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Semin Liver Dis 2019; 39(02): 153-162
DOI: 10.1055/s-0039-1681031
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hepatocellular Carcinoma Risk Stratification by Genetic Profiling in Patients with Cirrhosis

Naoto Fujiwara
1   Liver Tumor Translational Research Program, Simmons Comprehensive Cancer Center, Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
2   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Yujin Hoshida
1   Liver Tumor Translational Research Program, Simmons Comprehensive Cancer Center, Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
› Author Affiliations Funding This work is supported by Uehara Memorial Foundation (to N.F.) and U.S. NIH/NIDDK R01 DK099558, European Union ERC-2014-AdG-671231 HEPCIR, Irma T. Hirschl Trust, U.S. Department of Defense W81XWH-16-1-0363, and Cancer Prevention and Research Institute of Texas RR180016 (to Y.H.).
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Publication History

Publication Date:
25 March 2019 (online)

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Abstract

Prediction of future hepatocellular carcinoma (HCC) risk in the sizable chronic liver disease population is an urgent unmet need to enable regular HCC screening for early detection. Germline deoxyribonucleic acid polymorphisms likely represent etiology-specific host factors that determine HCC susceptibility, including single nucleotide polymorphisms in EGF, IFNL3, MICA, and TLL1 in hepatitis C with or without active viral infection, and PNPLA3, TM6SF2, and MBOAT7 in metabolic liver diseases. Transcriptome-based prognostic liver signature in diseased liver tissue has been associated with long-term HCC risk in viral and metabolic etiologies. Transcriptomic signatures of hepatic injury and specific cell type such as aggregated lymphocytes also predict HCC development. Circulating factors such as proteins and their chemical modification, nucleotides, and metabolites may serve for less-invasive assessment of short- or long-term HCC risk. These biomarkers will enable individual HCC risk-based personalized clinical management for cost-effective early HCC detection and improvement of patient survival.

Keywords

risk prediction - cirrhosis - hepatocellular carcinoma - precision medicine
 

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