title: Detection of hepatocellular carcinoma in hepatitis C patients: biomarker discovery by LC-MS.
abstract: Hepatocellular carcinoma (HCC) accounts for most cases of liver cancer worldwide; contraction of hepatitis C (HCV) is considered a major risk factor for liver cancer even when individuals have not developed formal cirrhosis. Global, untargeted metabolic profiling methods were applied to serum samples from patients with either HCV alone or HCC (with underlying HCV). The main objective of the study was to identify metabolite based biomarkers associated with cancer risk, with the long term goal of ultimately improving early detection and prognosis. Serum global metabolite profiles from patients with HCC (n=37) and HCV (n=21) were obtained using high performance liquid chromatography-mass spectrometry (HPLC-MS) methods. The selection of statistically significant metabolites for partial least-squares discriminant analysis (PLS-DA) model creation based on biological and statistical significance was contrasted to that of a traditional approach utilizing p-values alone. A PLS-DA model created using the former approach resulted in a model with 92% sensitivity, 95% specificity, and an AUROC of 0.93. A series of PLS-DA models iteratively utilizing three to seven metabolites that were altered significantly (p<0.05) and sufficiently (FC≤0.7 or FC≥1.3) showed good performance using p-values alone; the best of these PLS-DA models was capable of generating 73% sensitivity, 95% specificity, and an AUROC of 0.92. Metabolic profiles derived from LC-MS readily distinguish patients with HCC and HCV from those with HCV only. Differences in the metabolic profiles between high-risk individuals and HCC indicate the possibility of identifying the early development of liver cancer in at risk patients. The use of biological significance as a selection process prior to PLS-DA modeling may offer improved probabilities for translation of newly discovered biomarkers to clinical application.
authors.affiliation: Department of Chemistry, Purdue University, West Lafayette, IN 47907, United States.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Bowers
authors.affiliation: Mount Holyoke College, South Hadley, MA 01075, United States.
authors.forename: Emma
authors.initials: E
authors.lastname: Hughes
authors.affiliation: IU School of Medicine, Indianapolis, IN 46202, United States.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Skill
authors.affiliation: IU School of Medicine, Indianapolis, IN 46202, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Maluccio
authors.affiliation: Department of Anesthesiology, University of Washington, Seattle, WA 98109, United States. Electronic address: draftery@uw.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Raftery
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000821:virology*; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D016002:Discriminant Analysis; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000150:complications*; D006801:Humans; D016018:Least-Squares Analysis; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000821:virology*; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D055432:Metabolomics / Q000379:methods; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Biomarker; Early cancer detection; HPLC–MS; Hepatitis C; Hepatocellular carcinoma; LC–MS; Liver cancer; Metabolomics; metabolic profiling