomics tests. Tests involving urine or patient breaths are still relatively uncommonbut are being investigated. The limitation on the use of these new biomarkers is from the availabilityand costs of the tests. Only AFP-L3 and PIVKA-II are currently commercially available.