- Liver (hepatocellular) cancer is a leading cause of cancer-related
deaths worldwide; in 2015 alone 788000 persons died due to liver cancer
according to a World Health Organization (WHO) estimate
- Early diagnosis and treatment remains a challenge as the disease
does not become symptomatic until the advanced stages
- New rapid and inexpensive accurate blood test to detect liver
cancer can be done by the patient himself and overcomes costly tests and
cost-effective test for early diagnosis of liver cancer will have a major
impact in low and middle income countries where the incidence of the disease
and related mortality rates remain high. The test has been developed by a group
of scientists at the University of Utah led by Chemical
Engineering and Chemistry professor Marc Porter and surgeon and professor
Courtney Scaife. The details of their work appear in Analytical Methods
Need For Early Diagnosis of Liver Cancer
Rapid strides have been made in the field
of cancer both in terms of diagnostic modalities available, novel treatments
which have greatly improved the quality of life, as well as the long-term
prognosis of patients.
‘Rapid and inexpensive test to detect liver cancer, will be a boon in low and middle income countries for mass screening and prevention, as well as follow-up of treated patients’
Unfortunately however, liver cancer often
goes undetected in early stages, as it remains clinically silent and becomes
symptomatic only in the later stages of the disease, when a cure may not always
is very prevalent and one of the leading causes of death in
certain parts of Southeast Asia such as Mongolia. In addition, geographical
considerations with lack of access to proper health care and absence
of effective outreach programs also contribute to the increased mortality.
The study team believes that their simple
and portable test will go a long way in early diagnosis and treatment with
better outcome for such patients and their families.
For Early Liver Cancer Diagnosis - Alpha-fetoprotein Detection
- The test is based on the reaction of
specific antigen (alpha-fetoprotein, AFP in this case) and the
corresponding antibody to produce a color change or signal which is
visible and can be measured.
- The test kit consists of a small domino-sized
plastic cartridge having a thin paper membrane impregnated with antibody
(AFP antibody here) to the specific antigen which is being tested.
- The patient's test sample (eg: a
small drop of blood, urine, saliva or even a teardrop), is dropped onto
- Following this a drop of gold
nanoparticles is added to the membrane.
If the sample contains the antigen which
is being tested it will be selectively trapped by the antibody impregnated in
the membrane of the kit.
- Upon adding the gold nanoparticles the
trapped antigen will be tagged by the nanoparticles, resulting in a red
spot on the membrane. This indicates that the person might have the
disease and he needs to seek further medical advice and tests to confirm
"The concept is similar to a home
pregnancy test, but instead of flowing laterally, it flows through the
membrane," says Granger, the lead author on the paper.
- Furthermore, a portable spectrometer
(manufactured by project collaborator B&W Tek, a Delaware-based
manufacturer of mobile spectrometers), can then analyze the membranes and
measure the intensity of color change (proportional to the concentration
of biomarkers) present. This will potentially aid in determining the
severity of disease and response of patient to therapy.
Interestingly the idea for this test came
about following a similar test Porter developed for astronauts to test the
cleanliness of their drinking water on the International Space Station. over
eight years ago.
"This is a smarter offshoot of
that," says Porter, who also is the director of the Nano Institute of
Of Current Diagnostic Tests For Liver Cancer
Currently, diagnosis of liver cancer is based on blood tests and ultrasound imaging
that would require travelling to a diagnostic lab or a medical facility in the
. For many persons, especially in the developing world, this could be
very expensive and the results will take
about two weeks.
"If we can develop a rapid test that
performs at a high level of clinical accuracy," Porter says,
"then we've got something that can
have an impact on human lives."
of Current Study and Future Plans
- The team feels that the test can be
modified (by changing the impregnated antibody) to diagnose several
infectious diseases such as tuberculosis, dengue and malaria.
- The scientists are planning to test
their technology in Mongolia in the spring of 2019, which has one of the
highest death rates from liver cancer.
If the test proves to be beneficial and
effective in field testing, it could usher in a new era in liver cancer
screening, prevention and treatment.
- Third Cohort joins NCI's Affordable Cancer Technologies Program: supporting the development of affordable technologies for cancer detection, diagnosis, and treatment in LMICs - (https://www.cancer.gov/about-nci/organization/cgh/blog/2017/acts-cohort3\