Background/Aims Hepatocellular carcinoma (HCC) is a prevalent form of primary liver cancer and the fifth leading cause of worldwide cancer mortality. Though early diagnosis of HCC is important, so far lack of effective biomarkers for early diagnosis of HCC has been a problem. In this study, we searched for potential functional biomarkers of alcoholic HCC by using metagenomics approach.
Methods Between September 2017 and April 2019, normal control (n=44), alcoholic liver cirrhosis (n=44), and alcoholic HCC (n=13) groups were prospectively enrolled and analyzed. Gut microbiota was analyzed using the 16S-based microbiome taxonomic profiling platform of EzBioCloud Apps and analyzing system.
Results There was a statistically significant difference among groups in diversity (P<0.05). In the comparison of phylum between cirrhosis and HCC, Proteobacteria were increased and Bacteroidetes were decreased. Firmicutes were not significantly different among the three groups. In the taxonomic profiling, relative abundance of Lactobacillus in the cirrhosis and HCC groups showed richness (P<0.05). In the biomarker analysis between cirrhosis and HCC, obiquinome Fe-S protein 3, global nitrogen regulator, Vesicle-associated membrane protein 7, toxin YoeB, peroxisome-assembly ATPase, and nitrogen oxide reductase regulator were differently expressed (P<0.001).
Conclusions Alcoholic HCC showed different expressions in the stool taxonomy and biomarker compared with that of cirrhosis and control. Therefore, new biomarkers using stool analysis for alcoholic HCC are necessary.
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Hepatocellular carcinoma (HCC) is well known malignancy with poor prognosis, even after
resection of the primary tumor. Sorafenib is the first-line treatment in advanced HCC, but the
disease control rate of sorafenib is only 43%. Pulmonary metastasectomy in patients with
pulmonary metastasis from HCC has been reported to increase long-term survival compared
with systemic chemotherapy. Video-assisted thoracic surgery is considered a reliable
approach to the diagnosis and treatment of pulmonary diseases with low complication
rate. Pulmonary metastasectomy is not universally accepted because of frequent local
recurrence, an uncontrollable primary tumor, and frequent multiple pulmonary metastases
in HCC, but outcome of pulmonary metastasectomy and adjuvant sorafenib therapy has
not been studied. We experienced a patient who had advanced HCC with pulmonary
oligometastasis and received surgical resection of the metastatic pulmonary nodule and
sorafenib chemotherapy. In advanced HCC with pulmonary oligometastasis, surgical
resection of pulmonary metastasis and sorafenib chemotherapy should be considered.