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Jayachandran et al. Hepatoma Res 2018;4:44 Hepatoma Research
DOI: 10.20517/2394-5079.2018.59

Review Open Access

Exosome-based liquid biopsy in the management of
hepatocellular carcinoma

Aparna Jayachandran , Sasidhar Venkata Manda , Ritu Shrestha , Kim R. Bridle , Prashanth Prithviraj ,
1,2
1,2
4
1,2
3
Darrell H. G. Crawford 1,2
1 School of Clinical Medicine, The University of Queensland, Brisbane, QLD 4072, Australia.
2 Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, QLD 4120, Australia.
3 Apollo Hospitals Educational and Research Foundation, Hyderabad, Telangana 500096, India.
4 Fiona Elsey Cancer Research Institute, Ballarat, VIC 3350, Australia.
Correspondence to: Dr. Aparna Jayachandran, Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, QLD 4120,
Australia. E-mail: a.jayachandran@uq.edu.au
How to cite this article: Jayachandran A, Manda SV, Shrestha R, Bridle KR, Prithviraj P, Crawford DHG. Exosome-based liquid biopsy
in the management of hepatocellular carcinoma. Hepatoma Res 2018;4:44. http://dx.doi.org/10.20517/2394-5079.2018.59
Received: 14 May 2018 First Decision: 3 Jul 2018 Revised: 11 Jul 2018 Accepted: 12 Jul 2018 Published: 13 Aug 2018

Science Editor: Guang-Wen Cao Copy Editor: Jun-Yao Li Production Editor: Cai-Hong Wang

Abstract
Hepatocellular carcinoma (HCC) commonly presents at an advanced stage due to the lack of efficient early screening
tools. Early, non-invasive biomarkers useful in the diagnosis and prognosis of HCC would be of significant benefit for
HCC management. Development of exosome-based liquid biopsy as a non-invasive method for the management of HCC
has gained much traction. Exosomes are small membranous vesicles secreted by most cell types including HCC cells.
Exosomes serve as couriers for the intercellular transfer of important biomolecules, including, protein, nucleic acids
and lipids to nearby and distant cells in the body. The molecular cargos carried by exosome have been described to play
significant roles in cancer progression. Herein, we will dissect how HCC-derived exosomes confer aggressive traits such
as tumour growth, invasion, immune remodelling and drug resistance to HCC cells. We review the current literature
concerning exosomes as biomarkers in a diagnostic setting, evaluating their prognostic, predictive and monitoring
capabilities. This review will highlight and discuss emerging research in the utility of exosome-based liquid biopsies
therapeutic tools in HCC management. Here we will also focus on advances in exosome biology in preclinical studies.

Keywords: Hepatocellular carcinoma, liquid biopsy, exosomes, microRNA, epithelial-to-mesenchymal transition, cancer
stem cell

INTRODUCTION
Hepatocellular carcinoma (HCC), a fatal primary malignancy of hepatocytes remains a global challenge
due to its high mortality rates and high frequency of recurrence . Surgical resection, chemotherapeutic or
[1-3]
© 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
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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