Abstract
Diagnosis of hepatitis B virus (HBV)-positive hepatocellular carcinoma (HCC), particularly HCC independent of cirrhosis etiology, presents a great challenge because of a lack of biomarkers. Here we test the hypothesis that expression profiles of microRNAs (miRNAs) in serum can serve as biomarkers for diagnosis of HBV infection and HBV-positive HCC. We recruited 513 subjects (210 controls and 135 HBV-, 48 hepatitis C virus (HCV)-, and 120 HCC-affected individuals) and employed a strategy of initial screening by Solexa sequencing followed by validation with TaqMan probe-based quantitative reverse transcription-PCR assay. First, because of a close link between chronic hepatitis B and HCC, we compared miRNA expression profiles in HBV serum with that in control serum and successfully obtained 13 miRNAs that were differentially expressed in HBV serum. This 13-miRNA-based biomarker accurately discriminated not only HBV cases from controls and HCV cases, but also HBV-positive HCC cases from control and HBV cases. Second, we directly compared miRNA expressions in HCC serum with those in controls and identified 6 miRNAs that were significantly upregulated in HCC samples. Interestingly, 2 of these miRNAs, miR-375 and miR-92a, were also identified by our first approach as HBV specific. When we employed 3 of these miRNAs (miR-25, miR-375, and let-7f) as biomarkers, we could clearly separate HCC cases from controls, and miR-375 alone had an ROC of 0.96 (specificity: 96%; sensitivity: 100%) in HCC prediction. In conclusion, our study demonstrates for the first time that serum miRNA profiles can serve as novel and noninvasive biomarkers for HBV infection and HBV-positive HCC diagnosis.
Highlights
Hepatitis B virus (HBV) infection is endemic in many Asian countries including China
The results demonstrate that the unique expression pattern of serum miRNAs can serve as a sensitive, specific, and noninvasive biomarker for the diagnosis of HBV infection and HBV-positive hepatocellular carcinoma (HCC) independent of cirrhosis etiology
To obtain an expression profile of serum miRNAs that is specific for HBV infection or HBV-positive HCC, we employed a strategy including the initial screening by Solexa sequencing and the validation by quantitative reverse transcription-PCR (qRT-PCR) on an individual basis (Fig. 1)
Summary
Hepatitis B virus (HBV) infection is endemic in many Asian countries including China. There are 400 million people worldwide living with chronic HBV infection, of which more than 30% are Chinese [1]. Chronic HBV infection continues to be a major contributor to morbidity and mortality despite the availability of vaccination programs in China and elsewhere [2]. The implementation of hepatitis B surface antigen. Authors' Affiliations: 1Institute for Virology, State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, 2Department of Epidemiology and Biostatistics, Cancer Center, Nanjing Medical University, and 3Clinical Laboratory, Nanjing Second Hospital, Nanjing, China; and 4Department of Virology, University of California School of Public Health, Berkeley, California. Note: Supplementary data for this article are available at Cancer Research Online (http://cancerres.aacrjournals.org/).
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