Prevalence and Frequency of Risk Factors in MDM2 Gene Associated with Liver Cancer among Patients in UCTH, Calabar, Nigeria

Abstract

Liver cancer is a global health concern with high morbidity and mortality. It remains the sixth most common cancer worldwide despite the preventable nature of its risk factors. Mouse double minute-2 (MDM2) is one of the candidate genes associated with liver cancer and an over expression of the gene may lead to liver cancer. This research was aimed at investigating the prevalence and frequency of risk factors in the MDM2 gene among liver cancer patients in the University of Calabar Teaching Hospital, Calabar. Forty five liver cancer patients and fifty controls were recruited for the study. Demographic information was collected from all the subjects using questionnaires and analyzed while blood samples were collected for molecular analysis. The result revealed a significant difference in the distribution of demographic variables in cases and controls (P<0.05). The overall frequency of mutations in MDM2 gene in the studied population in Calabar was 40%, odd ratio 1.25 and sex ratio 2.2:0.5.The major risk factors of liver cancer are hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, heavy alcohol consumption, aflatoxin B1 ingestion, tobacco smoking and non-alcoholic fatty liver disease caused by obesity and insulin resistance.The risk factors associated with liver cancer cases revealed that Hepatitis C virus infection was detected in 11 patients (24.4%), Hepatitis B virus surface antigen positive (HBsAg+) was found in 27 patients (60%), co-infection was found in 11 patients (24.4%), 19(42.2%) were involved in alcoholism and chain smoking, alcoholic consumption was 41(91%), consumption of moldy groundnut soup was 43 (95.6%) and family history of the disease was 10 (22.2%).The results revealed that out of the 45 patients recruited for the study, 15.1% were HIV positive, 17.7% were diabetic, 31.1% had melanin stool 24.4% had ascitis and 17.7% had hepatic encephalopathy as shown in Table 3. The liver function test carried out on the patients revealed that the albumin was 43.58±9.42 g/dl, creatinine was 136.62±177.98µmol/l, urea was 4.20±1.88mmol/l, the platelet was 180.74±104.70 x109 l/cells, the haemoglobin was 11.01±3.36g/dl, the alpha-fetoprotein (AFP) present was 398.8±103.2ng/ml, the aspartate aminotransferase (AST) was 45.65±66.01μmol/l, alanine transaminase was 31.67±33.37μmol/l and the international normalized ratio (INR) was 6.4±23.04.The alpha-feto protein among patients was 398.8±103.2ng/ml and this showed a strong indicator of hepatocellular cancer.The study therefore recommends that people in the area should avoid predisposing and risk factors such as alcoholism, smoking and unhealthy lifestyle which promotes the spreading of liver cancer among genetically (MDM2) susceptible liver cancer patients in Calabar The findings serve as baseline information for further studies on the genetic etiology and therapeutic initiative for the disease.