Scientists at Birmingham University are using cutting edge technologies to move closer to a blood test that will improve early diagnosis of liver cancer in high risk groups, according to research published in the British Journal of Cancer* today (Tuesday 24 January 2006).

Cancer which first arises in the liver, or hepatocellular carcinoma, is the sixth most common cancer in the world, being especially widespread in East Asia. Treatment works better the earlier it is administered, so finding a way to pick up small tumours in the liver is crucial. High-risk groups, such as people with cirrhosis of the liver, can be monitored currently, but tests are not sensitive enough to detect the disease early.

Studies at the Cancer Research UK Institute for Cancer Studies in Birmingham, in collaboration with researchers in Paris, now suggest that a new approach could find liver cancer at an earlier stage. Using sophisticated blood protein spectrum measurements analysed by computer artificial neural networks, the team was able to define and detect changes characteristic of early liver cancer.

Lead researcher Professor Philip Johnson said: “We’ve shown that the right combination of technology and computer analysis can ‘break the code’ of liver cancer and distinguish people with early liver cancer from those without the disease. Our method was more accurate than the existing liver cancer blood test.

“However, this is only the first step on a long road towards a test that can be reliably used for the many people at risk of developing primary liver cancer. We want to improve the technology to make the test even more accurate. The work to date shows that our test has the potential to reveal liver cancer before symptoms show up.”

Liver diseases, including cirrhosis and hepatitis from the hepatitis B and C viruses, greatly increase the risk of hepatocellular carcinoma. Although vaccinations against the hepatitis B virus are now administered to children in most countries of the world, there are millions of people already infected for whom vaccination would be too late. And as there is no effective vaccination for hepatitis C, the global incidence of liver cancer is going to remain high for several decades.

The current methods used to monitor such high-risk groups include ultrasound scans and a test for the presence of a single protein in the blood called alpha-fetoprotein. It is a good indicator of advanced liver cancer, but less able to detect early disease.

Professor John Toy, medical director of Cancer Research UK, which owns the British Journal of Cancer, said: “In Britain, cancer in the liver most commonly occurs when a cancer spreads from another part of the body. Primary liver cancer is relatively rare. As it usually follows other forms of liver disease, it would be extremely valuable to have reliable ways of detecting early cancer so that people with liver disease could be regularly screened.

“Professor Johnson and his colleagues have made a promising start in developing a potential new test for primary liver cancer. More work is needed to prove that patterns of protein levels associated with liver cancer can be used as a reliable test for monitoring high-risk groups.”


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* British Journal of Cancer, Volume 94, Issue 2

Professor Philip Johnson is director of the Clinical Trials Unit at the Cancer Research UK Institute for Cancer Studies at the University of Birmingham.

The work was carried out in collaboration with Michel Beaugrand’s group at Jean Verdier Hospital, Bondy and Université Paris, France.

Around 2,500 people are diagnosed with primary liver cancer in the UK each year. This is about one per cent of all cancer diagnoses. The major risk factors for liver cancer are infection with hepatitis B and C and consumption of foods contaminated with aflatoxin. Hepatitis B is more common and the distribution of this infection worldwide largely explains differences in rates of liver cancer, with the exception of Japan which has high levels of infection with hepatitis C.

People in Britain with established cirrhosis of the liver may be advised by their doctor to be tested for liver cancer every six months. This would currently involve a blood test for alpha-fetoprotein and a liver ultrasound. For more information, go to Cancer Research UK’s patient information website, CancerHelp UK.

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