Environmental exposure and clinical correlates of hepatocellular carcinoma in New York City: a case only study.

Hui-Chen Wu,Jing Shen,Abby Siegel,Regina M Santella

doi:10.1007/s10552-021-01494-2

Abstract

In the U.S., Hepatocellular carcinoma (HCC) incidence rates have increased. We aimed to determine whether environmental exposure plays a role in the high incidence of HCC observed in New York City. We conducted a hospital-based case only study to examine the prevalence of aflatoxin B1 (AFB1)- and polycyclic aromatic hydrocarbon (PAH)-albumin adducts and the distribution of adducts by different characteristics of HCC patients. Blood samples were collected from 155 HCC patients for biomarker analyses.We observed that about 46% and 49% of cases had detectable AFB1- and PAH-albumin adducts, respectively. There were significant differences between AFB1-albumin adducts and selected factors such as HCV infection status (p = 0.04), diabetes (p = 0.03) and Barcelona Clinic Liver Cancer stage (p = 0.02). Cases with detectable PAH-albumin adducts had a smoking history compared with those with nondetectable levels (p = 0.04). The level of AFB1-albumin adducts was positively correlated with plasma bilirubin (rs = 0.32, p < 0.0001) and adiponectin concentrations (rs = 0.28, p = 0.0005). The level of aflatoxin B1-albumin adducts was negatively associated with blood albumin concentration (rs = -0.28, p = 0.0009) and plasma DNA LINE-1 methylation (rs = -0.16, p = 0.04). Our study provides additional evidence that environmental exposures including to aflatoxin might drive the high incidence of HCC observed in the New York City.

Highlights

Hepatocellular carcinoma (HCC) death rates are rising, even as most other cancers in the US are declining.[1]
The risk of dying from HCC is much greater for people who live in the Bronx and nearby neighborhoods that are predominantly populated by Blacks and Hispanics, compared to other parts of New York City (NYC) and the US.[2]
Using a prospective study design, we reported that higher levels of aflatoxin B1- (AFB1) and polycyclic aromatic hydrocarbon (PAH)-albumin adducts were associated with HCC risk in Taiwan where the incidence of HCC is high.[4]

Summary

Introduction

Hepatocellular carcinoma (HCC) death rates are rising, even as most other cancers in the US are declining.[1] In New York City (NYC), HCC is one of the leading causes of cancer-related death. The risk of dying from HCC is much greater for people who live in the Bronx and nearby neighborhoods that are predominantly populated by Blacks and Hispanics, compared to other parts of NYC and the US.[2] Differences in traditional risk factors likely contribute to HCC disparity,[2] but less is known about the role of environmental exposure in both geographic and racial disparities. Aflatoxins, genotoxic hepatocarcinogens, are toxic fungal metabolites that commonly contaminate crops. These observation suggest that aflatoxin might explain some of the epidemiology of US HCC in term of the significant geographic and ethnic variations in incidence.[1]

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Results

Conclusion