Common Sensitive Diagnostic and Prognostic Markers in Hepatocellular Carcinoma and Their Clinical Significance: A Review

Liver cancer is one of the most serious cancers that lead to death around the world. In Saudi Arabia, it represents 4.1% of all diagnosed cancers in 2020. The total survival rate for all stages of liver cancer is 15% at five years after diagnosis, and this can be affected by the available therapy. Hepatocellular carcinoma (HCC) is known to be the most prevalent primary malignant tumor of the liver, and several studies have been conducted to improve the management approach in the early and late stages. Biomarkers are a useful tool for early diagnosis, disease progression, prognosis, and targeted therapy for patients with liver cancer. The most important biomarker that has been studied is alpha-fetoprotein (AFP), which is elevated in 70% of patients with liver cancer. Also, des-gamma-carboxyprothrombin (DCP) is a more specific biomarker in HCC compared to AFP as it is elevated in HCC, which can be elevated in several conditions that cause active hepatitis. In addition, squamous cell carcinoma antigen (SCCA) and Golgi protein 73 (GP73) have high sensitivity compared to AFP and DCP but poor specificity. All of these markers are useful in the diagnosis, management, and prognosis prediction of liver cancer, especially the combination of AFP and DCP.