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Banini et al. Hepatoma Res 2019;5:34 Hepatoma Research
DOI: 10.20517/2394-5079.2019.30

Review Open Access

The use of cell free DNA in the diagnosis of HCC

Bubu A. Banini, Arun J. Sanyal

Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University,
Richmond, VA 23298, USA.

Correspondence to: Dr. Arun J. Sanyal and Dr. Bubu A. Banini, Division of Gastroenterology, Hepatology and Nutrition,
Department of Internal Medicine, Virginia Commonwealth University, MCV Box 980341, Richmond, VA 23298, USA. Email:
arun.sanyal@vcuhealth.org; bubu.banini@vcuhealth.org

How to cite this article: Banini BA, Sanyal AJ. The use of cell free DNA in the diagnosis of HCC. Hepatoma Res 2019;5:34x.
http://dx.doi.org/10.20517/2394-5079.2019.30

Received: 1 Aug 2019 First Decision: 15 Aug 2019 Revised: 22 Aug 2019 Accepted: 29 Aug 2019 Published: 23 Sep 2019
Science Editor: Jin-Lin Hou Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide and is associated with
Received: First Decision: Revised: Accepted: Published: high mortality. The currently used methods for diagnosing HCC, including imaging modalities and liver biopsy,
detect tumors at a relatively advanced stage or are invasive. Non-invasive biomarkers are urgently needed to
Science Editor: Copy Editor: Production Editor: Jing Yu
facilitate screening and early diagnosis of HCC, as well as treatment monitoring and detection of tumor recurrence.
Liquid biopsy, the analysis of blood or other body fluids to obtain genetic and epigenetic information, has historically
been applied to other types of cancer including breast and prostate cancer. Over the past few decades, liquid biopsy
analysis has shed significant insights on genetic and epigenetic aberrations in HCC detectable in peripheral blood.
Aberrations in nucleic acids found circulating freely in body fluids or contained within extracellular vesicles such
as exosomes or microvesicles show potential clinical utility as non-invasive biomarkers. In this review, we present
available literature on cell-free nucleic acids in the diagnosis of HCC.

Keywords: Hepatocellular carcinoma, liquid biopsy, cell free nucleic acid, cell free DNA, exosomes, microvesicles,
biomarkers

INTRODUCTION
[1]
Hepatocellular cancer (HCC) has become the second leading cause of cancer deaths worldwide .
Unfortunately, most cases of HCC are undetected until late stage due to absence of symptoms in early stage
HCC, and the lack of sensitive and convenient methods of screening. Previous estimates showed that the

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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