Liquid biopsy for early diagnosis of hepatocellular carcinoma: Current state and future perspectives

Liquid biopsies in cancer have received considerable attention as new biomarkers and subjects of clinical translational research. Liquid biopsy-derived biomarkers, including circulating tumor cells, cell-free nucleic acids, exosomes, tumor-educated platelets, proteins, and metabolites, have shown enormous potential to improve the sensitivity and specificity in early diagnosis of multiple cancer types, including hepatocellular carcinoma (HCC). Several analytes are already used in HCC clinical trials and are currently under investigation with encouraging preliminary results. This article will review the latest studies on liquid biopsy for early diagnosis and screening of HCC and discuss the current advantages and challenges of liquid biopsies in tumor biomarkers and clinical applications. In the future, the validation of large prospective clinical studies, the development of standardized operating procedures, and the integration of other diagnostic tools will open new avenues for applying liquid biopsy in early cancer detection.