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Detection of Cell-Free DNA in Blood Plasma Samples of Cancer Patients
Published on: September 9, 2020
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Cell-free DNA testing for early hepatocellular carcinoma surveillance
Lei Chen1, Tong Wu2, Rong Fan3
1National Center of Liver Cancer, Navel Medical University, Shanghai, 210822, PR China; International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute/Hospital, Shanghai, 200438, PR China.
Ebiomedicine
|January 7, 2024
Summary
A new cell-free DNA (cfDNA) test, PreCar Score, shows higher sensitivity for early hepatocellular carcinoma (HCC) detection in liver cirrhosis patients. Combining PreCar Score with ultrasound (US) offers a promising strategy for HCC surveillance.
Area of Science:
- Hepatology
- Oncology
- Biomarkers
Background:
- Liver cirrhosis (LC) is a major risk factor for hepatocellular carcinoma (HCC).
- Current surveillance methods for HCC in LC patients have limited efficacy.
- Early detection of HCC is crucial for improving patient outcomes.
Purpose of the Study:
- To develop and validate a novel screening tool for early HCC detection in high-risk individuals with LC.
- To evaluate the performance of the PreCar Score, a cell-free DNA (cfDNA)-based model, for HCC surveillance.
- To compare the efficacy of PreCar Score, alone and in combination with ultrasound (US) and alpha-fetoprotein (AFP), against existing methods.
Main Methods:
- A multi-center, cross-sectional study involving 4367 LC patients without known HCC and 510 HCC patients in China.
- Development of the PreCar Score using cfDNA features in Stage I cohort (510 HCCs, 2074 LCs).
- Validation of PreCar Score performance in Stage II cohort (2293 LCs) using Tri-phasic CT/enhanced MRI, US, AFP, and cfDNA.
Main Results:
- PreCar Score demonstrated significantly higher sensitivity (51.32%) for detecting early/very early HCC compared to US (23.68%) at 95.53% specificity.
- The combination of PreCar Score and US achieved a sensitivity of 60.53% for early/very early HCC screening with 95.08% specificity.
- P-value < 0.01 (Fisher's exact test) indicated a statistically significant difference in detection rates.
Conclusions:
- A novel cfDNA-based screening tool, PreCar Score, has been developed and validated for HCC detection in high-risk LC populations.
- The combination of PreCar Score and US presents a practical and effective strategy for routine HCC surveillance.
- This approach holds potential for improving early diagnosis and management of HCC in patients with liver cirrhosis.
