Shao S, Xiong Y, Kong MW, Yu Y, Zhang CX. Digital polymerase chain reaction detection of telomerase reverse transcriptase promoter mutations in hepatitis B virus related hepatocellular carcinoma. World J Gastrointest Oncol 2026; 18(4): 116504 [DOI: 10.4251/wjgo.v18.i4.116504]
Corresponding Author of This Article
Chun-Xiang Zhang, MD, PhD, Professor, Department of Cardiology, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. zhangchx999@163.com
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Gastroenterology & Hepatology
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Editorial
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Apr 15, 2026 (publication date) through Apr 11, 2026
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Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Shao S, Xiong Y, Kong MW, Yu Y, Zhang CX. Digital polymerase chain reaction detection of telomerase reverse transcriptase promoter mutations in hepatitis B virus related hepatocellular carcinoma. World J Gastrointest Oncol 2026; 18(4): 116504 [DOI: 10.4251/wjgo.v18.i4.116504]
World J Gastrointest Oncol. Apr 15, 2026; 18(4): 116504 Published online Apr 15, 2026. doi: 10.4251/wjgo.v18.i4.116504
Digital polymerase chain reaction detection of telomerase reverse transcriptase promoter mutations in hepatitis B virus related hepatocellular carcinoma
Shuai Shao, Yu Xiong, Mo-Wei Kong, Yang Yu, Chun-Xiang Zhang
Shuai Shao, Yu Xiong, Mo-Wei Kong, Yang Yu, Chun-Xiang Zhang, Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Co-first authors: Shuai Shao and Yu Xiong.
Co-corresponding authors: Yang Yu and Chun-Xiang Zhang.
Author contributions: Shao S and Kong MW wrote the manuscript; Yu Y and Zhang CX provided crucial suggestions, guidance for the writing, and they contributed equally to this manuscript and are co-corresponding authors; Xiong Y reviewed and revised the manuscript; Shao S and Xiong Y contributed equally to this manuscript and are co-first authors. All authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Chun-Xiang Zhang, MD, PhD, Professor, Department of Cardiology, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. zhangchx999@163.com
Received: November 13, 2025 Revised: January 9, 2026 Accepted: January 23, 2026 Published online: April 15, 2026 Processing time: 146 Days and 19.1 Hours
Abstract
This editorial provides an in-depth evaluation of the study by Aizimuaji et al published in the recent issue of the World Journal of Gastrointestinal Oncology, which investigates the prognostic value of the telomerase reverse transcriptase (TERT) promoter C228T mutation in hepatitis B virus-related hepatocellular carcinoma (HCC). The study highlights the innovative application of optimized digital polymerase chain reaction technology to improve the sensitivity of TERT mutation detection. The results demonstrate that the TERT C228T mutation is significantly associated with reduced overall survival and disease-free survival, identifying it as a potential biomarker for poor prognosis. Additionally, the study successfully developed a nomogram model incorporating TERT mutation status, which significantly enhances the accuracy of postoperative recurrence risk prediction. This editorial further discusses the biological significance of TERT mutations in hepatitis B virus-related HCC, emphasizing their role as an early driver of liver carcinogenesis. While digital polymerase chain reaction offers significant advantages over traditional Sanger sequencing, providing a more precise detection tool for clinical applications, large-scale and multi-center validation is still required for broader clinical adoption. Moreover, the editorial explores the potential of integrating TERT mutation detection with other molecular biomarkers for a more comprehensive approach to personalized treatment, providing valuable insights for future precision therapy in liver cancer. This study not only opens new avenues for individualized treatment and early intervention in HCC but also serves as an important reference for the future development of liver cancer biomarkers.
Core Tip: This study provides the first systematic evidence that an optimized digital polymerase chain reaction assay can achieve ultra-sensitive detection of the guanine-cytosine-rich telomerase reverse transcriptase (TERT) promoter C228T mutation in hepatitis B virus-related hepatocellular carcinoma, with 100% sensitivity and a detection limit of 0.55 cp/μL - far surpassing traditional sequencing methods. By integrating TERT mutation status with clinical variables, we developed a prognostic nomogram that accurately predicts overall and disease-free survival, enabling early recurrence detection through ctDNA-based liquid biopsy. This work bridges molecular mechanism and clinical translation, establishing TERT mutation detection by digital polymerase chain reaction as a cornerstone technology for precision hepatocarcinology and individualized postoperative surveillance.
