• Wataru Okajima, Shuhei Komatsu, Daisuke Ichikawa, Mahito Miyamae, Takuma Ohashi, Taisuke Imamura, Jun Kiuchi, Keiji Nishibeppu, Tomohiro Arita, Hirotaka Konishi, Atsushi Shiozaki, Ryo Morimura, Hisashi Ikoma, Kazuma Okamoto, and Eigo Otsuji.
• Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
• World J. Gastroenterol. 2017 Aug 21; 23 (31): 5650-5668.

AbstractHepatocellular carcinoma (HCC), with its high incidence and mortality rate, is one of the most common malignant tumors. Despite recent development of a diagnostic and treatment method, the prognosis of HCC remains poor. Therefore, to provide optimal treatment for each patient with HCC, more precise and effective biomarkers are urgently needed which could facilitate a more detailed individualized decision-making during HCC treatment, including the following; risk assessment, early cancer detection, prediction of treatment or prognostic outcome. In the blood of cancer patients, accumulating evidence about circulating tumor cells and cell-free nucleic acids has suggested their potent clinical utilities as novel biomarker. This concept, so-called "liquid biopsy" is widely known as an alternative approach to cancer tissue biopsy. This method might facilitate a more sensitive diagnosis and better decision-making by obtaining genetic and epigenetic aberrations that are closely associated with cancer initiation and progression. In this article, we review recent developments based on the available literature on both circulating tumor cells and cell-free nucleic acids in cancer patients, especially focusing on Hepatocellular carcinoma.

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