Earlier detection is important to improving survival of patients with liver cancer, and combining an ultrasound imaging with a blood test can help achieve that, say researchers, including one of Indian-origin.

Using ultrasound and a blood test for high alpha fetoprotein (AFP) levels together improves detection of early-stage liver cancer significantly, said the study published in the journal Gastroenterology. AFP is a plasma protein that is produced in abundance by the liver cells in the foetus. In adults, AFP levels are normally low, but liver cancer can cause AFP levels to rise. "Liver cancer screening in patients with chronic liver disease has traditionally been performed using an abdominal ultrasound. While ultrasound is readily available and noninvasive, it misses many cancers when they are small," said Amit Singal, associate professor at the University of Texas Southwestern Medical Centre.

Risk factors for liver cancer -- also known as hepatocellular carcinoma (HCC) -- include hepatitis C infection, chronic heavy alcohol consumption, and nonalcoholic fatty liver disease related to diabetes and obesity. Symptoms can include upper abdominal pain or swelling, loss of weight or appetite, white chalky stools, and general fatigue, the researchers said. "Our study found that adding the blood biomarker alpha fetoprotein increased detection of early-stage hepatocellular carcinoma from 45 per cent with ultrasound alone to 63 per cent using the two tests in combination," Singal said.

Liver cancer screening guidelines for patients with cirrhosis vary, with some guidelines calling for just imaging and other guidelines calling for both imaging and AFP measurement. "Our results support a change in clinical practice and the routine use of ultrasound and biomarkers together for liver cancer screening," Singal said. The results were based on a meta-analysis of 32 previous studies. Meta-analysis refers to a technique of combining the results of multiple scientific studies.