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What types of blood tests can help detect liver cancer?

No single blood test can diagnose liver cancer, but blood tests for liver cancer can detect signs of liver dysfunction. Depending on a person’s signs and symptoms, a doctor may recommend additional tests, such as a liver biopsy.

Although blood tests cannot diagnose liver cancer, they can filter for signs of cancer. Blood tests can also look for other causes of a person’s symptoms – these causes can include viral hepatitis.

Some liver diseases, including viral hepatitis, are risk factors for liver cancer. Thus, the presence of a diagnosis does not necessarily mean that a person does not have cancer.

In this article, we look at the blood tests that doctors use to detect liver cancer. We look at the types of blood tests, what they measure, and other tests healthcare professionals use for liver cancer.

A doctor may order blood tests to screen for liver cancer if a person has a high risk liver cancer. This includes people with a history of:

  • cirrhosis
  • hereditary hemochromatosis, where the body absorbs excess iron from the diet
  • chronic hepatitis B

A doctor can also order blood tests for liver cancer if a person has symptoms of liver cancer, such as:

  • an enlarged liver
  • weightloss
  • chronic abdominal pain
  • belly swelling
  • jaundice

Additionally, a doctor may order blood tests for liver cancer if routine blood tests show an atypical result.

Blood tests for liver cancer can test for several symptoms of liver cancer, including:

  • Hepatic dysfunction: Liver function tests may show signs of liver damage. It can mean that a person has liver disease, including cancer or non-alcoholic fatty liver disease.
  • Alpha-fetoprotein (AFP): AFP is present at high levels in people with cancer or liver disease or who are pregnant.
  • Blood clotting problems: The liver helps make proteins that help blood clot. A blood clotting test that shows slow clotting could be a sign of liver damage due to cancer or another disease.
  • Organ damage: Blood urea nitrogen (BUN) and creatinine levels can help assess kidney function. Kidney disease can be a risk factor and sometimes a byproduct of liver disease.
  • Other diseases: Blood tests for other illnesses, such as hepatitis, can help explain symptoms of liver damage.
  • Other signs of illness: Changes in blood chemistry or the balance of red and white blood cells can signal serious illness, including liver cancer.

What follows various blood tests can screen for symptoms of liver cancer:

Complete blood count

A complete blood count may show signs of illness. For example, the white blood cell count may be higher than expected in someone with cancer or an infection. A doctor may recommend additional tests based on the results of a complete blood count.

Blood chemistry tests

Blood chemistry tests look for changes in the balance of various chemicals in the blood. For example, an increase in calcium and a decrease in glucose could indicate liver cancer.

Liver function tests

When the liver is damaged, it released enzymes in the bloodstream. These enzymes include alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP).

Some liver diseases that decrease bile flow can also increase blood bilirubin levels. Elevated liver enzymes or bilirubin suggest that a person has liver disease, such as liver cancer, but a doctor will need to perform further tests.

The proportion of liver enzyme elevations can help indicate cancer. For example, elevations in ALT and AST without a significant elevation in bilirubin or ALP can suggest a problem in liver cells, including potential cancer.

Hepatitis tests

Viral hepatitis is a contagious disease and relatively common a condition that can damage the liver, which could explain the symptoms of liver disease. A person can be diagnosed with hepatitis using a blood test, and the condition is treatable.

However, chronic hepatitis is a risk factor for liver cancer. So a doctor can always recommend other tests to rule out liver cancer.

blood clotting test

The liver helps make proteins that allow blood to clot and stop bleeding. Slower clotting times can signal liver damage. A prothrombin time test measures how long it takes for blood to clot.

AFP test

AFP is a protein that can ride at higher than usual levels in the blood of people with cancer, including liver cancer. This too tends to increase in people with liver disease and during pregnancy. So while it may help indicate a liver problem, it cannot diagnose liver cancer without further testing.

A doctor will need to perform additional tests to diagnose liver cancer. Some tests a doctor could recommend May include:

  • liver biopsy to check for signs of cancer in the liver
  • MRI to visualize a suspected tumor and assess its size
  • CT scans to look for signs of cancer
  • other cancer screening tests to look for cancer that has spread to the liver or to the liver from other places

Typical blood tests should show:

  • no signs of hepatitis or other infections
  • no elevation of liver enzymes
  • no changes in blood chemistry
  • no signs of kidney failure, such as high levels of urea nitrogen
  • typical blood clotting rate

Blood tests alone cannot conclusively diagnose cancer. But in combination with other tests, such as a liver ultrasound, they can strongly indicate disease. If a doctor suspects liver cancer, they can order liver biopsy or MRI.

If a person already has another type of cancer, atypical test results could mean the cancer has spread to the liver or is damaging organs.

Atypical test results can also report another type of liver disease, such as:

No single blood test can diagnose liver cancer, but blood tests can help indicate liver problems that doctors can confirm with additional tests.

Many different medical conditions can cause elevated liver enzymes and other signs of liver damage. Some conditions, such as non-alcoholic fatty liver disease, are common and manageable, while others, such as viral hepatitis, require prompt treatment.

Early-stage liver cancers with liver transplantation have 5-year survival rates of 60–70%. This means that getting an early diagnosis is key to having the best possible outcome.

Doctors do further investigations after atypical liver function tests to rule out cancer and other serious medical conditions. Blood tests and other testing methods can also help people access treatment before their condition worsens.