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Zacharakis et al. Hepatoma Res 2018;4:65 Hepatoma Research
DOI: 10.20517/2394-5079.2018.76

Review Open Access

New and old biomarkers of hepatocellular carcinoma

3
1,2
Georgios Zacharakis , Ahmad Aleid , Khaled K Aldossari 4
1 Endoscopy Unit, Limassol General Hospital, St George’s Medical School, University of Nicosia, Nicosia 1700, Republic of Cyprus.
2 Endoscopy Unit, Department of Internal Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, University Hospital,
Al Kharj 16277, Saudi Arabia.
3 Department of Gastroenterology and Hepatology, King Fahad Medical City, Riyadh 11525, Saudi Arabia.
4 Department of Family Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, University Hospital, Al Kharj 16277,
Saudi Arabia.
Correspondence to: Dr. Georgios Zacharakis, Endoscopy Unit, Department of Internal Medicine, Prince Sattam bin Abdulaziz University
Hospital, Al Kharj 16277, Saudi Arabia. E-mail: GZacharakis@yahoo.gr
How to cite this article: Zacharakis G, Aleid A, Aldossari KK. New and old biomarkers of hepatocellular carcinoma. Hepatoma Res
2018;4:65. http://dx.doi.org/10.20517/2394-5079.2018.76

Received: 11 Jun 2018 First Decision: 24 Jul 2018 Revised: 12 Sep 2018 Accepted: 13 Sep 2018 Published: 17 Oct 2018

Science Editor: Guang-Wen Cao Copy Editor: Cui Yu Production Editor: Zhong-Yu Guo

Abstract
Hepatocellular carcinoma (HCC) is a significant cause of mortality in patients with chronic liver disease around the
world. Development of biomarkers for early HCC detection is a primary public health goal to decrease mortality.
The ideal biomarkers should be highly sensitive and specific for surveillance of high-risk populations and early
detection of HCC and also be able to predict therapeutic outcome and provide a prognosis on survival. Currently,
the new biomarkers do not perform better than the conventional ones such as alpha-fetoprotein in such a way
that they could be widely adopted in clinical practice. Another problem is the low sensitivity of these biomarkers
in the detection of HCC. Further work on the development of novel biomarkers and on a combination of them is
necessary. Advances in identifying unique molecular signatures including genomic, proteomic, metabolomic, and
glycomic profiles have improved our understanding of many biological processes involved in HCC. This review
focuses on the role of old and new biomarkers in surveillance, diagnosis, prognosis, and prediction of response
to therapeutic targets for HCC and provides up-to-date data to health-care providers which would be applied in
clinical practice.

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

INTRODUCTION
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related mortality and morbidity. HCC
accounts for about 6% of all newly diagnosed cancer cases worldwide . Risk factors include chronic hepatitis
[1,2]
[3]
B virus (HBV) and hepatitis C virus (HCV) infection which contributes up to 85% of HCC cases worldwide .

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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