Clinical utilization of testing for cell-free DNA in hepatocellular cancer.

HCCs are often diagnosed in advanced stages, and most patients are not eligible for curative treatments.

HCCs通常在晚期被诊断出来，大多数患者不符合治愈性治疗的条件。

Semiannual abdominal ultrasound with serum alpha-fetoprotein is the current recommended surveillance strategy; however, it has suboptimal sensitivity and implementation, thereby lowering its effectiveness for early-stage HCC detection.

目前推荐的监测策略是每半年进行一次腹部超声检查并检测血清甲胎蛋白，然而这种方法的敏感性和实施情况并不理想，从而降低了其对早期HCC检测的有效性。

Further, post-treatment monitoring of HCC recurrence or progression is not tailored to tumor aggressiveness.

此外，对HCC复发或进展的术后监测并未根据肿瘤的侵袭性进行个性化调整。

These failures highlight critical unmet needs, which can be addressed by novel biomarkers that enable early detection and guide individualized surveillance and post-treatment follow-up for HCC, ultimately leading to improved outcomes in this disease.

这些失败凸显了关键的未满足需求，这些问题可以通过新的生物标志物来解决，这些生物标志物能够实现早期检测，并指导针对HCC的个性化监测和术后随访，最终导致这种疾病的改善结果。

Cell-free DNA (cfDNA), consisting of small fragments of DNA released from tumor and normal cells into the bloodstream, reflects tumor-specific molecular alterations and has emerged as a promising noninvasive biomarker.

细胞自由DNA（cfDNA），由肿瘤和正常细胞释放到血液中的小片段DNA组成，反映了肿瘤特异性分子改变，并已成为一种有前途的非侵入性生物标志物。

This review summarizes recent advances in cfDNA applications in HCC, including risk stratification, early detection, prognostication, and minimal residual disease assessment.

这篇综述总结了cfDNA在HCC中的最新应用进展，包括风险分层、早期检测、预后评估和微小残留病评估。

Among them, cfDNA has made the most progress in early detection. cfDNA assays, combined with clinical and serum parameters, demonstrate sensitivity noninferior or superior to ultrasound for detecting early HCC, with larger phase 3 validation studies ongoing.

在这些应用中，cfDNA在早期检测方面取得了最大进展。结合临床和血清参数的cfDNA检测，其敏感性不低于或优于超声检查，用于检测早期HCC，更大规模的III期验证研究正在进行中。

In contrast, the use of cfDNA for risk stratification, prognostication, and minimal residual disease detection remains in the early stages of clinical development.

相比之下，使用循环游离DNA（cfDNA）进行风险分层、预后评估和微小残留病检测仍处于临床开发的早期阶段。

Future multicenter studies with standardized methodologies and rigorous validation will be essential to translate cfDNA into routine clinical practice for the management of HCC.

未来需要进行多中心研究，采用标准化的方法学和严格的验证，这对于将cfDNA转化为HCC常规临床管理至关重要。