Liver Cancer Screening Research Articles

Long-term effectiveness of liver cancer screening: a large-scale prospective community-based trial in Zhongshan City, China

Long-term effectiveness of liver cancer screening: a large-scale prospective community-based trial in Zhongshan City, China

Targeted Analysis of Glycerophospholipids and Mono-, Di-, or Tri-Acylglycerides in Liver Cancer.

The metabolic rearrangements of hepatic metabolism associated with liver cancer are still incompletely understood. There is an ongoing need to identify novel and more efficient diagnostic biomarkers and therapeutic targets based on the metabolic mechanisms of these diseases. In comparison to traditional diagnostic biomarkers, metabolomics is a comprehensive technique for discovering chemical signatures for liver cancer screening, prediction, and earlier diagnosis. Lipids are a large and diverse group of complex biomolecules that are at the heart of liver physiology and play an important role in the development and progression of cancer. In this chapter, we described two detailed protocols for targeted lipids analysis: glycerophospholipids and mono, di, tri-acylglycerides, both by Flow Injection Analysis (FIA) HPLC coupled to a SelexIon/QTRAP 6500+ system. These approaches provide a targeted lipidomic metabolomic signature of dissimilar metabolic disorders affecting liver cancers.

Abstract C104: Addressing health disparities: Enhancing knowledge and screening practices for liver disease risk factors among African Americans

Abstract Background: Liver cancer poses a significant health burden globally, with racial and ethnic disparities in its incidence. Among these disparities, the Black population in the United States faces a heightened risk of liver cancer due to the higher prevalence of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. This study aimed to evaluate the effectiveness of a culturally tailored educational intervention designed to enhance awareness of liver cancer prevention and screening among at-risk populations. Methods: Descriptive statistics were used to characterize participant demographics and clinical factors. Paired t-tests assessed the difference in knowledge scores before and after the intervention. Poisson regression with robust variance estimation determined the association between physicians' recommendations for testing and patients receiving blood tests. Results: The study included 137 African American participants. Prior to the intervention, the majority were aware that casual contact does not transmit HBV or HCV (79.6%) and that sharing needles for tattoos or drug injection can transmit the viruses (77.4%). The mean knowledge score increased significantly from 6.61 pre-intervention to 8.44 post-intervention (p-value<0.001). Poisson regression analysis showed that African American adults were less likely to receive physician recommendations for blood tests for HBV (RR=0.95, 95%CI:0.87,1.04) and HCV (RR=0.91, 95%CI:0.83,1.00) compared to other racial/ethnic groups. Conclusions: The culturally tailored educational intervention effectively improved knowledge of HBV and HCV among African American participants, indicating the importance of culturally sensitive programs in reducing liver cancer disparities. Efforts to increase awareness of liver disease and promote testing within the healthcare system are crucial for reducing the morbidity and mortality associated with HBV and HCV infections among African Americans. Character count (with spaces): 1,963 Acknowledgment: This study was supported by TUFCCC/HC Regional Comprehensive Cancer Health Disparity Partnership, Award Number U54 CA221704(5) from the National Cancer Institute of National Institutes of Health (NCI/NIH) and by NIGMS/NIH award # 1SC3GM131949[GXM1] . The author team would like to thank Community Advisory Board members, leaders, and staff members for collaborating with community/faith-based organization partners. We also acknowledge the research team staff of Planning Evaluation Core under TUFCCC/HC Regional Comprehensive Cancer Health Disparity Partnership for their support and contribution for their support and contributions to Community Outreach Core's data management. Its contents are solely the authors' responsibility and do not necessarily represent the official views of the NCI/NIH or the NIGMS/NIH. Citation Format: Jade A. Truehart, Thoin F. Begum, Keshanti Bruce, Lin Zhu, Ming-Chin Yeh, Evelyn Gonzalez, Marilyn A. Fraser, Ada Wong, Steven Zhu, Nathaly Rubio-Torio, Grace X. Ma, Yin Tan. Addressing health disparities: Enhancing knowledge and screening practices for liver disease risk factors among African Americans [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C104.

Projected population mortality reduction from liquid biopsy screening approaches: High sensitivity screening for focused cancer types and populations—High specificity screening for broad cancer types and populations.

33 Background: There are two distinct ‘liquid biopsy’ cancer screening approaches. Focused testing for selected cancers where screening is recommended but not being received, in which test sensitivity can be prioritized as false positives reflex to standard of care screening. Broad testing for many cancers where false-positives necessitate high test specificity, typically at the expense of sensitivity. The public health impact and testing burden of these approaches has not been explored. Methods: Projected cancer deaths averted and annual number of tests performed based on published performance and target populations for liquid biopsy tests with published data. Focused screening modeled for patients who are not receiving guideline-recommended screening for lung, liver and colorectal cancer. Broad screening modeled for all individuals aged 50-80 and assumed to detect all cancer types. Averted deaths determined by combining the mortality reduction associated with screening (published literature, 20% if no literature); adjusted for reported prospective test sensitivities: focused (85%), broad (28%). Only individuals not receiving a particular cancer screening could have liquid biopsy avert a death for that cancer. Results: Focused and broad screening strategies each prevented approximately 20,000 cancer deaths annually. Focused screening required testing one-fifth as many people annually as the broad testing approach (30MM vs.150MM). All of the projected reduction in mortality associated with focused testing was based on randomized studies; for the broad strategy the equivalent statistic was 53%. Conclusions: Cancer deaths can be reduced equivalently through focused cancer screening at high sensitivity and broad cancer screening at high specificity at one-fifth the testing burden. The impact of false positives in the focused testing approach and false reassurance in the broad testing approach might alter these findings, which could also be affected by the cost of testing and follow-up. [Table: see text]

Serum lipidomic profiling for liver cancer screening using surface-assisted laser desorption ionization MS and machine learning

The liver is a major organ in metabolism, and alterations in serum lipids are associated with liver disorders. Here, a rapid, easy, and reliable screening technique based on lipidomic profiling was developed using machine learning and surface-assisted laser desorption ionization mass spectrometry (SALDI MS) for liver cancer diagnosis. A graphitized carbon matrix (GCM) was created for serum lipid profiling in SALDI MS and demonstrated a better performance for neutral lipids analysis than conventional organic matrices. The fingerprint of serum lipids, including triacylglycerols (TGs), diacylglycerols (DGs), cholesteryl esters (CEs), glycerophospholipids (GPs), and other components, could be directly obtained by GCM-assisted LDI MS without extraction. Five machine learning methods were applied to distinguish liver cancer (LC) patients from healthy controls (HC) and chronic hepatitis B (CHB) patients. The best diagnostic performance was attained by linear discriminant analysis (LDA), which has a confusion matrix accuracy of 98.3 %. The receiver operating characteristic (ROC) curve for liver cancer exhibited an area under the curve (AUC) of 0.99, indicating a high degree of prediction accuracy. One-way ANOVA analysis revealed that numerous TGs were down-regulated in LC group. The results demonstrated the viability of GCM-assisted LDI MS as a valuable diagnostic tool for liver cancer.

Cohort profile: design and methods of the Chinese colorectal, breast, lung, liver, and stomach cancer screening trial (C-BLAST)

Cohort profile: design and methods of the Chinese colorectal, breast, lung, liver, and stomach cancer screening trial (C-BLAST)

Rapid and Label-Free Analysis of Antigen-Antibody Dynamic Binding of Tumor Markers Using Piezoelectric Quartz Crystal Biosensor.

Quantitative biomacromolecular diagnosis is rapidly developing in molecular oncology. In this study, we developed a continuous flow immunoassay device based on a piezoelectric (PZ) quartz crystal biosensor fabricated with whole-electrode occupation for the quantitative molecular diagnosis of tumor markers such as alpha-fetoprotein (AFP). Only one face of the crystal was in contact with the serum sample during the assays. First, the characteristics of AFP and anti-AFP binding kinetics, such as the optimal time for immune response, the average antigen binding rate, the kinetic constants and the optimal standard curve, were investigated. The overall immunoreaction time was only 12 min, the average antigen binding rate of AFP was 45.9 ng/min, the concentration range of AFP detection was 18.8-1100 ng/mL and the association rate constant (kon), dissociation rate constant (koff) and equilibrium dissociation constant (KD) were 5.58×104 M-1s-1,1.79×10-5 s-1 and 3.21×10-10 M, respectively. This sensing system was further validated by detecting AFP values from clinical serum samples, which were obtained from pregnant women, liver and lung cancer patients and those undergoing liver cancer screening. No cross-reactivity with lung cancer markers were found, and the detection results were in good agreement with the radioimmunoassay (RIA) results, with a relative deviation of no more than 3.7% and correlation coefficient r of 0.9998. Therefore, the developed immunoassay device has the potential to be used in large-scale screening for cancers, as well as in novel high-affinity binding drug development.

Spatiotemporal knowledge teacher–student reinforcement learning to detect liver tumors without contrast agents

Detecting Liver tumors without contrast agents (CAs) has shown great potential to advance liver cancer screening. It enables the provision of a reliable liver tumor-detecting result from non-enhanced MR images comparable to the radiologists’ results from CA-enhanced MR images, thus eliminating the high risk of CAs, preventing an experience gap between radiologists and simplifying clinical workflows. In this paper, we proposed a novel spatiotemporal knowledge teacher–student reinforcement learning (SKT-RL) as a safe, speedy, and inexpensive contrast-free technology for liver tumor detection. Our SKT-RL builds a teacher–student framework to realize the exploring of explicit liver tumor knowledge from a teacher network on clear contrast-enhanced images to guide a student network to detect tumors from non-enhanced images directly. Importantly, our STK-RL enables three novelties in aspects of construction, transferring, and optimization to tumor knowledge to improve the guide effect. (1) A new spatiotemporal ternary knowledge set enables the construction of accurate knowledge that allows understanding of DRL’s behavior (what to do) and reason (why to do it) behind reliable detection within each state and between their related historical states. (2) A novel pixel momentum transferring strategy enables detailed and controlled knowledge transfer ability. It transfers knowledge at a pixel level to enlarge the explorable space of transferring and control how much knowledge is transferred to prevent over-rely of the student to the teacher. (3) A phase-trend reward function designs different evaluations according to different detection phases to optimal for each phase in high-precision but also allows reward trend to constraint the evaluation to improve stability. Comprehensive experiments on a generalized liver tumor dataset with 375 patients (including hemangiomas, hepatocellular carcinoma, and normal controls) show that our novel SKT-RL attains a new state-of-the-art performance (improved precision by at least 4% when comparing the six recent advanced methods) in the task of liver tumor detection without CAs. The results proved that our SKT-DRL has greatly promoted the development and deployment of contrast-free liver tumor technology.

Risk-stratified approach by aMAP score for community population infected with hepatitis B and C to guide subsequent liver cancer screening practice: A cohort study with 10-year follow-up.

The aim of this study was to determine whether the age-Male-ALBI-Platelet (aMAP) score is applicable in community settings and how to maximise its role in risk stratification. A total of thousand five hundred and three participants had an aMAP score calculated at baseline and were followed up for about 10 years to obtain information on liver cancer incidence and death. After assessing the ability of aMAP to predict liver cancer incidence and death in terms of differentiation and calibration, the optimal risk stratification threshold of the aMAP score was explored, based on absolute and relative risks. The aMAP score achieved higher area under curves (AUCs) (almost all above 0.8) within 10 years and exhibited a better calibration within 5 years. Regarding absolute risk, the risk of incidence of and death from liver cancer showed a rapid increase after an aMAP score of 55. The cumulative incidence (5-year: 8.3% vs. 1.3% and 10-year: 20.9% vs. 3.6%) and mortality (5-year: 6.7% vs. 1.1% and 10-year: 17.5% vs. 3.1%) of liver cancer in individuals with an aMAP score of ≥55 were significantly higher than in those with a score of <55 (Grey's test p < .001). In terms of relative risk, the risk of death from liver cancer surpassed that from other causes after an aMAP score of ≥55 [HR = 1.38(1.02-1.87)]. Notably, the two types of death risk had opposite trends between the subpopulation with an aMAP score of ≥55 and < 55. To conclude, this study showed the value of the aMAP score in community settings and recommends using 55 as a new risk stratification threshold to guide subsequent liver cancer screening.

Impact of perceived ease of use, organizational support mechanism, and industry competitive pressure on physicians' use of liver cancer screening technology in medical alliances.

Liver cancer is one of the malignant tumors worldwide, while the prevention and control situation is grim at present, and the diffusion of its early screening technology still faces some challenges. This study aims to investigate the influencing mechanism of perceived ease of use, organizational support mechanism, and industry competitive pressure on hepatic early screening technologies use by physicians, so as to promote the wider use of corresponding technologies. Under the theoretical guidance of technology-organization-environment framework and mindsponge theory, this study took hepatic contrast-enhanced ultrasound as an example, and conducted a cross-sectional questionnaire by randomly selecting physicians from Fujian and Jiangxi provinces in China with a high and low incidence of liver cancer, respectively. Structural equation modeling was used to determine the correlation among perceived ease of use, organizational support mechanism, and industry competitive pressure, as well as their impact on the physicians' behavior toward contrast-enhanced ultrasound use. The hypothesis model fits well with the data (χ2/df = 1.863, GFI = 0.937, AGFI = 0.908, RMSEA = 0.054, NFI = 0.959, IFI = 0.980, CFI = 0.980). Under technology-organization-environment framework, the perceived ease of use (β = 0.171, p < 0.05), organizational support mechanism (β = 0.423, p < 0.01), industry competitive pressure (β = 0.159, p < 0.05) significantly influenced physicians' use of hepatic contrast-enhanced ultrasound. Besides, perceived ease of use and organizational support mechanism (β = 0.216, p < 0.01), perceived ease of use and industry competitive pressure (β = 0.671, p < 0.01), organizational support mechanism and industry competitive pressure (β = 0.330, p < 0.01) were all associated significantly. From the lens of information processing (mindsponge theory) and technology-organization-environment framework, this study clarified the social and psychological influencing mechanism of perceived ease of use, organizational support mechanism, and industry competitive pressure on physicians' use of hepatic contrast-enhanced ultrasound. The results will directly propose recommendations for expanding hepatic contrast-enhanced ultrasound utilization and indirectly promoting other appropriate and effective health technologies diffusion within the integrated health system.

Application of the Multi-Omics Liquid Biopsy Method M2P-HCC in Early Liver Cancer Screening for High-Risk Individuals with Hepatitis B-Related Liver Cancer.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide, with low rates of early diagnosis and surgical resection. In recent years, with the rapid development of liquid biopsy technology, circulating tumor DNA (ctDNA) has emerged as a research hotspot in the field of precision medicine for liver cancer. Existing studies have demonstrated the suitability of ctDNA for combined detection with other liver cancer diagnostic markers, enabling a multi-index analysis. In recent years, a novel prediction model has been developed for early liver cancer screening based on ctDNA liquid biopsy, M2P-HCC (methylation, mutation, and protein-HCC), mainly incorporating methylation changes, gene mutations, and protein markers associated with liver cancer. Preliminary validation in the HCCscreenTM Investigational (HIT, ChiCTR1800020233) study, which focused on screening early liver cancer in communities with Hepatitis B surface antigen (HBsAg) positivity, yielded promising results with 100% sensitivity and 94% specificity. However, it remains uncertain whether M2P-HCC can be effectively applied in high-risk populations for Hepatitis B-associated liver cancer, warranting further research. Patients who were under long-term follow-up at the outpatient clinic of the Infectious Diseases Center of West China Hospital of Sichuan University from December 2020 to January 2023 were recruited in this prospective observational study and underwent the M2P-HCC test. The study population consisted of high-risk patients with Hepatitis B-related liver cancer who met the inclusion criteria. Patients with a history of previous malignancy, recent blood transfusion, autoimmune diseases, and human immunodeficiency virus (HIV) infection were excluded. Clinical data were collected at a baseline, and all patients underwent the M2P-HCC blood test. Based on the test results, they were categorized into positive, early-warning, and negative groups. Prospective cohort observation and regular follow-ups were performed for 6-8 months. 313 patients met the inclusion criteria and were included in the study. After 6-8 months of follow-up, HCC occurred in 41(13.1%) participants. The M2P-HCC test demonstrated good predictive performance with an area under the curve (AUC) of 0.88 (95% CI: 0.81-0.95, p < 0.001) and a cutoff value of 83 points (sensitivity 82.9% and specificity 85.7%). In contrast, the combination of alpha-fetoprotein (AFP) and ultrasound (US) yielded an inferior predictive performance (AUC 0.76 (95% CI: 0.69-0.84, p < 0.001), sensitivity 58.5%, and specificity 94.1%). Multivariate analyses revealed that M2P-HCC was an independent predictor of increased risk of HCC (OR = 1.16 [1.09-1.22], p < 0.001). M2P-HCC liquid biopsy demonstrated good performance for early liver cancer screening in high-risk populations of Hepatitis B-related liver cancer, exhibiting better sensitivity than the combination of AFP and US.

Screening for liver cancer: The good, the bad, and the ugly.

Screening for liver cancer: The good, the bad, and the ugly.

EE508 Cost of Liver Cancer Screening in Patients with Cirrhosis

Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, is the fastest growing cause of cancer deaths among Americans. Guidelines recommend biannual ultrasound-based screening, with or without a serum biomarker alpha fetoprotein (AFP) for early detection of HCC in at-risk individuals with cirrhosis. Our objective was to estimate the overall cost of HCC screening from a commercial healthcare system’s perspective.

Application of a Novel One-Side Cell Quartz Crystal Microbalance Immunosensor in the Determination of Alpha-Fetoprotein from Human Serum.

The rapid and accurate detection of alpha-fetoprotein (AFP) levels is of great significance for the diagnosis and later treatment evaluation of liver cancer. In this study, a novel integrated quartz crystal microbalance (QCM) immunosensor based on the design to contact liquids on one side only was developed for the label-free detection of AFP. Anti-AFP mouse monoclonal antibodies were immobilized onto the upper electrode surface of the pre-treatment crystals using the staphylococcus aureus protein A. The AFP antigens in human serum were captured by specific surface-coated antibodies, and testing was carried out by monitoring the corresponding changes in frequency. The concentration range of the antigen detected was 13-760 ng/mL. The frequency characteristics of the process of antibody immobilization were investigated in detail, and high reproducibility of AFP antibody immobilization was achieved (standard deviation (SD) = 2.2 Hz). The developed QCM measurement system demonstrated a short test time (only 30 min), good reproducibility (the biological activity can still maintain more than 90% of the first test till it is reused five times), and accuracy as good as the one achieved with the radioimmunoassay (the maximum relative deviation = 4.8%). The designed QCM test system can easily and quickly detect AFP concentrations up to 760 ng/mL, indicating that the developed QCM assay is likely to lead to an alternative approach in large-scale screening for liver cancer in the near future.

Screening of liver cancer with abbreviated MRI.

Current recommendations for the surveillance of HCC are based on the semiannual liver ultrasound (with or without serum alpha-fetoprotein) in patients with cirrhosis and in subgroups with chronic hepatitis B infection. However, the sensitivity of this strategy is suboptimal for the detection of early-stage tumors, especially in obese patients, due to interoperator variability and poor adherence. The detection rate of focal liver lesions is excellent with MRI, making it the best alternative candidate for surveillance. However, performing a full contrast-enhanced MRI is unrealistic because of limited availability and health economics. Abbreviated MRI (AMRI) corresponds to the acquisition of a limited number of sequences with a high detection rate. The theoretical benefits of AMRI are a reduced acquisition time (≤10 min) with improved time-effectiveness and cost-effectiveness compared with conventional MRI, and greater accuracy than ultrasound. Numerous protocols may be performed, including T1-weighted, T2-weighted, and DWI sequences, with or without contrast administration. Although published studies report promising per-patient results, they should be interpreted with caution. Indeed, most studies were simulated, retrospectively reviewing a subset of sequences in relatively small populations who underwent a full MRI. They also included groups that were not representative of screening populations. In addition, most were published by Asian groups, with at-risk populations that were different from Western populations. There are no existing longitudinal studies that directly compare the different AMRI approaches or AMRI to ultrasound. Finally, it is possible that 1 approach will not fit all patients and that strategies should be tailored to the risk of HCC, in particular in relation to the cost and availability of AMRI. Several trials are ongoing to evaluate these questions.

Disparities in the first-ever diagnosed liver cancers between the emergency department and outpatient department in Taiwan: a population-based study

BackgroundLiver cancer is ranked fifth in incidence and second in mortality among cancers in Taiwan. Nevertheless, the Taiwan government does not screen for liver cancer in its free cancer screening and preventive health examination service. This study compared the differences in cancer stage and survival between patients who received an initial liver cancer diagnosis in outpatient departments (OPDs) and those who received such a diagnosis in emergency departments (EDs).MethodsThis retrospective cohort study used the 2000–2016 National Health Insurance Database to obtain a sample from 2 million Taiwanese residents. To evaluate the effect of the utilization of the adult health examination offered to people aged ≥ 40 years, patients aged ≥ 40 years who received an initial liver cancer diagnosis between 2003 and 2015 were followed up until December 31, 2016.ResultsIn total, 2,881 patients were included in this study. A greater proportion of cancer cases in the OPD group were non-advanced than those in the ED group (75.26% vs. 54.23%). Having stage C or D cancer, having a low monthly salary, and a Charlson comorbidity index score ≥ 8, not having hepatitis B, being divorced, and attending a non-public hospital as the primary care institution were risk factors for initial ED diagnosis. The risk of liver cancer-specific death among the ED group patients was 1.38 times that among the OPD group patients (adjusted hazard ratio = 1.38, 95% confidence interval [CI] = 1.14–1.68, P < 0.001). However, the use of health examination did not exert a significant effect on the likelihood of liver cancer diagnosis in an ED (adjusted odds ratio = 0.86, 95% CI = 0.61–1.21, P = 0.381).ConclusionGovernment-subsidized health examinations are insufficient to prevent first-ever diagnosed liver cancers in EDs. Patients with liver cancers diagnosed in EDs had a higher risk of advanced stage and mortality. For early detection and treatment, the government may consider implementing liver cancer screening for high-risk and low-socioeconomic people.

Research progress in cuproptosis in liver cancer.

Copper, like iron, is an essential trace metal element for human cells. The role of iron overload and ferroptosis has been gradually clarified in tumors, but the role of copper overload and cuproptosis is still being explored. Cuproptosis is a novel mode of cell death, secondary to impaired mitochondrial function induced by copper overload, and characterized by copper-dependent and programmed. The excessive copper leads to protein toxicity stress by binding to sulfhydryl proteins in the tricarboxylic acid (TCA) cycle of mitochondria, disrupting cellular homeostasis and triggering cuproptosis. Copper accumulation has carcinogenic effects on normal cells, dual effects on tumor cells. Liver cancer is one of the most common malignant tumors in China and even globally, with hepatocellular carcinoma (HCC) being the most common histological subtype. Copper exhibits dualism in HCC, as it both contributes to the growth and invasion of HCC cells, and exerts anticancer effects by inducing cuproptosis. Also, cuproptosis-related genes can be the evaluation of immunotherapy effect and the construction of prognostic models. Clarifying the role of copper death in liver cancer can help explore new methods for liver cancer screening, treatment, and prognosis evaluation.

The role of next-generation sequencing in genetic screening of liver cancer

The role of next-generation sequencing in genetic screening of liver cancer

Abstract P060: A case of stage II hepatocellular carcinoma diagnosed using a multi-cancer early detection test

Abstract Introduction: Liver cancer is the third leading cause of cancer-related deaths in the world, with liver cancer incidence and related deaths increasing in the United States. Although there is no guideline-recommending screening for liver cancer for the general population, the American Association for the Study of Liver Diseases recommends liver cancer surveillance in individuals with cirrhosis through ultrasound imaging, with or without alpha-fetoprotein (AFP) testing, every 6 months. A multi-cancer early detection (MCED) test was developed that detects a shared cancer signal from methylation patterns of cell-free DNA in blood. A ‘cancer signal detected’ result (positive result) is reported with 1 or 2 cancer signal origin (CSO) prediction(s). Here, an early-stage liver cancer case is presented to review the diagnostic pathway guided by a positive MCED test result. Case Description/Methods: A 62-year-old White male (BMI: 25.2 kg/m2) with chronic hepatitis B (low viral load since 9 years ago; no active therapy) underwent MCED testing. He reported moderate alcohol use (2-3 drinks/day) and that he formerly smoked over 10 years ago. He had a prostatectomy for prostate cancer 2 years prior to using the test. Three days after a blood sample was collected for analysis by the MCED test, computed tomography (CT) of the abdomen was performed as follow-up on a 1.9 cm indeterminate nodule without interval change for 1 year; CT of the abdomen showed a 1.9x1.9x1.9 cm left hepatic lobe nodule. Ten days after the CT scan, a positive MCED test result (top-CSO prediction=Liver/Bile duct; second-CSO prediction=Lung) was reported to the provider (Day 1). The result was communicated to the patient the next day (Day 2). The positive MCED test result resulted in aggressive evaluation of the mass. Biopsy of the liver nodule revealed hepatocellular carcinoma, moderately differentiated (Day 10). The cancer was subsequently classified as stage II. The mass was completely resected (Day 52). Prior to surgery, AFP level was 29.3 ng/mL (Day 13); after surgery, AFP level was 5.7 ng/mL (Day 66). The patient currently has no clinical symptoms (normal appetite and no weight loss, pain, or jaundice; Day 234). Discussion: The MCED test detected a cancer signal and predicted a liver CSO for an individual with stage II liver cancer. An indeterminate nodule was found in the patient 1 year prior to MCED test use with no resolution. Neither the CT scan results nor AFP level, which was lower than the AFP threshold (400 ng/mL) potentially indicative of hepatocellular carcinoma, would have led to this cancer being worked up without the MCED test. In conjunction with a positive MCED test result with a top-CSO prediction of liver, an aggressive workup took place resulting in diagnostic resolution within 1 month. Early-stage hepatocellular carcinoma has better prognosis and outcomes than late-stage disease. The use of the MCED test guided aggressive diagnostic workup and potentially improved outcomes for this patient. Citation Format: Martin Poliak. A case of stage II hepatocellular carcinoma diagnosed using a multi-cancer early detection test. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P060.

Exploring GI Diseases Across the Lifespan.

Exploring GI Diseases Across the Lifespan.