Progress and prospects of biomarkers in primary liver cancer (Review)

Int J Oncol. 2020 Jul;57(1):54-66. doi: 10.3892/ijo.2020.5035. Epub 2020 Apr 1.


Tumor biomarkers are important in the early screening, diagnosis, therapeutic evaluation, recurrence and prognosis prediction of tumors. Primary liver cancer is one of the most common malignant tumors; it has high incidence and mortality rates and seriously endangers human health. The main pathological types of primary liver cancer include hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) and combined HCC‑cholangiocarcinoma (cHCC‑CC). In the present review, a systematic outline of the current biomarkers of primary liver cancer is presented, from conventional blood biomarkers, histochemical biomarkers and potential biomarkers to resistance‑associated biomarkers. The important relationships are deeply elucidated between biomarkers and diagnosis, prognosis, clinicopathological features and resistance, as well as their clinical significance, in patients with the three main types of primary liver cancer. Moreover, a summary of several important biomarker signaling pathways is provided, which is helpful for studying the biological mechanism of liver cancer. The purpose of this review is to provide help for clinical or medical researchers in the early diagnosis, differential diagnosis, prognosis and treatment of HCC.

Keywords: hepatocellular carcinoma; intrahepatic cholangiocarcinoma; combined hepatocellular carcinoma-cholangiocarcinoma; biomarker; cell signaling; drug resistance.

Publication types

  • Systematic Review

MeSH terms

  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / drug therapy
  • Bile Duct Neoplasms / mortality
  • Bile Duct Neoplasms / pathology
  • Bile Ducts, Intrahepatic / pathology
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / drug therapy
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Diagnosis, Differential
  • Drug Resistance, Neoplasm
  • Early Detection of Cancer / methods
  • Humans
  • Liver / pathology
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Prognosis
  • Signal Transduction


  • Antineoplastic Agents
  • Biomarkers, Tumor