Pairing ultrasound with a blood test to detect high alpha fetoprotein (AFP) levels demonstrated up to a 40 percent improvement in detecting early-stage liver cancer, according to new research published in the journal Gastroenterology.
Liver cancer is on the rise and currently the fastest increasing solid-tumor cancer in the U.S., according to a National Cancer Institute (NCI) statistic.
"If the cancer is found early, then we can perform curative therapies, allowing patients to live many years," said corresponding author G. Amit Singal, MD, and associate professor of internal medicine and clinical sciences with UT Southwestern Harold C. Simmons Comprehensive Cancer Center in a university release. "Unfortunately, most liver cancer in the United States is discovered at later stages, when curative treatment is not possible, and survival is much worse."
A lack of standard screening guidelines for patients with cirrhosis adds to this problem, with some calling for imaging alone and others requiring imaging along with alpha fetoprotein (AFP) measurement.
In the meta-analysis, published online Feb. 6, UT researchers looked through 32 studies, totaling 13,367 patients, to compare the performance of surveillance imaging, with or without AFP, for early detection of early-stage hepatocellular carcinoma (HCC) in patients with cirrhosis.
Below are some key findings:
- Results showed ultrasound detected any stage HCC with 84 percent sensitivity, but early-stage HCC with only 47 percent sensitivity.
- Ultrasound alone detected HCC with a higher level of specificity than ultrasound plus AFP measurement.
- However, ultrasound with AFP detected early-stage HCC with 63 percent sensitivity, and without AFP with 45 percent sensitivity.
“Our results highlight the importance of continued development and validation of blood-based biomarkers for liver cancer early detection. Most important, our results support a change in clinical practice and the routine use of ultrasound and biomarkers together for liver cancer screening," said Singal.