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Shanghai doctors find vital liver test

Patients may one day be able to have a blood test costing just 100 yuan (HK$122) to discover whether they have hepatitis B, cirrhosis or liver cancer, even if their tumour is as small as two centimetres in diameter, thanks to research by a Shanghai medical team.

The discovery by doctors at Zhongshan Hospital that seven microRNAs, or short ribonucleic acid molecules, are strongly related to liver problems, news of which was reported at the website of the Journal of Clinical Oncology last month, can also significantly raise the accuracy of tests for early-stage liver cancer.

Each year, about 400,000 mainlanders are diagnosed with hepatocellular carcinoma (HCC), the most common type of liver cancer, accounting for more than half of new cases around the world.

More than 60 per cent of mainland liver cancer patients are diagnosed too late to be cured. The five-year survival rate for mainland liver cancer patients is just 5 per cent, said Dr Fan Jia , vice-president of Zhongshan Hospital and one of the mainland's leading liver surgeons.

From 2008 to 2010, Fan's team examined blood samples from 947 people in Shanghai, including healthy individuals and those with hepatitis B, cirrhosis or liver cancer. Seven of the more than 130 microRNAs in their blood were closely linked to liver problems and can be used to test the health of a patient's liver. Fan said the tests were 89 per cent accurate.

He said the current check for liver cancer, which looks for the volume of alpha-fetoprotein (AFP) in blood, was not accurate enough. AFP, produced before birth, remains constantly low after the age of one but can rise if the liver becomes diseases.

'For some people, like pregnant women, [or] patients with hepatitis, gonadal carcinoma or gastrointestinal cancer, their AFP level will also possibly shoot up,' Fan said. 'On the other hand, about 40 per cent of liver cancer patients present with normal AFP levels.'

In addition, the small tumours in many early-stage liver cancer patients cannot be identified by ultrasound or computed tomography (CT) scans, he said.

'We would like to develop a new marker to more accurately diagnose liver cancer,' Fan said. 'Since 90 per cent of liver cancer patients have cirrhosis as well, we want this new marker to also distinguish between these two illnesses.'

The test can also tell if a patient has hepatitis B.

Fan said doctors at Zhongshan Hospital plan to test their discovery on 10,000 people before making it available for clinical diagnosis. He estimated blood examinations would only cost 100 yuan a time if they were adopted on a large scale.

Fan's team has applied for patents for the test on the mainland and in the US, Japan and Europe.

120

The number, in millions, of hepatitis B virus carriers on the mainland. Another 40 million carry the hepatitis C virus

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