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Biomarkers for Hepatocellular Carcinoma in East Asia

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Biomarkers in Liver Disease

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Abstract

Hepatocellular carcinoma (HCC) is undoubtedly a great health threat in East Asia, with the highest incidence of an age-standardized rate of 31.9 per 100,000 in men. In terms of the absolute number of cases, almost half a million cases were reported in China, Japan, and South Korea in 2012. Worldwide, alpha-fetoprotein (AFP) testing and abdominal ultrasound (US) every 6 months are recommended for routine surveillance of HCC in high-risk patients according to many HCC guidelines, and AFP has also been used as a diagnostic test for HCC and to evaluate prognosis and monitor recurrence following treatment. However, controversy regarding the clinical utility of AFP has arisen in the West and East in recent years. This controversy is also evident in HCC guidelines in countries in East Asia. Advances in technology and greater understanding of the pathology of HCC have led to the discovery of novel biomarkers. Data have indicated that the combined testing of AFP, the lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), or des-γ-carboxyprothrombin (DCP) could help to increase the sensitivity of diagnosis of HCC, but this approach is currently used in only a few countries, such as Japan. In recent years, numerous studies have investigated the clinical usefulness of some novel biomarkers in early diagnosis of HCC, including Dickkopf-1 (DKK1), midkine (MDK), and microRNA (miRNA). Moreover, the prognostic significance of some biomarkers, such as miRNA, gamma-glutamyl transferase (GGT), and indocyanine green retention 15 min after administration (ICG-R15), has also been evaluated. However, further studies are needed to better characterize the accuracy and potential role of these approaches in clinical practice. The prevailing hope is that novel biomarkers can support clinicians in their daily practice and improve care for patients with HCC.

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Abbreviations

AASLD:

American Association for the Study of Liver Disease

AFP:

Alpha-fetoprotein

AFP-L3:

The lens culinaris agglutinin-reactive fraction of AFP

ALD:

Alcohol-induced liver disease

APASL:

Asian Pacific Association for the Study of the Liver

CI:

Confidence interval

CT:

Computed tomography

DCP:

Des-γ-carboxyprothrombin

DKK1:

Dickkopf-1

EASL:

European Association for the Study of the Liver

EBM:

Evidence-based medicine

Gd-EOB-DTPA:

Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid

GGT:

Gamma-glutamyl transferase

GP73:

Golgi protein 73

GPC3:

Glypican-3

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

HR:

Hazard ratio

ICG-R15:

Indocyanine green retention 15 min after administration

IL-6:

Interleukin-6

INASL:

Indian National Association for Study of the Liver

KLCSG:

Korean Liver Cancer Study Group

LR+:

Positive likelihood ratio

MDK:

Midkine

miRNA:

MicroRNA

MRI:

Magnetic resonance imaging

NAFLD:

Nonalcoholic fatty liver disease

NCC:

National Cancer Center

NCCN:

National Comprehensive Cancer Network

NHFPC:

National Health and Family Planning Commission

OR:

Odds ratio

SCCA:

Squamous cell carcinoma antigen

TACE:

Transarterial chemoembolization

TARE:

Transarterial radioembolization

US:

Ultrasound

VEGF:

Vascular endothelial growth factor

WHO:

World Health Organization

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Authors and Affiliations

  1. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan

    Peipei Song, Wei Tang & Norihiro Kokudo

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  1. Peipei Song
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  2. Wei Tang
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  3. Norihiro Kokudo
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Correspondence to Peipei Song , Wei Tang or Norihiro Kokudo .

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  1. Sciences Division, King's College, London, United Kingdom

    Victor R. Preedy

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Song, P., Tang, W., Kokudo, N. (2015). Biomarkers for Hepatocellular Carcinoma in East Asia. In: Preedy, V. (eds) Biomarkers in Liver Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7742-2_4-1

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