Review
Copyright ©The Author(s) 2021.
World J Hepatol. Nov 27, 2021; 13(11): 1568-1583
Published online Nov 27, 2021. doi: 10.4254/wjh.v13.i11.1568
Table 1 Utility and detection limits of existing diagnostic measures of hepatocellular carcinoma
Diagnostic methods
Definition/concept
Diagnostic limit/range
Ref.
Contrast-enhanced ultrasound Inexpensive, non-invasive, first choice for screening HCC; Real time dynamic of blood supply.Small HCC less than 1 cm[101]
Multi phasic enhanced computed tomography 3 dimensional reconstructions, high sensitivity1-2 cm HCC lesion[102]
Magnetic resonance imagingHigh resolution anatomic details, pre-contrast and multi-phasic enhanced 3D; Diffusion weighted imaging-functional imaging2-3 cm HCC lesion [103]
Positron emission tomographyHepatocyte-specific PET tracer, 2-[18F] fluoro-2-deoxy-D-galactose, is used which accumulates in the liver compared with other tissuesDetection of small intrahepatic; HCC lesions[104]
AFPElevated in HCC, non-specific Range: > 500 ng/mL[23]
α-L-fucosidaseExpressed in liver cirrhosisCut-off: 870 nmol/L[105]
Des-γ-carboxy prothrombinSensitive; Not expressed in other liver diseaseCut-off: 40 mAU/mL[105,106]
HSP90α + AFP +TKICombination of markers have improved diagnostic valueHSP90- (76.65-144.00); AFP- (5.33-2000.00); TK1- (0.57-2.30)[26]
AFP, GPC3, and GP73Useful markers for early diagnosis and prognosisUpregulated[27,107]
microRNA: miR-21, miR-199, and miR-122, miR-23aSpecific for diagnosis of HCC; Extremely sensitiveCut-off value of ≥ 210[108,109]
Table 2 List of Food and Drug Administration approved/under trial epi-drugs
Drugs
Classification
Approved year
Indicated disease
Reference/ clinical trial number
AzacytidineDNMT inhibitor 2004MDSNCT01186939
2009AMLNCT00887068
DecitabineDNMT inhibitor2006MDS NCT01751867
2011AMLNCT00260832
VorinostatHDAC inhibitor 2006CTCLNCT00773747
RomidepsinHDAC inhibitor 2009TCLNCT02296398
BelinostatHDAC inhibitor 2015PTCL NCT01839097
PanobinostatHDAC inhibitor 2015MMNCT01023308
2016CMLNCT00451035
2017TCLNCT00490776