Omics‐derived hepatocellular carcinoma risk biomarkers for precision care of chronic liver diseases

Abstract

Precise hepatocellular carcinoma (HCC) risk prediction will play increasingly important role with the contemporary HCC etiologies, i.e., non‐alcoholic fatty liver disease and resolved HCV. Because HCC incidence rate in this emerging patient population is relatively low (~1% per year), identification of a subset of patients at the highest risk is critical to concentrate the effort and resources of regular HCC screening to those who most need it. Omics profiling has been derived several candidate HCC risk biomarkers, which could refine HCC screening by enabling individual‐risk‐based personalized or risk‐stratified patient management. Various types of biomolecule have been explored as sources of information to predict HCC risk at various time horizons. Germline DNA polymorphisms likely reflect race/ethnicity‐ and/or etiology‐specific susceptibility to HCC development or chronic liver disease progression toward carcinogenesis. Transcriptomic dysregulations in the diseased liver capture functional molecular status supporting oncogenesis such as inflammatory pathway and myofibroblast activation. Circulating nucleic acids, proteins, and metabolites may serve as less‐invasive measure of molecular HCC risk. Characterization of gut microbiota may also inform HCC risk estimation. Each biomarker may have its niche of clinical application depending on logistics of use, performance, and costs with a goal to eventually improve patient prognosis as a part of the whole algorithm of chronic liver disease management.