According to an article recently published in the Journal of the American Medical Association, patients with cirrhosis of the liver who overexpress epithelial growth factor (EGF) in the liver have a significantly increased risk of developing hepatocellular carcinoma (liver cancer). Patients who overexpress EGF may benefit from enhanced screening for liver cancer.
The liver is the largest organ in the body and is responsible for more than 500 functions. These include the secretion of glucose, proteins, vitamins, and fats; the production of bile; the processing of hemoglobin; and the detoxification of numerous substances.
Hepatocellular carcinoma (HCC) is the most common type of liver cancer; it is named for the type of cell within the liver where the cancer originated. Prognosis for patients with HCC is improved when the disease is detected and treated prior to spread.
Cirrhosis of the liver is a condition in which a patient's liver has scar tissue, which impedes the organ's metabolic functions. This condition often deteriorates-potentially to a point when the liver stops functioning.
Epidermal growth factor is involved in the growth and replication of cells. Often, there are mutations within genes affecting the EGF pathway. These mutations may be involved in the initiation and spread of cancer. Alterations in this pathway can be measured through EGF expression.
Researchers from multiple institutions in the United States recently conducted a clinical trial to evaluate the link between expression of EGF in patients with cirrhosis and the potential for increased risk of HCC. This trial included data from 1999 through 2006 involving 328 patients with cirrhosis. Patients were monitored for expression of EGF.
This study demonstrated that patients with higher EGF overexpression in specific areas of the genes had significantly increased rates of HCC.
The researchers concluded that in the future, it may be beneficial for patients with cirrhosis to be checked for EGF levels; those with high levels may benefit from monitoring for HCC to better their chances of optimal outcomes.
Patients with cirrhosis of the liver may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating EGF expression or other "markers" to identify their risk of developing HCC. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (http://www.cancer.gov) and http://www.eCancerTrials.com.
Reference: Tanabe K, Lemoine A, Finkelstin D, et al. Epidermal growth factor gene functional polymorphism and the risk of hepatocellular carcinoma in patients with cirrhosis. Journal of the American Medical Association. 2008;299:53-60.
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