Abstract: Application and prospect of molecular biomarkers in neoadjuvant therapy of hepatocellular carcinoma        LI Zhen-li*, YANG Tian. *The Second Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai 200438；Department of General Surgery, the 963rd Hospital of Joint Service Support Force of PLA, Jiamusi 154000，China
Corresponding author: YANG Tian，E-mail: yangtianehbh@
smmu.edu.cn
Abstract    Hepatectomy remains to be the mainstay of treatment to cure hepatocellular carcinoma（HCC）, while the high postoperative recurrence rate is the dominating factor that restricts its prognosis. Through preoperative intervention, neoadjuvant therapy of HCC can reduce the risk of recurrence after surgery, which is one of the emerging comprehensive therapeutic options in the past few years. It mainly includes local treatment（transcatheter arterial chemoembolization, hepatic artery infusion chemotherapy and radiotherapy，etc.）and systematic treatment（targeted therapy, immunotherapy and combinational therapy, etc.）.Though lacking high-level evidence, increasing prospective studies show neoadjuvant therapy of HCC could confer benefits in pathological remission rate, radical resection rate, as well as long-term disease-free survival after surgery， etc. On the other side, there are still challenges such as low response rate and drug resistance in selected patients, leading to unsatisfactory outcomes including tumor progression during neoadjuvant therapy and poor long-term oncological prognosis. Thus, how to select the potential beneficiaries of neoadjuvant therapy, dynamically monitor the therapeutic response, and predict the surgical prognosis through molecular biomarkers of HCC, has become a research focus in next-stage neoadjuvant therapy for HCC.

Key words: hepatocellular carcinoma, neoadjuvant therapy, molecular biomarker, precise therapy

摘要： 肝切除术是根治原发性肝癌（主要为肝细胞癌）的最主要手段，而术后高复发率是制约病人手术预后的首要因素。新辅助治疗能够通过术前干预降低术后肝癌复发的风险，是近几年来兴起的综合治疗手段之一，主要包括新辅助局部治疗（经肝动脉化疗栓塞术、肝动脉灌注化疗和放疗等）和新辅助系统治疗（靶向治疗、免疫治疗及靶免治疗等）。尽管缺乏高级别证据，但是越来越多的前瞻性研究结果显示，接受新辅助治疗的病人在病理缓解率、根治性切除率、术后无瘤生存等方面均能获益。然而，同样也存在部分病人响应率低下、药物耐药等问题，以至于出现新辅助治疗过程中肿瘤进展、术后肿瘤复发等预后较差的情况。因此，如何个体化地通过肝癌分子标记物选择新辅助治疗的受益人群、动态监测术前治疗效果以及预测手术预后成为肝癌新辅助治疗未来的研究热点。

关键词: 肝细胞癌, 新辅助治疗, 分子标记物, 精准治疗