Abstract

Early non-invasive identification of hepatocellular carcinoma could significantly lower its high global fatality rate. A possible non-invasive method for liquid tumor biopsy is provided by the quantitative measurement of cell-free circulating DNA in plasma or serum. To evaluate the diagnostic accuracy of non-invasive liquid biopsy test for screening and early detection of hepatocellular carcinoma in high-risk individuals, taking histopathology as gold standard. Free circulating DNA in plasma was amplified using a real-time polymerase chain reaction (PCR) technology. Nanodrop 2000 spectrophotometry was used to measure the amount of free circulating DNA, and gel electrophoresis was used to quantify the amount of DNA in blood. The amplification status of hTERT and ?-Globulin gene as markers of hepatocellular carcinoma was estimated. Hepatocellular carcinoma patients had a concentration of free circulating DNA (61.6 ng/ul), which was around six times higher than the value seen in healthy people (10.3 ng/ul). The 95% CI for the area under the ROC curve was 0.890-0.967, with a P-value of less than 0.01. Considerable variation in the copy numbers of hTERT gene and ?-Globulin gene was seen in patients with hepatocellular carcinoma and patients without hepatocellular carcinoma (P<0.01). The hTERT gene had maximum sensitivity of 90% but at the expense of specificity. Whereas, ?-Globulin gene had the highest specificity of 74.9%. The amplification of cell free DNA as well as estimation of hTERT gene quantification status, seems to be higher in patients than in healthy individuals. That’s why liquid biopsy can be helpful in the early diagnosis of HCC.