Biomarkery jako prognostické a prediktivní faktory u pacientů s hepatocelulárním karcinomem podstupujících radiologické onkologické intervence
Title in English | Biomarkers as prognostic and predictive factors in patient with hepatocellular carcinoma undergoing radiological oncological interventions |
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Authors | |
Year of publication | 2023 |
Type | Article in Periodical |
Magazine / Source | Klinická onkologie |
MU Faculty or unit | |
Citation | |
web | https://www.linkos.cz/casopis-klinicka-onkologie/2023-04-15-2/biomarkery-jako-prognosticke-a-prediktivni-faktory-u-pacientu-s-hepatocelularnim/ |
Doi | http://dx.doi.org/10.48095/ccko2023104 |
Keywords | biomarkers; hepatocellular carcinoma; predictive factor; prognosis; thermal ablation; transarterial chemoembolization |
Description | Background: Hepatocellular carcinoma is the most common malignant liver tumor in adults and thermal ablation and transarterial embolization are important methods of therapy. Thermal ablation can be used in early stages. Methods based on the transarterial approach, especially transarterial chemoembolization, play an important role in intermediate stage diseases. The success of procedures depends not only on the bio logical nature and the size of the tumor, on the technical design of the procedure and on the patient‘s response to treatment, but also on the molecular changes associated with these procedures. In addition to classic predictive and prognostic factors including age, patient comorbidities, Child-Pugh score, tumor characteristics, presence of large surrounding vessels, and portal vein thrombosis, molecular prognostic and predictive factors (serum bio markers) are often mentioned in studies. Currently, only a-fetoprotein is routinely used as a prognostic bio marker; however, there are studies referring to new serum bio markers that can potentially help to classical markers and imaging methods to determine the cancer prognosis and predict the success of therapy. These bio markers most often include g-glutamyltranspeptidase, des-?g-carboxyprothrombin, some types of microRNAs, inflammatory and hypoxic substances, whose serum levels are changed by the intervention therapies. Evaluation of these molecules could lead to the optimization of the medical intervention (choice of therapy method, timing of treatment) or change the management of patient follow-up after interventions. Although several bio markers have shown promising results, most serum bio markers still require validation in phase III studies. Purpose: The aim of this work is to present a comprehensive overview of classical and molecular bio markers that could potentially help in the prognostic stratification of patients and better predict the success and effect of radiological intervention methods. |
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