Intratumoral heterogeneity of hepatocellular carcinoma: From single-cell to population-based studies

Figure 3 Schematic diagram of potential workflow for intratumoral heterogeneity clinical applications. For the patients with resectable liver cancer, intratumoral heterogeneity (ITH) can be evaluated by multiregional sampling of surgical samples, and in the meantime, patient-derived organoid model can be constructed for drug screening. The individualized treatment strategy will be determined according to the heterogeneity evaluation and the pharmacological results. For the patients with advanced hepatocellular carcinoma, biopsies will be used for both pathological diagnosis and ITH investigation. Moreover, ITH evaluation based on cell-free DNA and advanced imaging should be carried out to monitor ITH dynamically and guide medication adjustment. ITH: Intratumoral heterogeneity; cfDNA: Cell-free DNA.