title: Plasma Folate and Vitamin B12 Levels in Patients with Hepatocellular Carcinoma.
abstract: Folate and vitamin B12 involved in the one-carbon metabolism may play a key role in carcinogenesis and progression of hepatocellular carcinoma (HCC) through influencing DNA integrity. The purpose of this study is to evaluate the association of plasma folate and vitamin B12 levels with HCC in a case-control study on 312 HCC patients and 325 cancer-free controls. Plasma concentrations of folate and vitamin B12 in all the subjects were measured by electrochemiluminescence immunoassay. Meanwhile, the information of HCC patients' clinical characteristics including tumor-node-metastasis (TNM) stage, tumor size and tumor markers were collected. The patients of HCC had significantly lower folate levels than those of controls; there was no significant difference in the mean of plasma vitamin B12 levels. We also observed an inverse association between the levels of plasma folate and HCC: the adjusted odds ratios (OR) (95% confidence intervals (CI)) of HCC from the highest to lowest quartile of folate were 0.30 (0.15-0.60), 0.33 (0.17-0.65), and 0.19 (0.09-0.38). Compared to the subjects in the lowest quartile of plasma vitamin B12, only the subjects in the highest quartile of vitamin B12 exhibited a significant positive relationship with HCC, the adjusted OR was 2.01 (95% CI, 1.02-3.98). HCC patients with Stage III and IV or bigger tumor size had lower folate and higher vitamin B12 levels. There was no significant difference in the mean plasma folate levels of the HCC cases in tumor markers status (AFP, CEA and CA19-9 levels), whereas patients with higher CEA or CA19-9 levels retained significantly more plasma vitamin B12 than those with normal-CEA or CA19-9 level. In conclusion, plasma folate and vitamin B12 levels could be associated with HCC, and might be used as predictors of clinical characteristics of HCC patients. However, further prospective studies are essential to confirm the observed results.
authors.affiliation: Department of Public Health, Qingdao University Medical College, No. 38 Dengzhou Road, Qingdao 266021, China. lianhuacui520@hanmail.net.
authors.forename: Lian-Hua
authors.initials: LH
authors.lastname: Cui
authors.affiliation: Department of Public Health, Yanbian University Medical College, No. 977 Gongyuan Road, Yanji 133002, China. zyquan@ybu.edu.cn.
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: Quan
authors.affiliation: Department of Public Health, Qingdao University Medical College, No. 38 Dengzhou Road, Qingdao 266021, China. jinmeipark@163.com.
authors.forename: Jin-Mei
authors.initials: JM
authors.lastname: Piao
authors.affiliation: Department of Public Health, Qingdao University Medical College, No. 38 Dengzhou Road, Qingdao 266021, China. guti2016@163.com.|Department of Oncology, Shengli Oil-Field Central Hospital, No. 31 Jinan Road, Dongying 257000, China. guti2016@163.com.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Zhang
authors.affiliation: Department of Public Health, Qingdao University Medical College, No. 38 Dengzhou Road, Qingdao 266021, China. menghuidream@163.com.
authors.forename: Meng-Hui
authors.initials: MH
authors.lastname: Jiang
authors.affiliation: Department of Preventive Medicine, Chonnam National University Medical School, Gwangju 501-746, Korea. mhshinx@paran.com.
authors.forename: Min-Ho
authors.initials: MH
authors.lastname: Shin
authors.affiliation: Department of Preventive Medicine, Chonnam National University Medical School, Gwangju 501-746, Korea. jschoix@jnu.ac.kr.
authors.forename: Jin-Su
authors.initials: JS
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D007118:Immunoassay; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology*; D008163:Luminescent Measurements; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D012307:Risk Factors; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D015415:Biomarkers; D005492:Folic Acid; D014805:Vitamin B 12
keywords: folate; hepatocellular carcinoma; susceptibility; tumor progression; vitamin B12