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World J Gastroenterol. Mar 28, 2014; 20(12): 3112-3124
Published online Mar 28, 2014. doi: 10.3748/wjg.v20.i12.3112
Prognostic biomarkers for prediction of recurrence of hepatocellular carcinoma: Current status and future prospects
Seow Chong Lee, Hwee Tong Tan, Maxey Ching Ming Chung
Seow Chong Lee, Hwee Tong Tan, Maxey Ching Ming Chung, Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
Maxey Ching Ming Chung, Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore 117543, Singapore
Author contributions: Lee SC, Tan HT and Chung MCM contributed to this paper.
Supported by The National Medical Research Council (NMRC), Singapore (NMRC grant 1259/2010), and a National University of Singapore President’s Graduate Fellowship to Lee SC
Correspondence to: Maxey Ching Ming Chung, Professor, Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 8 Medical Drive, Singapore 117597, Singapore. bchcm@nus.edu.sg
Telephone: +65-65163252 Fax: +65-67791453
Received: September 30, 2013
Revised: December 3, 2013
Accepted: January 2, 2014
Published online: March 28, 2014
Processing time: 177 Days and 21.5 Hours
Abstract

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death worldwide, with region specific etiologies. Despite improvements made in the diagnosis of HCC, the prognosis of HCC patients remains poor due to the high recurrence rate of HCC. There is an urgent need for development of prognostic biomarkers to predict the risk of recurrence in HCC patients after “curative” treatment. Such stratification may aid in patient management and development of personalized medicine for HCC treatment. Omics based studies facilitate the study of global changes in biomolecules in a disease in a high throughput manner, and hence are well poised to understand the complex changes which led to HCC recurrence. The quantitative nature of data obtained from omics based studies allow for development of prognostic biomarkers based on changes in gene, protein and metabolite expression. In this review, we surveyed the application of transcriptomics, proteomics and metabolomics in the study of HCC recurrence. We summarised the data in the literature from these three fields of studies that claimed to be prognostic for HCC recurrence. We critiqued on the limitations of each area of research and the challenges faced in translating the research results for clinical application in predicting HCC recurrence.

Keywords: Liver cancer; Biomarker; Transcriptomics; Proteomics; Metabolomics; Recurrence

Core tip: Hepatocellular carcinoma (HCC) patients have poor prognosis, largely due to the high incidence of recurrence. There is an urgent need for prognostic biomarkers to stratify patients with higher risk of recurrence to aid in clinical management. This review surveys the use of transcriptomics, proteomics and metabolomics in identifying prognostic biomarkers for HCC recurrence. Integration of data from various omics field allow for understanding of major pathways that were dysregulated in HCC recurrence, which could pave the way for development of personalized medicine for management of HCC recurrence.