Biomarkers for Hepatocellular Carcinoma: Diagnosis, Prognosis, and Treatment Response Assessment - A Systematic Review

Md Sohel Rana¹,  Md Samiul Bashir²,  Shib Shankar Das³, Moazzam Hossian⁴, Sushant Barua⁵

This review discusses the enhancement of management of hepatocellular carcinoma (HCC) through the use of biomarkers offers substantial benefits by improving early diagnosis, providing accurate prognostic assessments, and enabling personalized treatment response predictions.

Abstract

Background: Hepatocellular carcinoma (HCC) is a significant global health concern due to its high mortality rates, highlighting the urgent need for improved diagnostic, prognostic, and therapeutic markers. Biomarkers hold potential for enhancing the early detection, prognostic evaluation, and treatment response assessment of HCC. Methods: A systematic review was conducted to evaluate the utility of various biomarkers in the diagnosis, prognosis, and prediction of treatment responses in HCC. A comprehensive search was performed in electronic databases, including PubMed, Embase, Scopus, and the Cochrane Library, up to January 2024. Studies that assessed biomarkers for HCC in terms of diagnostic accuracy, prognostic value, or their role in predicting treatment responses were included. Data extraction and quality assessment were performed for all eligible studies. Results: The search initially identified 78 articles, of which 41 met the inclusion criteria. The review evaluated biomarkers from genomic, epigenomic, transcriptomic, proteomic, and metabolomic sources. The diagnostic accuracy of these biomarkers ranged from 70% to 90%, with alpha-fetoprotein (AFP) being the most frequently studied and widely utilized biomarker. Prognostic biomarkers were found to have significant associations with overall survival and disease-free survival. Biomarkers predicting treatment responses, particularly to sorafenib and immunotherapy, exhibited varying levels of sensitivity and specificity. Conclusion: Biomarkers play a critical role in the management of HCC, offering promising potential for early diagnosis, prognostic assessment, and prediction of treatment responses. However, further validation and standardization of these biomarkers are required before they can be implemented clinically. Future research should aim to identify and integrate novel biomarkers within a multidisciplinary framework to enable personalized management of HCC.

Keywords: Hepatocellular carcinoma, biomarkers, diagnosis, prognosis, treatment response.

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