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Urine DNA biomarkers for hepatocellular carcinoma screening
Journal article   Open access   Peer reviewed

Urine DNA biomarkers for hepatocellular carcinoma screening

Amy K Kim, James P Hamilton, Selena Y Lin, Ting-Tsung Chang, Hie-Won Hann, Chi-Tan Hu, Yue Lou, Yih-Jyh Lin, Terence P Gade, Grace Park, …
British journal of cancer, v 126(10), pp 1432-1438
01 Jun 2022
DOI: https://doi.org/10.1038/s41416-022-01706-9
PMID: 35046521
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1038/s41416-022-01706-9View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

alpha-Fetoproteins - analysis Biomarkers, Tumor - urine Carcinoma, Hepatocellular - diagnosis Carcinoma, Hepatocellular - genetics Carcinoma, Hepatocellular - pathology Circulating Tumor DNA - urine Humans Liver Neoplasms - diagnosis Liver Neoplasms - genetics Liver Neoplasms - pathology
Hepatocellular carcinoma (HCC) occurs in a well-defined high-risk patient population, but better screening tests are needed to improve sensitivity and efficacy. Therefore, we investigated the use of urine circulating tumour DNA (ctDNA) as a screening test. Candidate markers in urine were selected from HCC and controls. We then enrolled 609 patients from five medical centres to test the selected urine panel. A two-stage model was developed to combine AFP and urine panel as a screening test. Mutated TP53, and methylated RASSF1a, and GSTP1 were selected as the urine panel markers. Serum AFP outperformed the urine panel among all cases of HCC, but the urine panel identified 49% of HCC cases with low AFP < 20 ng/ml. Using the two-stage model, the combined AFP and urine panel identified 148 of the 186 HCC cases (79.6% sensitivity at 90% specificity), which was 30% more than the cases detected with serum AFP alone. It also increased early-stage HCC detection from 62% to 92% (BCLC stage 0), and 40% to 77% (BCLC stage A). Urine ctDNA has promising diagnostic utility in patients in HCC, especially in those with low AFP and can be used as a potential non-invasive HCC screening test.

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33 citations in Web of Science
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Domestic collaboration
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Web of Science research areas
Oncology
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