Differential Diagnosis Between Hepatocellular Carcinoma And Cirrhosis By Serum Amino Acids And Acylcarnitines

Objective:The biochemical indicators used for the diagnosis of hepatocellular carcinoma(HCC)are all protein indicators.The purpose of this experimental study was to analyze metabolomic differences in plasma from patients with cirrhosis and hepatocellular carcinoma using metabolomics techniques,and to discover metabolite combinations that have differential diagnostic significance for cirrhosis and hepatocellular carcinoma.This is to build a diagnostic model for the identification of the two.Methods: A traditionally used mass spectrometry-based new born screening strategy was employed to profile some amino acids and acylcarnitines in the samples collected from HCC and cirrhosis patients.The blood was sampled on filter paper and dried at room temperature.Metabolites in the dried blood spots were extracted using organic solvent and then condensed for mass spectrometry analysis.Metabolites playing key roles in separating the HCC and cirrhosis groups were selected through multivariate analysis.Diagnosis utilities of the selected metabolites were also evaluated.Results: Found that 11 parameters,including amino acids,acylcarnitines and some of their relevant ratios: C10 ?C10:1?C18:1 ? C3/Met? C3DC/C10 ?C4/C8 ? C4DC?C5-OH/C0? Glu ?Thr ? Val/Phe.We construct a satisfied differential diagnosis model.In this model,most of the involved amino acids were essential amino acids.What should be noticed was that short-chain acylcarnitines tended to be risk factors for HCC.Long-chain acylcarnitines seemed to be risk factors for cirrhosis.Conclusions: In this study,a traditionally used DBS-based MS analysis was adopted to differentiate HCC and cirrhosis.By combined using 11 parameters,a feasible diagnosis model was formulated and could achieve satisfied HCC and cirrhosis differentiation.The diagnosis ability was comparable to that of the traditional protein biomarker-based strategy.