title: Prevalence of aflatoxin B1 in liver biopsies of proven hepatocellular carcinoma in India determined by an in-house immunoperoxidase test.
abstract: Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related death in the world. The incidence of HCC in India is reportedly low and varies from 0.2 to 1.9 %. Aflatoxins, secondary metabolites produced by Aspergillus flavus and Aspergillus parasiticus, are potent human carcinogens implicated in HCC. The prevalence of aflatoxin B1 (AFB1) as co-carcinogen was analysed using an in-house immunoperoxidase test in 31 liver biopsies and 7 liver-resection specimens from histopathologically proven HCC, and in 15 liver biopsies from cirrhosis patients (control group). Serum was tested for hepatitis B and C serological markers using commercial assays, and for AFB1 using an in-house ELISA with a sensitivity of approximately 1 ng ml(-1) for AFB1. In spite of positive AFB1 immunostaining in HCC cases, all serum specimens, from both HCC and the control groups, were AFB1-negative. There were 18 (58.1 %) HCC cases that revealed AFB1 in liver biopsies; 68.8 % (n=11) of non-B non-C hepatitis cases with HCC and 46.1 % (n=6) of the hepatitis B surface-antigen-positive subjects were positive for AFB1. Out of the two hepatitis B/hepatitis C virus co-infected cases, one was positive for AFB1. Of seven tumour-resection samples, six were positive for AFB1. Only one case revealed AFB1 in the non-tumour area of the resected material. Thus AFB1 staining was significantly associated with tumour tissue (P=0.03). Aflatoxins proved to have a significant association with HCC in this peninsular part of the subcontinent. The impact seems to be a cumulative process, as revealed by the AFB1 deposits in HCC liver tissue, even though the serum levels were undetectable.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Dr ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, India.
authors.forename: K G
authors.initials: KG
authors.lastname: Murugavel
authors.affiliation: Department of Microbiology, Faculty of Medicine, Dr ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, India.
authors.forename: P P
authors.initials: PP
authors.lastname: Naranatt
authors.affiliation: Department of Microbiology, Faculty of Medicine, Dr ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, India.
authors.forename: E M
authors.initials: EM
authors.lastname: Shankar
authors.affiliation: Medical Gastroenterology Unit of the Government General Hospital, Chennai 600 001, India.
authors.forename: S
authors.initials: S
authors.lastname: Mathews
authors.affiliation: Medical Gastroenterology Unit of the Government General Hospital, Chennai 600 001, India.
authors.forename: K
authors.initials: K
authors.lastname: Raghuram
authors.affiliation: Medical Gastroenterology Unit of the Government General Hospital, Chennai 600 001, India.
authors.forename: P
authors.initials: P
authors.lastname: Rajasambandam
authors.affiliation: Medical and Surgical Gastroenterology Unit of the Government Stanley Medical College and Hospital, Chennai 600 001, India.
authors.forename: V
authors.initials: V
authors.lastname: Jayanthi
authors.affiliation: Medical and Surgical Gastroenterology Unit of the Government Stanley Medical College and Hospital, Chennai 600 001, India.
authors.forename: R
authors.initials: R
authors.lastname: Surendran
authors.affiliation: Medical and Surgical Gastroenterology Unit of the Government Stanley Medical College and Hospital, Chennai 600 001, India.
authors.forename: A
authors.initials: A
authors.lastname: Murali
authors.affiliation: Medical and Surgical Gastroenterology Unit of the Government Stanley Medical College and Hospital, Chennai 600 001, India.
authors.forename: U
authors.initials: U
authors.lastname: Srinivas
authors.affiliation: Medical and Surgical Gastroenterology Unit of the Government Stanley Medical College and Hospital, Chennai 600 001, India.
authors.forename: K R
authors.initials: KR
authors.lastname: Palaniswamy
authors.affiliation: Government Kilpauk Medical College and Hospital, Chennai 600 029, India.
authors.forename: D
authors.initials: D
authors.lastname: Srikumari
authors.affiliation: Department of Microbiology, Faculty of Medicine, Dr ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, India.
authors.forename: S P
authors.initials: SP
authors.lastname: Thyagarajan
mesh_terms: D000328:Adult; D016604:Aflatoxin B1 / Q000032:analysis*; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007194:India; D008099:Liver / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D044967:Serum / Q000737:chemistry
chemical_list: D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D016604:Aflatoxin B1