{
  "abstract": "Conventional surveillance tools for hepatocellular carcinoma (HCC) have limited sensitivity. Circulating cell-free DNA (cfDNA)-based liquid biopsy is a promising minimally invasive approach; however, its overall diagnostic performance remains unclear. This meta-analysis aimed to comprehensively evaluate the diagnostic accuracy of cfDNA-based liquid biopsy in HCC. Following PRISMA-DTA guidelines, we searched PubMed, EMBASE, and Web of Science until July 2026. Diagnostic accuracy data were pooled using bivariate random-effects models. Methodological quality was assessed using QUADAS-2 and NOS. A total of 29 studies (4250 HCC patients, 7982 controls) were included. Pooled sensitivity and specificity of cfDNA-based testing were 0.82 (95% CI: 0.76-0.86) and 0.91 (95% CI: 0.88-0.93). The area under the summary receiver operating characteristic curve (AUC) was 0.93 (95% CI: 0.91-0.96). Subgroup analyses showed higher sensitivity in advanced HCC 0.91 (95% CI: 0.85-0.95) than early HCC 0.77 (95% CI: 0.71-0.83). Methylation profiling yielded relatively higher sensitivity 0.84 (95% CI: 0.77-0.89), whereas fragmentomics showed relatively favorable specificity 0.93 (95% CI: 0.88-0.96). Combining cfDNA-based testing with alpha-fetoprotein (AFP) significantly improved sensitivity compared with cfDNA alone (0.78 vs. 0.65). No significant publication bias was detected (p = 0.83). cfDNA-based liquid biopsy achieves high diagnostic accuracy for HCC. As exploratory observations, methylation-based assays with relatively higher sensitivity may have potential value for screening high-risk populations, while fragmentomics-based assays with relatively favorable specificity may aid differential diagnosis. Combining cfDNA-based liquid biopsy with AFP further improves diagnostic performance, supporting cfDNA as a promising noninvasive tool for HCC detection. Trial Registration: This systematic review was registered on PROSPERO: CRD420261293877 (https://www.crd.york.ac.uk/PROSPERO/).",
  "abstract_shown": true,
  "affiliations": [
    "Meihe Health Research Institute, The First Hospital of Jilin University, Changchun, China.",
    "Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jiwei Liu",
      "orcid": "0009-0000-6033-246X"
    },
    {
      "affs": [
        0
      ],
      "name": "Yangyu Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Shuo Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yanhua Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Jiang",
      "orcid": "0000-0001-9714-9255"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3ya0r1ts2y6sn.bib",
  "cited_by": 0,
  "doi": "10.1111/cas.70551",
  "fulltext_url": "https://europepmc.org/articles/PMC13683985",
  "id": "3ya0r1ts2y6sn",
  "issns": [
    "1347-9032",
    "1349-7006"
  ],
  "landing_url": "https://europepmc.org/article/MED/42902833",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1306|Cancer Genomics and Diagnostics"
    ]
  ],
  "openalex": "W7223154621",
  "pdf_url": "https://europepmc.org/articles/PMC13683985?pdf=render",
  "pmcid": "PMC13683985",
  "pmid": "42902833",
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3ya0r1ts2y6sn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:53Z",
      "native_id": "MED:42902833",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42902833"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:1306|Cancer Genomics and Diagnostics",
      "subfield": "oncology"
    }
  ],
  "title": "Diagnostic Performance of cfDNA-Based Liquid Biopsy for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.",
  "title_text": "Diagnostic Performance of cfDNA-Based Liquid Biopsy for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:53Z",
  "url": "https://research.draconitic.com/paper/3ya0r1ts2y6sn",
  "venue": "Cancer science",
  "versions": []
}