Hepatocellular carcinoma (HCC) is the sixth most frequently diagnosed cancer and the third leading cause of cancer-related deaths worldwide. Advanced-stage HCC patients have poor survival rates and this requires the discovery of novel clear biomarkers for HCC early diagnosis and prognosis, identifying risk factors, distinguishing HCC from non-HCC liver diseases, and assessment of treatment response. Liquid biopsy has emerged as a novel minimally invasive approach to enable monitoring tumor progression, metastasis, and recurrence. Since the liquid biopsy analysis has relatively high specificity and low sensitivity in cancer early detection, there is a risk of bias. Next-generation sequencing (NGS) technologies provide accurate and comprehensive gene expression and mutational profiling of liquid biopsies including cell-free circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and genomic components of extracellular vesicles (EVs) including micro-RNAs (miRNAs), long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs). Since HCC is a highly heterogeneous cancer, HCC patients can display various genomic, epigenomic, and transcriptomic patterns and exhibit varying sensitivity to treatment options. Identification of individual variabilities in genomic signatures in liquid biopsy has the potential to greatly enhance precision oncology capabilities. In this review, we highlight and critically discuss the latest progress in characterizing the genomic landscape of liquid biopsy, which can advance HCC personalized medicine.

中文翻译：

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肝细胞癌个性化医学液体活检的基因组景观。

肝细胞癌 (HCC) 是全球第六大最常诊断的癌症，也是全球癌症相关死亡的第三大原因。晚期 HCC 患者的生存率很低，这需要发现新的明确的 HCC 早期诊断和预后生物标志物，识别危险因素，区分 HCC 与非 HCC 肝病，以及评估治疗反应。液体活检已成为一种新型的微创方法，可用于监测肿瘤进展、转移和复发。由于液体活检分析在癌症早期检测中具有较高的特异性和较低的敏感性，因此存在偏倚风险。新一代测序 (NGS) 技术提供液体活检的准确和全面的基因表达和突变分析，包括无细胞循环肿瘤 DNA (ctDNA)、循环肿瘤细胞 (CTC) 和细胞外囊泡 (EV) 的基因组成分，包括微RNA (miRNA)、长链非编码 RNA (lncRNA) 和环状 RNA (circRNA)。由于 HCC 是一种高度异质性的癌症，HCC 患者可以表现出各种基因组、表观基因组和转录组模式，并对治疗方案表现出不同的敏感性。在液体活检中识别基因组特征的个体变异有可能大大提高精确的肿瘤学能力。在这篇综述中，我们强调并批判性地讨论了表征液体活检基因组景观的最新进展，