Serum biomarkers for early diagnosis of hepatocellular carcinoma

Globally, many guidelines for hepatocellular carcinoma (HCC) treatment recommend HCC screening and surveillance. Serum biomarkers are striking potential tools to screen for and diagnose HCC early thanks to the non-invasive, objective, and reproducible assessments they can potentially enable. α-fetoprotein (AFP) is the biomarker most widely used to test for HCC, but the sensitivity and specificity of AFP vary widely, and total AFP is not always specific, especially when HCC is in its early stages. Recent years, research into multiple serum biomarkers to detect HCC early has garnered attention around the world. Multiple reports have found that combined testing with des-γ-carboxyprothrombin (DCP) and AFP has a sensitivity of 47.5-94.0% and a specificity of 53.3-98.5% in detecting HCC early. Most recently, using new reliable serum biomarkers, such as Dickkopf-1 (DKK1) and Midkine (MDK), to complement AFP as a new trend is expected to be used to facilitate screening for and diagnosing HCC at an earlier stage. However, more such studies are needed before they can be included as valid biomarkers in programs to screen for HCC and in strategies to diagnose patients who present with liver masses.