Hepatocellular carcinoma (HCC) represents 75%–85% of primary liver cancers1 and is a major global disease, with a high incidence particularly in parts of South-East Asia and sub-Saharan Africa. While the overall incidence is low in countries such as the USA and Australia, risk factors like chronic HBV and HCV infections, autoimmune hepatitis, chronic alcohol abuse and obesity have led to an increased number of cases in recent years.2 Unfortunately, HCC remains a disease with high mortality, despite new therapeutic advances such as liver transplantation or ablation, which can have good outcomes if high-grade dysplastic nodules or small HCCs (<2 cm) are picked up early.3 4 However, the use of serum biomarker α-fetoprotein (AFP) combined with ultrasonography is dependent on the clinical setting and has suboptimal sensitivity for detection of HCC at an early stage.5 AFP also has poor sensitivity in the presence of chronic liver disease (CLD), which means novel biomarkers are needed for the management of at-risk populations.6 The extracellular component of serum and plasma is a rich source of material in the growing field of ‘liquid biopsy’, and extracellular vesicles (EVs) represent a compartment which can readily be isolated and contains lipid, protein and RNA/DNA cargo suitable for biomarker use. Importantly, EVs have also been found to have a wide-range of roles in intercellular communication in health and disease.7 EVs are broadly defined as lipid bilayer structures lacking organelles, which vary in size from 10 nm to 1 µm. EVs include endosomal vesicles formed intraluminally by …

中文翻译：

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血浆细胞外囊泡含有未注释的小 RNA 簇，适合作为检测早期肝细胞癌的生物标志物

肝细胞癌 (HCC) 占原发性肝癌的 75%–85%1，是一种主要的全球疾病，特别是在东南亚和撒哈拉以南非洲的部分地区发病率很高。虽然美国和澳大利亚等国家的总体发病率较低，但近年来，慢性 HBV 和 HCV 感染、自身免疫性肝炎、慢性酒精滥用和肥胖等风险因素导致病例数量增加。 2 不幸的是，HCC 仍然是一种尽管有新的治疗进展，例如肝移植或消融，但如果早期发现高度发育不良结节或小 HCC（<2 厘米），可能会产生良好的结果。 3 4 然而，这种疾病具有高死亡率。血清生物标志物甲胎蛋白 (AFP) 联合超声检查的使用取决于临床环境，并且在早期检测 HCC 方面的敏感性欠佳。 5 AFP 在存在慢性肝病 (CLD) 时的敏感性也很差，这意味着需要新的生物标志物来管理高危人群。 6 血清和血浆的细胞外成分是“液体活检”不断发展的领域中丰富的材料来源，而细胞外囊泡 (EV) 代表了一个隔室，可以易于分离并含有适合生物标志物使用的脂质、蛋白质和 RNA/DNA 货物。重要的是，还发现 EV 在健康和疾病的细胞间通讯中具有广泛的作用。 7 EV 被广泛定义为缺乏细胞器的脂质双层结构，其尺寸从 10 nm 到 1 µm 不等。EVs 包括腔内形成的内体囊泡……