Johns Hopkins Finds New Ai Blood Test Detects Liver Cancer In Study
The new AI-based blood test detects fragmentation changes that occur among cfDNA.
Johns Hopkins University School of Medicine in Maryland, US, has announced that a new artificial intelligence -based blood testing technology was found to detect more than 80% of liver cancers in a study.
The new blood test, dubbed DNA evaluation of fragments for early interception , was developed and used by researchers at the Johns Hopkins Sidney Kimmel Cancer Center.
It has been designed for the detection of fragmentation changes that occur among DNA shed from cancer cells into the bloodstream, known as cell-free DNA .
In the recent study, which was conducted last year, the researchers used the DELFI technology on blood samples obtained from 724 people to detect hepatocellular cancer , a type of liver cancer.
Of the total plasma samples, 501 were collected in the US and the European Union .
They also included samples from 75 HCC patients for training and validating the machine learning model, a type of AI that leverages data and algorithms to improve accuracy.
The remaining 223 samples were collected from Hong Kong and included samples from 90 HCC patients, 35 HBV-related liver cirrhosis patients, 66 hepatitis B virus patients, and 32 individuals with no underlying risk factors.
The technology detects cancer presence by evaluating several cfDNA fragments for abnormal patterns, along with the size and amount of DNA present in different genomic regions.
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I Have Liver Cancer How Do I Take Care Of Myself
Liver cancer and liver cancer treatments take a toll on your body. Some people have liver transplants or surgery to remove part of their liver. Other people may need treatment for as long as they live. Either way, you should plan on regular appointments with your healthcare provider so they can monitor your progress and watch for signs of recurring liver cancer . For example, people who dont have signs of liver cancer after treatment should plan on follow-up imaging and blood tests every three to six months for the first two years after treatment.
If youve been treated for liver cancer, here are some steps you can take that may reduce your risk for recurrent liver cancer:
A note from Cleveland Clinic
Primary liver cancer is a life-threatening illness. Often, people dont know they have liver cancer until the cancer is in an advanced stage, which limits treatment options. When that happens, healthcare providers focus on treatments to relieve symptoms and slow cancer growth while helping you maintain a quality of life. If you have an advanced form of liver cancer, talk to your healthcare provider about your treatment options, including benefits and side effects so you can feel confident about your choices going forward.
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What Is An Afp Tumor Marker Test
AFP stands for alpha-fetoprotein. It is a protein made in the liver of a developing baby. AFP levels are usually high when a baby is born, but fall to very low levels by the age of 1. Healthy adults should have very low levels of AFP.
An AFP tumor marker test is a blood test that measures the levels of AFP in adults. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body. High levels of AFP can be a sign of liver cancer or cancer of the ovaries or testicles, as well as noncancerous liver diseases such as cirrhosis and hepatitis.
High AFP levels don’t always mean cancer, and normal levels don’t always rule out cancer. So an AFP tumor marker test is not usually used by itself to screen for or diagnose cancer. But it can help diagnose cancer when used with other tests. The test may also be used to help monitor the effectiveness of cancer treatment and to see if cancer has returned after you’ve finished treatment.
Other names: total AFP, alpha-fetoprotein-L3 Percent
What Are Normal Levels Of Ast And Alt Chart
|5 to 40 units per liter of serum|
|ALT||7 to 56 units per liter of serum|
However, the ranges of AST and ALT numbers may differ slightly depending on the technique and protocols used by different laboratories worldwide. However, normal reference ranges are routinely provided by each laboratory and printed with each patient’s individual report.
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Do Ast And Alt Test Results Indicate Liver Function
It is important to clarify that ALT and AST levels do not reflect the function of the liver, even though in the medical community and in medical publications they commonly, and incorrectly, are referred to as liver function tests. Even in conditions when AST and ALT are very elevated, the liver still may function properly. Consequently, if you have “elevated liver enzymes” or a high or abnormal liver test, you need to ask your physician exactly what all of the tests indicate.
What Blood Tests Are Done To Detect Liver Function
- Platelet count:Low platelet count has many causes, one of which can be advanced liver disease. Normal platelet counts are about 150,000 to 400,000 per .
- Glucose: Glucose level is maintained in the body by a variety of mechanisms. The liver can release glucose in the blood for nourishment of other cells in case of starvation with insufficient oral intake of glucose. This process, called gluconeogenesis, is another major function of the liver. In advanced liver disease, this function of the liver can be compromised leading to unusually low glucose levels in the absence of adequate oral intake. Conversely, a large number of people with liver cirrhosis become glucose intolerant and develop diabetes.
- GGT : This enzyme is thought to indicate possible liver damage the higher the abnormal level, the more likely there is liver damage. Normal levels of GGT are about 9 to 48 U/L.
- ALP : The liver synthesizes the highest amounts of this enzyme so high levels in the blood may suggest liver injury among other causes. Normal levels of ALP are about 45 to 115 U/L.
- LD or LDH : This enzyme may be elevated in many types of diseases, including liver disease. Normal levels are about 122 to 222U/L.
There are other tests such as serum ammonia and serum lactate levels in their panels. There are home liver tests for blood enzyme levels and liver function however, individuals who use these tests should first discuss their use and results with their health care professional.
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What Is It Used For
An AFP tumor marker test may be used to:
- Help confirm or rule out a diagnosis of liver cancer or cancer of the ovaries or testicles.
- Monitor cancer treatment. AFP levels often go up if cancer is spreading and go down when treatment is working.
- See if cancer has returned after treatment.
- Monitor the health of people with cirrhosis or hepatitis.
If you were diagnosed with liver cancer, this test may also be used to help figure out the best treatment you. Certain types of liver cancer related to high AFP levels may be treated with targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells. This therapy may be more effective and cause fewer side effects than traditional chemotherapy.
What Tests Are Used To Diagnose Bile Duct Cancer
If your doctor thinks you may have bile duct cancer, one or more of the following tests may be used for diagnosis:
- Tumor marker test: Carbohydrate antigen 19-9 is a protein that is overproduced by bile duct cancer cells. High levels of carbohydrate antigen 19-9 in your blood may indicate cancer but may also indicate other bile duct diseases like bile duct obstruction or inflammation.
- Liver function tests: Blood tests measuring your liver function can help determine what may be causing your symptoms.
- Imaging tests: Computerized tomography , ultrasound and magnetic resonance imaging , along with magnetic resonance cholangiopancreatography , can help your doctor see your internal organs to search for signs of bile duct cancer.
- Endoscopic retrograde cholangiopancreatography : Your doctor will pass a thin, flexible tube with a small camera on it through your throat and digestive tract to your small intestine to examine the area where the bile ducts connect to the small intestine.
- Biopsy: Your doctor will remove a small tissue sample and send it to a lab to look for cancer cells. The biopsy may be taken during ERCP or by inserting a thin needle through your skin to the affected area.
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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too? Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Why Do I Need An Afp Tumor Marker Test
You may need an AFP tumor marker test if a physical exam and/or other tests show there is a chance you have liver cancer or cancer of the ovaries or testicles. Your provider may order an AFP test to help confirm or rule out the results of other tests.
You may also need this test if you are currently being treated for one of these cancers, or recently completed treatment. The test can help your provider see if your treatment is working or if your cancer has come back after treatment.
In addition, you may need this test if you have a noncancerous liver disease. Certain liver diseases can put you at a higher risk of getting liver cancer.
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What Do The Results Mean
If your results show high levels of AFP, it may confirm a diagnosis of liver cancer, or cancer of the ovaries or testicles. Sometimes, high levels of AFP can be a sign of other cancers, including Hodgkin disease and lymphoma, or noncancerous liver disorders.
If you are being treated for cancer, you may be tested several times throughout your treatment. After repeated tests, your results may show:
- Your AFP levels are increasing. This may mean your cancer is spreading, and/or your treatment is not working.
- Your AFP levels are decreasing. This may mean your treatment is working.
- Your AFP levels have not increased or decreased. This may mean your disease is stable.
- Your AFP levels decreased, but then later increased. This may mean your cancer has come back after you’ve been treated.
How Do Healthcare Providers Treat Liver Cancer
Healthcare providers have several common treatments for HCC and IHC, including surgery to remove part of your liver, liver transplantation and liver-directed treatments like hepatic arterial embolization and ablation. They may also use several types of chemotherapy, chemoembolization, radiation therapy, radioembolization, immunotherapy and targeted therapy.
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Circulating Tumor Cell Test
A circulating tumor cell test can check for blood biomarkers that show whether normal cells are transforming into cancer cells. CTC tests can help diagnose and screen patients who have a risk of developing cancer, such as a family history of the disease.
CTC tests are helpful in the early detection of cancer as well as monitoring treatment effectiveness over time. The only test currently approved for this purpose is called CellSearch CTC, which offers different prostate, colorectal, and breast cancer assays.
How Are Healthy People Evaluated For Mild To Moderate Rises In Ast/alt Levels
Evaluation of healthy individuals with abnormal liver enzymes needs to be individualized. A doctor may ask for the patients blood test data from old records for comparison. If no old records are available, the doctor may repeat blood tests in weeks to months to see whether these abnormalities persist.
In the meantime, along with a physical examination, by performing thorough medical history the doctor will search for potential infectious and non-infectious causes and risk factors for liver disease such as:
- History of injectable drug use
- Occupational exposure to blood products
- Family history of liver disease .
A complete list of routine medications including over-the-counter medications will be reviewed.
Signs and symptoms of liver disease may or may not be present in individuals with mild increase in liver enzymes. Signs of liver damage can include jaundice, easy bruising, ascites , enlarged spleen , and confusion. Symptoms of liver disease are non-specific and numerous. Some of the more common liver disease symptoms may include fatigue, itching, yellow skin, poor appetite, and abdominal discomfort.
The pattern of liver enzyme abnormalities can sometimes provide useful clues as to the cause of the liver condition. For example, in a majority of people with alcoholic liver disease, liver enzyme levels are not as high as the levels reached in acute viral hepatitis. In alcoholic liver disease, frequently AST tends to be higher than ALT .
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What To Expect During A Hepatic Function Panel Test
Theres no preparation for a liver panel, unless the doctor wants to expand the procedure to include a comprehensive metabolic panel, in which case the patient would need to avoid eating and drinking for eight to 12 hours before the test.
The blood sample may be taken by a phlebotomist, an expert in drawing blood. A small needle is inserted into a vein, usually in one of the patient’s arms. A thin plastic tube connects the needle to one or more vacuum test tubes. These are sent to a laboratory for processing and compared to reference ranges.
What Tests Are Most Often Used To Diagnose Kidney Cancer
Blood tests are not enough to diagnose kidney cancer. If your doctor suspects kidney cancer, youll likely have a range of other tests to confirm your diagnosis. This often includes:
- CT scan. A CT scan uses multiple X-ray images to create detailed images of your kidneys so doctors can look for tumors and other issues.
- MRI. An MRI uses magnetic imaging to create images of your kidney to check the size, shape, and location of any tumors.
- Ultrasound. Anultrasound uses sound waves to create images of your kidneys. It can help locate tumors and whether they are benign or cancerous.
- Bone scan. A bone scan can be done to see the inside of your bones. Your doctor might do this test if they suspect cancer has spread to your bones.
- Biopsy. During a biopsy, a small piece of your kidney is removed with a needle so it can be tested in a lab. Biopsy results can confirm cancer and help diagnose the stage of the tumor.
- Renal angiography.This test helps your doctor see the blood supply to your kidneys in detail. Blood supply to a tumor, if present, is also able to be seen here.
- Intravenous pyelogram. This test requires dye to be injected into a vein so the kidneys are more visible via X-ray. This is another way an obstruction or tumor can be detected.
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How Does Liver Cancer Affect My Body
Your liver is the largest organ in your body, helping you digest your food. Its also one of the most important organs, as no one can live without their liver. Some of the essential tasks your liver manages include:
- Collects and filters blood flowing from your intestines.
- Processes and stores nutrients that your intestines absorb.
- Changes some nutrients into energy or substances that your body needs to build tissue.
- Makes bile, a fluid that helps digest fat.
- Digests and stores other nutrients from food like sugar, which makes energy.
- Makes substances that help your blood to clot.
What Are Common Liver Blood Function Tests
Liver blood tests are some of the most commonly performed blood tests. These tests can be used to assess liver functions or liver injury. An initial step in detecting liver damage is a simple blood test to determine the level of certain liver enzymes in the blood. Under normal circumstances, these enzymes mostly reside within the cells of the liver. But when the liver is injured for any reason, these enzymes are spilled into the blood stream. Enzymes are proteins that are present throughout the body, each with a unique function. Enzymes help to speed up routine and vital chemical reactions in the body.
Among the most sensitive and widely used liver enzymes are the aminotransferases. They include aspartate aminotransferase and alanine aminotransferase . These enzymes are normally predominantly contained within liver cells and to a lesser degree in the muscle cells. If the liver is injured or damaged, the liver cells spill these enzymes into the blood, raising the AST and ALT enzyme blood levels and signaling liver disease.
Other blood tests pertaining to the liver are measurements of some of the other enzymes found the liver. In addition to AST and ALT, alkaline phosphatase, 5′ nucleotidase, and gamma-glutamyl transpeptidase are a few of the other enzymes located in the liver. The focus of this article is mainly on the most common liver enzymes, AST and ALT.
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