Prognostic biomarkers for prediction of recurrence of hepatocellular carcinoma: current status and future prospects

Abstract

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death worldwide, with region specific etiologies. Despite improvements made in the diagnosis of HCC, the prognosis of HCC patients remains poor due to the high recurrence rate of HCC. There is an urgent need for development of prognostic biomarkers to predict the risk of recurrence in HCC patients after "curative" treatment. Such stratification may aid in patient management and development of personalized medicine for HCC treatment. Omics based studies facilitate the study of global changes in biomolecules in a disease in a high throughput manner, and hence are well poised to understand the complex changes which led to HCC recurrence. The quantitative nature of data obtained from omics based studies allow for development of prognostic biomarkers based on changes in gene, protein and metabolite expression. In this review, we surveyed the application of transcriptomics, proteomics and metabolomics in the study of HCC recurrence. We summarised the data in the literature from these three fields of studies that claimed to be prognostic for HCC recurrence. We critiqued on the limitations of each area of research and the challenges faced in translating the research results for clinical application in predicting HCC recurrence.

Keywords: Biomarker; Liver cancer; Metabolomics; Proteomics; Recurrence; Transcriptomics.

Figure 1

Predictive systems for outcome of hepatocellular carcinoma patients. Tissue samples (tumour and non-tumour) as well as biological fluids (blood, urine etc.) are used for molecular analysis via omics based methodologies to obtain molecular based signatures for HCC recurrence. The combination of these signatures and clinicopathological features (e.g., HBV or HCV infection, serum AFP levels, tumour staging) would be used to generate predictive systems for intrahepatic recurrence and de novo recurrence. Personalised treatment could be generated and administered based on the molecular basis of recurrence. HCC: Hepatocellular carcinoma; HBV: Hepatitis B virus; HCV: Hepatitis C virus; AFP: Alpha-fetoprotein.