How Multiple Cancer Markers May Improve Liver Cancer Assessment?
Explore hepatic cancer marker testing with MoleculeDx. Learn about advanced blood-based approaches that support early liver cancer detection and screening.
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Early detection of liver cancer can be challenging, as hepatocellular carcinoma can be asymptomatic. Whilst we can gain valuable information from using a hepatic cancer marker, there is no single blood test for every patient. Traditional monitoring uses ultrasound and alpha-fetoprotein (AFP). However, some patients will have normal AFP results. Research is looking into the molecular markers within the blood, such as circulating fusion transcripts. Knowing what these are and how they are studied can help inform you about how they are being used within care.
Why early information is important?
Patients with cirrhosis, chronic hepatitis B/C, alcohol-related liver disease and metabolic liver disease are at an increased risk of developing HCC. As early HCC may be asymptomatic, most appropriate high-risk patients will be regularly monitored. We recommend using ultrasound and AFP for appropriate patients every 6 months or so according to the American Association for the Study of Liver Diseases. Whilst these are still important, due to their limitations, more research is being done.
What are fusion transcripts?
When cancer occurs, changes can occur within a patient’s DNA. Sometimes sections of two genes will become fused together, forming a fusion gene. This information is then transcribed into molecules called fusion transcripts. Researchers can look for specific fusion transcripts within a patient’s blood serum.
A 2019 study found that certain fusion transcripts were present within the serum of patients with HCC. This was compared to the tumor tissue. Different transcripts had varying levels of detectability, suggesting that looking at one marker may not take into account the biological differences between tumors.
Why multiple markers are looked?
Using multiple markers means we can look at trends within multiple molecular markers. A 2024 study looked at multiple fusion transcripts within HCC patients’ serum. They analyzed these using machine learning techniques to see how the trends differed. Some transcripts were also found within patients who did not have HCC. This suggests they cannot be described as specific to cancer.
Machine learning should never be used to replace clinical judgement. It can help researchers to look for trends within multiple markers. However, any results gained should still be interpreted within the correct medical context where appropriate, further imaging can be performed.
How does this relate to MoleculeDx?
Our science platform is focused on researching cancer-related fusion genes, circulating fusion transcripts and multi-marker analysis. Our educational resources state that we have developed a Liver Cancer Fusion Predictor test that uses blood samples. Our goal is to look at how molecular markers may help provide additional context to traditional monitoring. We are not suggesting that a molecular marker would replace ultrasound, imaging or biopsy. Or that it would replace professional medical advice.
Key points to take away:
The most important thing to take away from this is that liver cancer monitoring is most effective when you understand how useful and limiting each technique is. Whilst new molecular research may help provide more information to clinicians, results should always be interpreted based on the sample type, model and patient group. If you are researching a hepatic cancer marker, speak to a qualified health professional about appropriate monitoring. New testing methods should be seen as part of an ever-developing field.
