Diagnostics is one of the key pillars of modern medicine. Diagnostics allows patients and doctors to identify a problem and even get ahead of it if caught early enough.
Cancer diagnostics is an example of how diagnostics can effect significant change. Many cancers can escape notice for months or years, and recurrence is unfortunately quite common. Current research is trying to develop diagnostic tools that can catch cancers at earlier stages, both before and after treatment. Statistically, patients have a much better chance of defeating cancer if it is caught early.
Hepatocellular carcinoma, or liver cancer, is a common form of cancer across the world. It also has a high chance of recurrence after treatment, even when caught early. Current diagnostic testing relies on either imaging, biopsies, or biomarker tracking. The current standard biomarker is α-fetoprotein (AFP), but it lacks efficacy in detecting early-stage liver cancer.
In a new study out of Seoul National University in South Korea, a team of scientists wanted to see how the protein fibronectin would perform as a prognostic biomarker. Fibronectin is known to be expressed at high levels in some cancers and promote tumor progression. The team wanted to know if fibronectin to predict recurrence in a small group of liver cancer patients who experienced remission after successful treatment.
The team analyzed blood levels of both fibronectin and the current standard AFP and other characteristics such as age, sex, etc. All of the 83 patients in the study had early-stage liver cancer that had been successfully treated into remission. Of these, 39 patients developed recurrence over four years. Looking at the biomarker levels, the old standard, AFP, was of no significant predictive value. On the other hand, patients who developed recurrence tended to have higher fibronectin levels post-treatment. The team combined this with the observation that men were also more likely to have a recurrence and developed a prognostic test that could predict recurrence with better results than AFP.
This study managed to develop a simple and easy-to-use test that could predict early-stage liver cancer recurrence after successful remission better than AFP biomarker tests. The prognostic test used fibronectin levels and a patient’s sex, which performed better than alone. The study focused on early-stage liver cancers, and therefore the team admits the test may not work well with later-stage cancers. Catching cancer early is the goal, so even if this doesn’t hold up to late-stage cancers, it is a great step in the right direction.
The study concludes, “changes in serum fibronectin levels may be a surrogate indicator for assessment of treatment response in HCC. Our biomarker-based nomogram might be helpful for predicting tumor recurrence in patients with early HCC undergoing curative treatment.”