title: Serum and tissue markers in hepatocellular carcinoma and cholangiocarcinoma: clinical and prognostic implications.
abstract: HCC represents the sixth most common cancer worldwide and the second leading cause of cancer-related death. Despite the high incidence, treatment options for advanced HCC remain limited and unsuccessful, resulting in a poor prognosis. Despite the major advances achieved in the diagnostic management of HCC, only one third of the newly diagnosed patients are presently eligible for curative treatments. Advances in technology and an increased understanding of HCC biology have led to the discovery of novel biomarkers. Improving our knowledge about serum and tissutal markers could ultimately lead to an early diagnosis and better and early treatment strategies for this deadly disease. Serum biomarkers are striking potential tools for surveillance and early diagnosis of HCC thanks to the non-invasive, objective, and reproducible assessments they potentially enable. To date, many biomarkers have been proposed in the diagnosis of HCC. Cholangiocarcinoma (CCA) is an aggressive malignancy, characterized by early lymph node involvement and distant metastasis, with 5-year survival rates of 5%-10%. The identification of new biomarkers with diagnostic, prognostic or predictive value is especially important as resection (by surgery or combined with a liver transplant) has shown promising results and novel therapies are emerging. However, the relatively low incidence of CCA, high frequency of co-existing cholestasis or cholangitis (primary sclerosing cholangitis -PSC- above all), and difficulties with obtaining adequate samples, despite advances in sampling techniques and in endoscopic visualization of the bile ducts, have complicated the search for accurate biomarkers. In this review, we attempt to analyze the existing literature on this argument.
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.affiliation: Department of Onco-Ematology Medical Oncology, S.G. Moscati Hospital of Taranto Taranto, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Cavaliere
authors.affiliation: Division of Pathology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Alessandrini
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Brigida
authors.initials: B
authors.lastname: Stanzione
authors.affiliation: Department of Medical Oncology, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Facchini
authors.affiliation: Department of Radiology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Balestreri
authors.affiliation: Division of Pathology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Perin
authors.affiliation: Division of Pathology, National Cancer Institute, Aviano (PN), Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Canzonieri
mesh_terms: D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor
keywords: cholangiocarcinoma; hepatocellular carcinoma; metastasis; prognosis; serum markers; tissue markers