Test Tackles Cirrhosis Early on, Say Scientists

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Test Tackles Cirrhosis Early on, Say Scientists

by John C. Martin

Article 08-18-04

 

A new, non-invasive blood test is being touted by doctors in Belgium as an early

way of predicting liver cirrhosis in patients with hepatitis—a risk factor for

the development of hepatocellular carcinoma, known more commonly as liver

cancer.1

 

How It Works

The new test, designed by researchers at Ghent University in Belgium, detects

changes in the amount of various sugars that are produced by the liver, which

occur in the transition from fibrosis to cirrhosis. The study team published the

results of its test last April. They say it requires little blood, and avoids

the need for invasive liver biopsies.

 

“We hope to be able to alert patients when the chance of liver cancer increases

sharply,” explained study team leader Nico Callewaert, a researcher at Flanders

Interuniversity Institute for Biotechnology (VIB) in Belgium. “At that moment,

the doctor can test frequently for the presence of cancer cells, and detect the

cancer early enough so that the patient can quite possibly be helped.”

 

Liver Disease Incidence

Millions of people around the world have chronic liver disease. In the U.S.

alone, it’s estimated that as many as 25 million Americans—1 out of every 10—are

or have been affected with liver and biliary diseases. In addition, 300,000

people are hospitalized each year due to cirrhosis. The leading causes of

cirrhosis are chronic hepatitis C infection, and alcoholic liver disease.2

 

Experts describe the liver as a very complex organ where more than 500 metabolic

functions take place, including the clearing of toxic substances from the body,

and the production of proteins that coagulate the blood following wounds. Liver

problems also have a high rate of incidence, experts say, and after cancer and

cardiovascular disorders, are the third leading cause of death among people

between the ages of 40 and 65.

 

The Belgian researchers describe fibrosis as the most problematic aspect of

chronic liver disease, in which connective tissue grows throughout the liver,

disrupting the composition of the organ, and in time, its functioning, as well.

Depending on its cause and on the patient, liver fibrosis can evolve rapidly or

slowly. There are several distinct stages, the final of which is liver

cirrhosis. At that point, a person’s odds of developing liver cancer jump

sharply to between 25 and 40 times higher than normal. In a very advanced

cirrhotic stage, the liver is no longer able to function. The only possibility

at this point is a liver transplant.

 

Biopsy: The Only Current Option

Physicians, therefore, need to design effective treatment plans for patients

with fibrosis, depending on it stage and other factors, Callewaert and his

colleagues explain. If cirrhosis has set in, doctors will want to start keeping

track of the development of liver cancer, which can occur at any moment. While

early detection, followed by relevant treatment is vital, physicians cannot

determine whether a patient has developed cirrhosis except by performing a liver

biopsy, in which a tissue sample is taking by injecting a needle through the

skin into the liver.

 

That’s why Callewaert and his associates developed this less invasive blood

test, they say. In a test group of patients who took part in their trial, the

researchers succeeded in detecting 70% to 80% of early cirrhosis cases. After

the new test detected changes in blood sugars released by the liver, the study

team measured their levels, quite accurately they say, with advanced

instrumentation that is also in use in clinical laboratories for genetic tests.

 

Callewaert and his team say the test is now being perfected, and through

collaborations with industry, they hope to produce one that is easy to use and

shows 100% specificity for liver cirrhosis.

 

A Possible Clinical Approach

Often, a decade or more can pass between a person’s initial diagnosis and the

development of liver cirrhosis. The researchers envision physicians using their

test on an annual basis to quickly detect a change and be able to predict an

early stage of cirrhosis.

 

“The current ‘gold standard’ for liver cirrhosis detection is an invasive,

costly, often painful liver biopsy,” they wrote. “This biomarker combination

could eventually be used to follow-up examinations of chronic liver disease

patients to yield a warning that cirrhosis has developed, and that the risk of

complications (such as hepatocellular carcinoma) has increased considerably.”

 

1. Callewaert N, Van Vlierberghe H, Van Hecke A, Laroy W, Delanghe J, Contreras

R. Noninvasive diagnosis of liver cirrhosis using DNA sequencer-based total

serum protein glycomics. Nat Med 2004 Apr;10(4):429-34.

2. National Liver Foundation. Hepatitis and Liver Disease in the United States.

 

John Martin is a long-time health journalist and an editor for Priority

Healthcare. His credits include coverage of health news for the website of Fox

Television's The Health Network, and articles for the New York Post and other

consumer and trade publications.

 

 

 

 

 

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