Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2019; 11(10): 887-897
Published online Oct 15, 2019. doi: 10.4251/wjgo.v11.i10.887
Acylcarnitine: Useful biomarker for early diagnosis of hepatocellular carcinoma in non-steatohepatitis patients
Hiroaki Takaya, Tadashi Namisaki, Mitsuteru Kitade, Naotaka Shimozato, Kosuke Kaji, Yuki Tsuji, Keisuke Nakanishi, Ryuichi Noguchi, Yukihisa Fujinaga, Yasuhiko Sawada, Soichiro Saikawa, Shinya Sato, Hideto Kawaratani, Kei Moriya, Takemi Akahane, Hitoshi Yoshiji
Hiroaki Takaya, Tadashi Namisaki, Mitsuteru Kitade, Naotaka Shimozato, Kosuke Kaji, Yuki Tsuji, Keisuke Nakanishi, Ryuichi Noguchi, Yukihisa Fujinaga, Yasuhiko Sawada, Soichiro Saikawa, Shinya Sato, Hideto Kawaratani, Kei Moriya, Takemi Akahane, Hitoshi Yoshiji, Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara 6348522, Japan
Author contributions: Takaya H, Kitade M, Shimozato N, Kaji K, Tsuji Y, Nakanishi K, Noguchi R, Fujinaga Y, Sawada Y, Saikawa S, Sato S, Kawaratani H, Moriya K and Akahane T performed data analysis; Takaya H, Namisaki T and Yoshiji H contributed to the writing of the manuscript.
Institutional review board statement: Informed consent for the use of resected tissue was obtained from all patients, and the study protocol was approved by the Ethics Committee of Nara Medical University.
Informed consent statement: All study participants or their legal guardians provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: Informed consent for data sharing was not obtained but the presented data are anonymized, and risk of identification is low.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hiroaki Takaya, MD, PhD, Assistant Professor, Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 6348522, Japan. htky@naramed-u.ac.jp
Telephone: +81-744-223051 Fax: +81-744-247122
Received: March 21, 2019
Peer-review started: March 26, 2019
First decision: July 31, 2019
Revised: September 3, 2019
Accepted: September 10, 2019
Article in press: September 10, 2019
Published online: October 15, 2019
Processing time: 209 Days and 20.8 Hours
ARTICLE HIGHLIGHTS
Research background

Although numerous biomarkers, including α-fetoprotein (AFP), des-γ-carboxy prothrombin, and AFP-L3%, have been developed for early diagnosis of hepatocellular carcinoma (HCC), they are not useful in the early diagnosis of HCC.

Research motivation

The fatty acid metabolic pathways in the carnitine cycle may differ between steatohepatitis (SH) HCC and non-SH HCC.

Research objectives

This study aimed to investigate the usefulness of acylcarnitine as a biomarker for the early diagnosis of HCC in non-SH patients.

Research methods

Thirty-three non-SH patients (14 with HCC and 19 without HCC) were enrolled in this study. Blood samples were obtained from patients at the time of admission. The levels of acylcarnitine and acetylcarnitine in the serum were determined using tandem mass spectrometry. Univariate and multivariate analyses were used to determine early diagnostic factors of HCC.

Research results

The level of acylcarnitine was significantly lower in non-SH patients with HCC compared with those without HCC (P < 0.05). The multivariate analysis showed that a low level of acylcarnitine was the only independent factor for the early diagnosis of HCC.

Research conclusions

A low level of acylcarnitine is an independent early diagnostic biomarker for non-SH HCC. Moreover, the level of acetylcarnitine is associated with that of VEGF.

Research perspectives

We anticipate that the development of new diagnostic approaches for HCC may involve acylcarnitine.