title: Urinary metabolic biomarkers of hepatocellular carcinoma in an Egyptian population: a validation study.
abstract: The advent of metabonomics has seen a proliferation of biofluid profiling studies of patients with hepatocellular carcinoma. The majority of these studies have been conducted in single indigenous populations making the widespread applicability of candidate metabolite biomarkers difficult. Presented here is a urinary proton nuclear magnetic resonance spectroscopy study of mainly hepatitis C virus infected Egyptian patients with hepatocellular carcinoma, which corroborates findings of a previous study from our group of mainly hepatitis B-infected Nigerian patients with hepatocellular carcinoma. Using multivariate statistical analysis, in the form of orthogonal signal-corrected partial least squared discriminant analysis, the sensitivity and specificity of the technique for distinguishing patients with tumors from healthy controls and patients with cirrhosis was 100%/94% and 81%/71%, respectively. Discriminatory metabolites included glycine, trimethylamine-N-oxide, hippurate, citrate, creatinine, creatine, and carnitine. This metabolic profile bears similarity to profiles identified in the Nigerian cohort of subjects indicative of tumor effects on physiology, energy production, and aberrant chromosomal methylation. This is the first study to identify similarly altered urine metabolic profiles of hepatocellular carcinoma in two etiologically and ethnically distinct populations, suggesting that altered metabolism as a result of tumorogenesis is independent of these two factors.
authors.affiliation: Liver Unit, Division of Diabetes Endocrinology and Metabolism, Department of Medicine, Imperial College London, 10th Floor QEQM Building, St Mary's Hospital Campus, South Wharf Road, London W2 1NY, United Kingdom. m.shariff@imperial.ac.uk
authors.forename: Mohamed I F
authors.initials: MI
authors.lastname: Shariff
authors.forename: Asmaa I
authors.initials: AI
authors.lastname: Gomaa
authors.forename: I Jane
authors.initials: IJ
authors.lastname: Cox
authors.forename: Madhvi
authors.initials: M
authors.lastname: Patel
authors.forename: Horace R T
authors.initials: HR
authors.lastname: Williams
authors.forename: Mary M E
authors.initials: MM
authors.lastname: Crossey
authors.forename: Andrew V
authors.initials: AV
authors.lastname: Thillainayagam
authors.forename: Howard C
authors.initials: HC
authors.lastname: Thomas
authors.forename: Imam
authors.initials: I
authors.lastname: Waked
authors.forename: Shahid A
authors.initials: SA
authors.lastname: Khan
authors.forename: Simon D
authors.initials: SD
authors.lastname: Taylor-Robinson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine*; D006528:Carcinoma, Hepatocellular / Q000652:urine*; D004534:Egypt; D006801:Humans; D008103:Liver Cirrhosis / Q000652:urine; D008113:Liver Neoplasms / Q000652:urine*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D055432:Metabolomics / Q000379:methods; D008875:Middle Aged; D025341:Principal Component Analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers