Backgrounds/Aims Increasing evidence indicates that metabolites play a significant role in the pathogenesis of liver cancer and have potential as biomarkers for early detection. This review summarizes the current literature on the utility of metabolomic profiling as a screening strategy for early diagnosis of liver cancer.
Methods We searched PubMed, Embase, and Web of Science for studies published between 2004 and 2024 that examined metabolite alterations in liver cancer. The metabolites differentially expressed in liver cancer versus healthy controls, cirrhosis, and hepatic B virus cases are summarized. The diagnostic performance of the metabolite-based models was also evaluated, highlighting their potential as early detection biomarkers for liver cancer.
Results A total of 96 studies were included in this review, encompassing case-only, case-control, nested case-control, and cohort designs. The analysis identified taurine and taurochenodeoxycholic acid to be consistently associated with an increased risk of liver cancer, supported by findings from both the discovery and validation cohorts. Notably, a diagnostic model incorporating 10 metabolites including taurine and taurochenodeoxycholic acid, achieved an area under the receiver operating characteristic curve of 0.86 (95% confidence interval, 0.82-0.88), indicating strong discriminatory power for early liver cancer detection. Nevertheless, heterogeneity across studies was observed, largely owing to differences in biological sample types and metabolomic platforms.
Conclusions This review highlights the significant roles of taurine and taurochenodeoxycholic acid in liver cancer development. Future research should prioritize the standardization of analytical methodologies, increased sample sizes, and integration of metabolomics with other omics layers to enhance our understanding of liver cancer biology and improve biomarker accuracy and clinical utility.
Advances in our knowledge of the molecular characteristics of hepatocellular carcinoma (HCC) have enabled significant progress in the detection and therapeutic prediction of HCC. As a non-invasive alternative to tissue biopsy, liquid biopsy examines circulating cellular components such as exosomes, nucleic acids, and cell-free DNA found in body fluids (e.g., urine, saliva, ascites, and pleural effusions) and provides information about tumor characteristics. Technical advances in liquid biopsy have led to the increasing adoption of diagnostic and monitoring applications for HCC. This review summarizes the various analytes, ongoing clinical trials, and case studies of United States Food and Drug Administrationapproved in vitro diagnostic applications for liquid biopsy, and provides insight into its implementation in managing HCC.
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Liver cancer is more complex to treat compared to cancers in other organs, since liver function
should be considered. In addition, only a few patients can be applied curative treatment due to
advanced stage at diagnosis. Therefore, early stage detection is important and has been increased
through screening and surveillance programs using image modalities recently. However, it is still
difficult to diagnose small or hypovascular hepatocellular carcinoma (HCC) even using advanced
image modalties. In particular, hypovascular HCCs do not show arterial contrast enhancement
which is a typical finding of HCC on computed tomography (CT) and magnetic resonance
imaging (MRI). Those also account for a considerable portion of early HCC. We present 54 yearsold
man who had recurrent hypervascular and hypovascular nodules on three phase CT and
gadoxetic acid-enhanced MRI. The nodules were removed by surgical resection and confirmed
as combined hepatocellular-cholangiocarcinoma and well differentiated HCC respectively.