Molecular signatures associated with HCC recurrence and metastases, we have established an expression database of HCC patients using Affymetrix gene chips. Samples from patients with early recurrent disease were compared with non-recurrent human HCC tissue samples (recurrence is defined as recurrent disease occurring within a 2-year time point of the original treatment). Novel biomarkers associated with early HCC recurrence have been characterized and are being employed as diagnostic markers for early recurrent disease.Metastasis that is responsible for the majority of cancer-related deaths is initiated by cancer cells that are shed and disseminated through the circulation from the primary tumor to distant organs (circulating tumor cells, CTCs). Although the detection of CTCs may have important prognostic and therapeutic implications, their detection poses key technical challenges because their numbers can be very small. Great efforts have therefore been made toward the enhancement of signal amplification to significantly increase the sensitivity for the detection of tumor-specific biomarkers on the surface of CTCs. High sensitivity is achieved by using graphene to modify the immunosensor surface to accelerate electron transfer and quantum dot (QD)-coated silica nanoparticles as tracing tags. On the other hand, high specificity is obtained by the simultaneous measurement of multiple HCC-specific biomarkers, identified through the microarray studies, on the cell surface of CTCs using different QD-coated silica nanoparticle tracers.