Seoul National University Hospital suggests the possibility of an effective liver cancer surveillance test
Seoul National University Hospital suggests the possibility of an effective liver cancer surveillance test
- Liver cancer has different aspects depending on race and stage and is difficult to clearly distinguish from other liver diseases in surveillance tests.
- Methylation marker-based blood test can diagnose liver cancer with 70% sensitivity when combined with existing tests
The researchers suggested the possibility of simply and effectively diagnosing liver cancer regardless of race, stage, or presence of liver disease. A domestic research team discovered liver cancer-specific biomarkers and designed a simple blood test-based liver cancer monitoring method to measure them.
A joint research team led by Professor Yu Su Jong and Cho Eun of the Department of Gastroenterology at Seoul National University Hospital and Professor Kim Young-Joon (Researcher Kim Si-Cho and Kim Da-Won) of the Department of Biochemistry at Yonsei University set out a test method to quantitatively analyze methylation markers that appear only in liver cancer. The results of a study measuring the accuracy of the test based on 726 blood samples using this method were announced on November 17.
Liver cancer, the 7th most common cancer in Korea, has a poor prognosis, with 6 out of 10 patients dying within 5 years. Therefore, high-risk groups with risk factors such as liver cirrhosis and hepatitis virus are subject to regular surveillance tests.
However, in existing surveillance tests it is difficult to accurately distinguish between various liver diseases in high-risk groups and actual liver cancer. In addition to this, because the causes of liver cancer are diverse and the symptoms are different depending on racial background, an issue of difficulty in quickly determining whether liver cancer has occurred persists with existing surveillance testing methods.
The research team focused on ‘DNA methylation markers’ that appear specifically in liver cancer to find an effective surveillance test method that can be applied to various liver cancer patients as well as high-risk groups of liver cancer.
*DNA methylation: A type of epigenetic phenomenon that regulates gene expression. Since the developmental pattern can change under the influence of cancer cells, some specific DNA methylation patterns are used as cancer diagnostic biomarkers.
As a result of analyzing a cohort of liver cancer patients composed of people from various racial backgrounds and experiencing different stages, the methylation levels of two DNA types (RNF135 and LDHB) were specifically high. The research team designed a test method to score the methylation level of these DNA. The convenience of the method was increased by using the PCR technique, which can quickly diagnose disease with only a small number of genes.
In particular, the research team's testing method has the advantage of quantitatively analyzing changes in the amount of liver cancer-related DNA as liver cancer progresses. The research team explains that this is advantageous in monitoring the growth status of liver cancer and selecting an effective treatment for each patient.
Using this test method, a total of 726 blood samples consisting of 202 normal people, 211 people at risk for liver cancer, 170 patients with early-stage liver cancer, and 143 patients with late-stage liver cancer were analyzed, and the results showed positive sensitivity for liver cancer with a sensitivity of 57%. This was higher than the sensitivity (45%) of existing blood tests that measure alpha-fetoprotein concentration in the blood.
Furthermore, as a result of analyzing the methylation level and alpha-fetoprotein concentration in a blood test, it was possible to accurately diagnose positive for liver cancer in 7 out of 10 patients.
The research team emphasized that the liver cancer diagnosis method based on DNA methylation markers not only complements the clinical accuracy of existing surveillance tests but is also a useful technique that can be universally used to diagnose liver cancer, which shows various aspects depending on race and stage.
Professor Yu Su Jong (Department of Gastroenterology) at Seoul National University Hospital stated the significance of the study, saying, “This study is significant because it provides a technological foundation that can easily monitor the occurrence of liver cancer in high-risk groups.”
Professor Kim Young-Joon of Yonsei University said, “Through follow-up research, we will derive an AI-based liver cancer risk model that takes into account the patient’s clinical data and minute changes in the amount of methylation markers in the blood.”
This study, which received support from the National Research Foundation of Korea, was published in the international academic journal ‘BMC Molecular Cancer’.
[Photo from left] Professor Yu Su Jong and Cho Eun Ju of Seoul National University Hospital, and Professor Kim Young-Koon of Yonsei University