**4. Selection Criteria Based on Serum Biological Marker Measurements**

The measurement of serum markers referring to biological tumor characteristics and/or to host immune system reactivity has been considered a fascinating approach to overcome the limits of morphological criteria. Three main categories of measurable biological markers are currently available: (a) serum markers related to the biological characteristics of HCC, such as AFP and des-gamma-carboxyprothrombin (DCP); (b) markers reflecting systemic host inflammation (neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio); and (c) molecular biomarkers that may be measured both in liver tissue and in serum (genetic mutations, enzymes, and microRNAs). In relation to the clinical

purpose of this review, only serum markers will be discussed, as there is still no solid evidence justifying the use of inflammation and molecular biomarkers in clinical practice.
