People diagnosed with the liver disease hepatitis B are at a higher risk of developing deadly liver cancer within a decade if they carry a certain mutant protein, a clinical study released yesterday suggested.
The decade-long study conducted by the National Health Research Institute demonstrated a close link between the pre-S mutation and liver cancer. Among 200 hepatitis B patients monitored over the past decade, 25 were found to carry the pre-S mutant. Fourteen of the 25 developed the fatal liver cancer, or 56 percent.
"These patients' chances of [having the disease] deteriorate into liver cancer were two times higher than patients without the protein mutant," said the study's leading pathologist Su Ih-jen (蘇益仁).
According to Su, the protein mutant most often emerges in patients when they hit their thirties.
Once the mutation occurs, Su said, the abnormal protein will continue to replicate itself, damaging DNA in the person's liver cells, causing genomic instability, and finally impairing the liver.
Mutations
"Once a patient is infected with the virus, the liver cell's organic compounds start to mutate," Su explained, "Over the passage of decades, some compound mutants can be spotted and destroyed by the body's immune system. Yet as the immune system adapts to mitigate the virus' intrusion, the mutation also evolves. Someday, one way or another, a new mutant develops that can escape the immune system's attack and this leads to cancer. Unfortunately, this is the case with the pre-S mutant."
The study showed that people over the age of 50 were at highest risk. While the pre-S mutant appeared in 24 percent of those patients in the 40-49 age group, the rate increased to 40 percent in the 50-59 age group.
Search for a cure
Su said the research team will dedicate their efforts to finding a possible cure for the protein mutant. Currently, the research institute is cooperating with National Taiwan University Hospital and National Chang Kung University Hospital to expand the scope of human clinical trials.
An estimated 2000 patients with hepatitis B will be included in project and monitored for the next decade.
"We are confident of yielding fruitful results in the next three years," Su said.
Su suggested that people with hepatitis B undergo an ultrasound check two times a year to monitor the spread of cancer-prone cells. Most people with chronic hepatitis B may have no symptoms at all, he warned, but in others, chronic hepatitis can lead to cirrhosis of the liver.
Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. The liver stops working and can't cleanse the body of wastes.
People in the early stages of cirrhosis may not have symptoms. When cirrhosis gets worse, symptoms begin. They may include weight loss, fatigue, jaundice, nausea, vomiting and loss of appetite.
Cirrhosis can lead to liver failure and liver cancer.
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