Role of bile acids in the prediction of hepatocellular carcinoma in HCV-induced liver cirrhosis

Ashraf Khalil,Eman Abdelsameea,F F Mohamed Bayomy,Azza Elsheashaey,Manar Obada,Hala El-Said

doi:10.1186/s43066-021-00142-3

Ashraf Khalil, Eman Abdelsameea + Show 4 more

Open Access

https://doi.org/10.1186/s43066-021-00142-3

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Abstract

BackgroundBile acids are essential organic molecules synthesized from cholesterol in the liver and regarded as indicators of hepatobiliary impairment; however, their role in the pathogenesis of hepatocellular carcinoma (HCC) is still unclear. The study aimed to examine the feasibility of bile acids in distinguishing HCC from post hepatitis C virus liver cirrhosis. A UPLC/MS was used to measure 14 bile acids in patients with noncirrhotic HCV disease (n = 50), cirrhotic HCV disease (n = 50), hepatocellular carcinoma (n = 50), and control group (n = 50).ResultsThe progression of liver cirrhosis to HCC was associated with a significant increase in serum bile acids compared to the normal or the noncirrhotic HCV disease (p < 0.05). The fold changes in bile acids concentrations showed a trend that HCC > cirrhotic HCV disease > noncirrhotic HCV disease. Four conjugated acids GCA, GCDCA, GUDCA, and TCDCA steadily increased across the different groups. ROC curves analysis revealed that these bile acids discriminated noncirrhotic liver patients from HCC (AUC 0.850–0.963), with a weaker potential to distinguish chronic liver cirrhosis from HCC (AUC 0.414–0.638).ConclusionThe level of serum bile acid was associated primarily with liver cirrhosis, with little value in predicting the progress of chronic liver cirrhotic disease into hepatocellular carcinoma.

Highlights

Bile acids are essential organic molecules synthesized from cholesterol in the liver and regarded as indicators of hepatobiliary impairment; their role in the pathogenesis of hepatocellular carcinoma (HCC) is still unclear
The laboratory parameters showed that cirrhotic liver disease (CLD) and HCC groups had a significant increase in Aspartate transaminase (AST), Alanine transaminase (ALT), Total bilirubin (TBil), DBil, Gammaglutamyl transferase (GGT), Alkaline phosphatase (ALP), and AFP with a significant decrease in total protein Total protein (TP), Alb, Hb, White blood cells (WBCs), and platelets relative to the control group
The levels of DBil, GGT, and ALP increased while the level of Alb, TP, Hb, and platelets decreased in cirrhotic patients compared to noncirrhotic liver disease (NCLD) or Normal healthy control (NHC)

Summary

Introduction

Bile acids are essential organic molecules synthesized from cholesterol in the liver and regarded as indicators of hepatobiliary impairment; their role in the pathogenesis of hepatocellular carcinoma (HCC) is still unclear. Numerous studies related liver cirrhosis to the changes in bile acid metabolism, and high serum bile acids can distinguish liver cirrhosis with higher sensitivity than the traditional liver function tests [2,3,4]. Bile acids metabolism has a role in cellular processes related to carcinogenesis, e.g., elevated intracellular concentrations of bile acids were associated with oxidative stress and DNA damage both in adult and fetal liver [5, 6]. A metabolomics approach applying, ultra-performance liquid chromatography coupled with mass spectrometry was conducted to characterize 14 bile acids profiles in the serum of patients with post HCV noncirrhotic liver disease, in HCV cirrhotic liver disease, and post HCV complicating HCC patients, as potential markers for HCC

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