Laboratory diagnosis of hepatocellular carcinoma – conventional biomarkers and blood plasma spectroscopy
Abstract
Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, which in most cases develops in the field of liver cirrhosis of various etiologies. Only the early stages of the disease are indicated for surgical, potentially curative treatment.
Only about a third of cases of HCC are caught in the early stages. The screening examination of risk groups of patients is liver ultrasonography (USG) at 6-month intervals.
Besides its well-known advantages, USG has significant limitations. The sensitivity of USG for the early stages of HCC is only around 60 %.
Considering this and also because it is an expert-dependent method, there is an urgent need for an objective HCC biomarker. Alpha-fetoprotein is generally perceived as a biomarker of HCC, however, its sensitivity and specificity for diagnostic or even screening purposes are insufficient.
Other biomarkers have been investigated with varying results, but none have reached the effectiveness of USG. A relatively new approach to this problem is blood plasma spectroscopy, which has proven its effectiveness in various diseases.
From the perspective of HCC, few studies have focused on blood plasma spectroscopy. In the review, the authors also present their work, where blood plasma spectroscopy achieved a sensitivity and specificity of 88 % and 90 %, respectively, in differentiating patients with liver cirrhosis without and with HCC.
Despite all efforts, a sufficiently reliable and validated biomarker of HCC usable for early diagnosis and screening has not yet been identified.