Potential Biomarkers for Diagnosis and Prognosis of Hepatocellular Carcinoma

Hepatocellular carcinoma is a devastating disease that require the implementation of personalized medicine to improve management and care of patients with HCC. Developing biomarkers able to reach early diagnosis is crucial to improve survival. Besides, biomarkers helping predicting prognosis and to allow us to better monitoring HCC therapy could improve quality of life and survival. Liquid biopsy emerged as a powerful tool including genetics, epigenetics, transcriptomic, metabolomic, proteomic and exposome. The interaction between different intermediate metabolites is the major challenge we must address in the future. Improving technology, methodology and systems we could reach cheaper, faster, and more efficacious manner to reach our goals. Imaging biomarkers are a crucial pillar. MRI together with CT and ultrasonography in integrated systems could detect liver cancer in early stages. Moreover, dynamic studies could allow us to better understand the nature of the tumor and the potential progression. Bringing liquid biopsy and imaging biomarkers, radiomic, could impact in the clinical daily decision making. Physicians should improve knowledge and skills managing the interpretation of liquid biopsy and imaging biomarkers both for diagnostic aims but also to improve management and monitoring of this disease. Biomarkers could change our manner to apply therapy in patients with HCC. Biomarkers could be useful in the decision-making but also as potential target. Personalized medicine approach to liver cancer require feeling comfortable looking it at as a personalized approach when patient's characteristic are the driver in the decision making.