Gut-microbiome biomarkers identify early hepatocellular carcinoma

Last Updated: 2018-08-09

By Will Boggs MD

NEW YORK (Reuters Health) - A panel of gut-microbiome biomarkers can be useful for identifying patients with early hepatocellular carcinoma (HCC), researchers from China report.

"We have demonstrated characteristic changes in the gut microbiota in early HCC across a large clinical cohort, illustrated crucial bacterial candidates that may contribute to HCC development, identified specific microbial markers, and validated their diagnostic efficacy in three cohorts from three different regions of China," Dr. Zhigang Ren of Zhejiang University, in Hangzhou, told Reuters Health by email.

HCC is most often diagnosed in an advanced stage with poor prognosis because of the lack of early diagnostic markers and the absence of specific symptoms in earlier stages.

Dr. Ren and colleagues characterized the gut microbiome and evaluated its potential as a noninvasive biomarker for HCC in their study of 75 patients with early HCC, 40 patients with cirrhosis and 75 healthy controls. They validated the results in 30 patients with early HCC, 45 patients with advanced HCC and 56 controls and further validated the biomarker panel's diagnostic potential in 98 patients with HCC.

Microbial diversity was significantly increased in early HCC and significantly decreased in liver cirrhosis, the team reports in Gut, online July 25.

In patients with early HCC, bacteria belonging to butyrate-producing families were decreased, while lipopolysaccharide-producing bacteria were increased, compared with controls.

Among the 932 operational taxonomy units (OTUs) identified, 90 were unique for early HCC. Thirty of these OTUs proved optimal for differentiating early HCC from non-HCC.

The probability of disease (POD) index, based on these 30 OTUs, identified patients with early HCC with an accuracy of 80.64% in the discovery phase, 76.80% in the validation phase, and 79.20% and 81.70% in two independent cohorts from other regions of China.

"We propose that gut microbiota-targeted biomarkers may become potential non-invasive tools for early diagnosis of HCC," Dr. Ren said. "Gut microbial markers may be developed as a detection kit or a detection product and then used to screen or diagnose early HCC in regular clinical practice."

"Gut microbial alterations may contribute to the development of HCC, which implies that the changed gut microbiota may represent a potential target to prevent HCC development by the gut-microbiota-liver axis," he added.

Dr. Yasuhito Tanaka from Nagoya City University Graduate School of Medical Sciences, in Japan, who has researched various aspects of HCC and its diagnosis, said the new approach is "very attractive," but still faces a number of hurdles.

"First, this approach might be costly," he told Reuters Health by email. "Second, we will need a long time to obtain the results using this technique. I hope that these problems are overcome earlier and the application of this valuable method will be realized."

He added that he would like "to know the cause of hepatocellular carcinoma in this article. Probably, hepatocellular carcinoma caused by hepatitis B was most frequent. As a further project, I am much interested in the relationship between the underlying disease which can cause hepatocellular carcinoma and the (makeup) of the gut microbiota."

SOURCE: https://bit.ly/2KAiYsp

Gut 2018.