The clinical value of total plasma cell-free DNA in hepatitis B virus-related hepatocellular carcinoma

Hepatocellular carcinoma (HCC), one of the most common digestive system tumors, is the 4th most common cancer worldwide; moreover, its incidence continues to rise, resulting in a significant morbidity and mortality burden in recent years (1-4). Hepatitis B virus (HBV) is a major etiological agent of chronic diseases and HCC, especially in Asia and Africa. HBV affects nearly 2 billion people worldwide, and approximately 350 million will become chronic carriers (5). Furthermore, HBV is one of the leading causes of chronic liver disease and increases the risk of developing fibrosis, cirrhosis and HCC (6). Hepatectomy, liver transplantation, and radiofrequency ablation (RFA) are the first-line treatments for early HCC (7,8). However, many patients diagnosed with advanced HCC or poor liver function reserves are not eligible for potentially curative therapies (9). In addition, a high recurrence rate after surgery affects the overall survival (OS) of patients with HBV-related HCC (10)