TY - JOUR
T1 - Clinical and molecular prediction of hepatocellular carcinoma risk
AU - Kubota, Naoto
AU - Fujiwara, Naoto
AU - Hoshida, Yujin
N1 - Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/12
Y1 - 2020/12
N2 - Prediction of hepatocellular carcinoma (HCC) risk becomes increasingly important with recently emerging HCC‐predisposing conditions, namely non‐alcoholic fatty liver disease and cured hepatitis C virus infection. These etiologies are accompanied with a relatively low HCC incidence rate (~1% per year or less), while affecting a large patient population. Hepatitis B virus infection remains a major HCC risk factor, but a majority of the patients are now on antiviral therapy, which substantially lowers, but does not eliminate, HCC risk. Thus, it is critically important to identify a small subset of patients who have elevated likelihood of developing HCC, to optimize the allocation of limited HCC screening resources to those who need it most and enable cost-effective early HCC diagnosis to prolong patient survival. To date, numerous clinical‐variable‐based HCC risk scores have been developed for specific clinical contexts defined by liver disease etiology, severity, and other factors. In parallel, various molecular features have been reported as potential HCC risk biomarkers, utilizing both tissue and body‐fluid specimens. Deep‐learning‐based risk modeling is an emerging strategy. Although none of them has been widely incorporated in clinical care of liver disease patients yet, some have been undergoing the process of validation and clinical development. In this review, these risk scores and biomarker candidates are overviewed, and strategic issues in their validation and clinical translation are discussed.
AB - Prediction of hepatocellular carcinoma (HCC) risk becomes increasingly important with recently emerging HCC‐predisposing conditions, namely non‐alcoholic fatty liver disease and cured hepatitis C virus infection. These etiologies are accompanied with a relatively low HCC incidence rate (~1% per year or less), while affecting a large patient population. Hepatitis B virus infection remains a major HCC risk factor, but a majority of the patients are now on antiviral therapy, which substantially lowers, but does not eliminate, HCC risk. Thus, it is critically important to identify a small subset of patients who have elevated likelihood of developing HCC, to optimize the allocation of limited HCC screening resources to those who need it most and enable cost-effective early HCC diagnosis to prolong patient survival. To date, numerous clinical‐variable‐based HCC risk scores have been developed for specific clinical contexts defined by liver disease etiology, severity, and other factors. In parallel, various molecular features have been reported as potential HCC risk biomarkers, utilizing both tissue and body‐fluid specimens. Deep‐learning‐based risk modeling is an emerging strategy. Although none of them has been widely incorporated in clinical care of liver disease patients yet, some have been undergoing the process of validation and clinical development. In this review, these risk scores and biomarker candidates are overviewed, and strategic issues in their validation and clinical translation are discussed.
KW - Biomarker
KW - Cancer screening
KW - Cirrhosis
KW - Hepatocellular carcinoma
KW - Precision medicine
KW - Risk prediction
UR - http://www.scopus.com/inward/record.url?scp=85107349991&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107349991&partnerID=8YFLogxK
U2 - 10.3390/jcm9123843
DO - 10.3390/jcm9123843
M3 - Review article
C2 - 33256232
AN - SCOPUS:85107349991
SN - 2077-0383
VL - 9
SP - 1
EP - 24
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 12
M1 - 3843
ER -