HCC Screening Test: Understanding Blood-Based Fusion-Transcript Research

Finding reliable signals for hepatocellular carcinoma (HCC) remains a challenge because biological differences among tumors can affect what appears in blood. An HCC screening test built around a single marker may not capture that variation. MoleculeDx approaches this question through cancer-associated fusion transcripts—RNA molecules that can be produced when parts of genes become joined through cancer-associated genomic rearrangements. Its research program evaluates multiple fusion-transcript signals in blood or serum and uses machine-learning models to combine measured molecular features. This approach is designed to support risk assessment while preserving an essential principle: a blood-based result is not a stand-alone diagnosis. 

What Are Fusion Genes and Fusion Transcripts?

Chromosomal rearrangements can generate recurrent fusion genes whose RNA products may be detected as fusion transcripts. A fusion gene describes the underlying genomic rearrangement joining genetic material from two loci or genes. A fusion transcript is the RNA product derived from that event. When detected in serum’s cell-free fraction, it may be called a cell-free fusion transcript or cell-free fusion RNA.

MoleculeDx uses Fusion-detect™ to describe its proprietary fusion-transcript detection approach. Its preferred public-facing name for the HCC test is Liver Cancer Fusion Predictor.

Why a Multi-Marker Approach Matters?

Different fusion transcripts can occur at different frequencies in tumors and have different detectability in blood or serum. A single marker may not reflect the biological variation among tumors. The MoleculeDx research program therefore evaluates combinations of fusion-transcript signals rather than relying on one marker alone.

This approach does not mean that every fusion transcript occurs only in cancer, or that one detected transcript proves HCC. Some fusion transcripts may also appear in non-HCC individuals. Specificity depends on the fusion, specimen, threshold, and context, so results require appropriate clinical interpretation. 

What the Research Has Evaluated?

Peer-reviewed studies from the MoleculeDx research program identified recurrent fusion transcripts in human cancers and validated several through genomic, transcriptomic, molecular, and functional approaches. A 2019 study demonstrated selected circulating cell-free fusion transcripts in serum from patients with HCC, with heterogeneous detectability among individual fusion transcripts.

A 2024 HCC serum study evaluated a nine-fusion panel and machine-learning classifiers in 61 HCC and 75 non-HCC individuals. Published HCC studies also assessed combinations of serum fusion-transcript measurements using machine-learning models. These models combine measured molecular features to generate a classification or risk assessment. Any reported performance must remain tied to the exact feature set, cutoff scheme, cohort, and specimen type.

Interpreting Blood-Based Molecular Information:

MoleculeDx is grounded in more than a decade of peer-reviewed research on cancer-associated fusion genes and fusion transcripts. The program has studied MAN2A1-FER, PTEN-NOLC1, and SLC45A2-AMACR, which demonstrated oncogenic activity in experimental systems. Findings from experimental models should not be presented as a direct clinical diagnosis or generalized beyond the study context. 

A positive molecular signal is not proof of cancer, and a negative result does not rule out cancer. Fusion-transcript analysis does not replace imaging or other elements of a diagnostic pathway. Discuss blood-based molecular information with a qualified healthcare professional and consider it alongside other clinical information.

A Responsible Screening Conversation:

A modern HCC screening test is not simply another label on a blood sample. It reflects an effort to understand cancer-associated biology, measure multiple signals, and communicate what evidence does—and does not—show. MoleculeDx. presents its Liver Cancer Fusion Predictor through this qualified, research-based framework. Discuss your circumstances with a healthcare professional and ask about the HCC screening test that best fits your clinical context.