**Abbreviations**

(an anticancer drug)-induced the death of tumor cells. Similarly, Liu et al. [77] and Huang et al. [78] investigated the roles of microRNAs, such as microRNA-24 and microRNA-429, in the tumorigenesis of liver cancer on the basis of analyses of hepatocarcinoma samples and genic toxicity induced by aflatoxin B1 and found the dysregulation of these microRNAs increased microvessel density and mutation frequency of TP53 gene possibly resulting from the loss of DNA repair capacity. Taken together, these reports indicate that microRNAs in body fluids and cancerous tissues may be important candidate biomarkers for hepatocarcinoma prognosis.

In the past decades, the advance in pathological mechanisms of microRNAs regulating tumorigenesis and procession of hepatocarcinoma holds great promise for identifying whether microRNAs in body fluids (such as blood and urine) act as novel early diagnostic and prognostic biomarkers for this malignancy. However, we are still far from a comprehensive view of this kind of potentials. Although some hepato-specific microRNAs have been identified, microRNAs in body fluids may be from hemocytes and vascular endothelial cells and others from tissues and organs with high blood flow as well as hepatocarcinoma. This kind of heterogeneous origin indicates that the dysregulation of tumor-specific microRNA signatures may be concealed by microRNAs from other origins. Furthermore, well-standardized protocols of testing microRNAs have not been constructed or confirmed on the basis of the prospective, randomized controlled trials. Disclosing the different diagnostic and prognostic potential of microRNAs will greatly benefit our constructing high accurate diagnostic and prognostic models for hepatocarcinoma and will shed important light on the early diagnosis,

tumor monitoring, and prognosis prediction for individuals with risk factors.

prognosis because they are early detected and easily monitored.

To conclude, the advances in technologies, including microarray PCR technology, highthroughput sequencing, and mass spectrometry, make it possible to identify new markers for hepatocarcinoma diagnosis and prognosis. On the whole, the microRNAs are a class of attractive markers and may replace known traditional serum markers such as AFP on the basis of the following reasons. First, because many circulating microRNAs is highly stable and readily detected in patients with hepatocarcinoma, they may have higher diagnostic potential (with high AUCs, sensitivity, and specificity) for hepatocarcinoma than AFP. Second, some microR-NAs appear in the urine and can be utilized for screening patients with high-risk factors of hepatocarcinoma. Third, some dysregulated microRNAs in the body fluids can change with the different stages of hepatocarcinoma, indicative of their potential in monitoring tumor recurrence. Finally, different expressions of microRNAs are useful for treatment strategies such as TACE selection. Taken together, the dysregulated microRNAs in body fluids (including urine and blood) may be a kind of promised biomarkers for liver carcinoma diagnosis and

**5. Further direction**

116 Hepatocellular Carcinoma - Advances in Diagnosis and Treatment

**6. Summary**

AFP α-fetoprotein AFB1 aflatoxin B1 AUC the area under the receiver operating characteristic curve CT computed tomography HBV hepatitis virus B HCC hepatocellular carcinoma HCV hepatitis virus C MRI magnetic resonance imaging
