CURRENT UPDATES ON DIAGNOSTIC BIOMARKERS OF HEPATOCELLULAR CARCINOMA

Hepatocellular carcinoma (HCC) is a liver malignancy, which is a cause of several deaths related to cancer worldwide. In early stages, curative treatment such as surgical resection, liver transplant and local ablation can improve the patient's survival. However, the disease is often diagnosed in an advanced stage; moreover, some available therapies are restricted to palliative care and local treatment. Early diagnosis of HCC and adequate therapy are crucial to increasing survival as well as to improve the patient's quality of life. Therefore, many researchers have been investigating biomarkers such as alpha-fetoprotein (AFP), glypican-3 (GPC3), des-γ-carboxyprothrombin, gamma-glutamyl transferase (GGT), serum α-L-fucosidase (AFU), carbonyl reductase 2, golgi phosphoprotein 2, transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), tumor- specific growth factor (TSGF), epidermal growth factor receptor family (EGFR), hepatocyte growth factor/scatter factor, fibroblast growth factor (FGF), circulating nucleic acids (mRNAs), gamma-glutamyl transferase mRNA (GGT mRNA), insulin-like growth factor II (IGF-II) mRNA, albumin mRNA, circulating micro RNAs, heat shock protein (HSP), Golgi protein 73 (GP73), squamous cell carcinoma antigen (SCCA), tumor-associated glycoprotein 72 (TAG-72), zinc-α2-glycoprotein (ZAG), cytokeratin 19, osteopontin, midkine (MDK), gankyrin, annexin A2, soluble urokinase plasminogen activator receptor (suPAR), AXL, thioredoxins (TRXs), cluster of differentiation 147 (CD147) and microRNAs, which can regulate important pathways in carcinogensis, tumor angiogenesis and progression. So, they can be considered as possible markers of progression in HCC and therapeutic targets for this type of cancer. In this review, we discuss the recent advances related to diagnostic biomarkers, clinical aspects and outcome in hepatocellular carcinoma.