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Liquid biopsy identifies chronic liver disease, liver cancer vs. healthy blood

A recently developed liquid biopsy cell-sorting device was able to detect circulating epithelial cells of hepatocyte origin in blood from healthy individuals, patients with chronic liver disease without hepatocellular cancer, and those with HCC, according to a recently published study.

Irun Bhan, MD, from the Massachusetts General Hospital, and colleagues stated that hepatic circulating epithelial cells (CECs) could serve as a significant biomarker in the diagnosis and monitoring of CLD and HCC.

Bhan and colleagues developed an antigen-agnostic cell sorting device — the iChip — which isolates CECs while preserving cell viability and high-quality RNA content.

To determine the iChip’s ability to detect CECs in patients without HCC and discriminate between CECs in patients with and without HCC, the researchers obtained blood samples from 10 healthy donors, 39 patients with CLD and no evidence of HCC, 54 patients with HCC, and 10 who underwent curative treatment for HCC with no evidence of disease.

The procedure including RNA sequencing and immunofluorescent quantification with a threshold of 5 cells per 10 mL of whole blood.

CECs presented in a similar proportion of patients with CLD (79%), those with HCC (81%) and those with no evidence of HCC after treatment (90%) in contrast to 5% in the healthy donors (P < .01).

Among patients with CLD, those with advanced fibrosis (stage 3 or 4) had a higher concentration of CECs compared with those without advanced fibrosis (5.1 vs. 0.7 cells/mL; P < .01).

In a subanalysis, the researchers found that liquid biopsy CEC detection could phenotypically differentiate underlying disease state in cases of chronic liver disease vs. HCC with a preliminary sensitivity of 85% at a specificity of 95%.

“Here we report the novel detection of cells from diseased livers circulating in the bloodstream both by immunofluorescence and [RNA-sequencing] and the potential to use these cells as biomarkers. Important applications of this liquid biopsy may include CLD etiology determination, fibrosis staging, and HCC surveillance,” Bhan and colleagues wrote. “Further study of CECs could open a new field of biomarker development leading to a spectrum of non-invasive diagnosis and monitoring techniques for patients with liver disease.” – by Talitha Bennett

Disclosure: The authors report nor relevant financial disclosures.