Military University Hospital Prague, Department of Medicine 1st Faculty of Medicine Charles University and Military University Hospital, U Vojenske nemocnice 1200, 16902 Prague, Czechia; Department of Internal Medicine, University of Defense, Faculty of Military Health Sciences, Trebesska 1575, 50001 Hradec Kralove, Czechia.
Department of Analytical Chemistry, University of Chemistry and Technology, Technicka 5, 16628 Prague, Czechia.
Ann Hepatol. 2024 Sep-Oct;29(5):101519. doi: 10.1016/j.aohep.2024.101519. Epub 2024 Jun 10.
Hepatocellular carcinoma (HCC) represents one of the most common cancers worldwide. A considerable proportion of HCC is caused by cirrhosis related to metabolic dysfunction-associated steatohepatitis (MASH). Due to the increasing prevalence of metabolic syndrome, it is estimated that MASH-related HCC will become the most prevalent etiology of HCC. Currently, HCC screening is based on liver ultrasonography; however, the sensitivity of ultrasonography for early HCC stages in obese patients only reaches 23 %. To date, no studied biomarker shows sufficient efficacy for screening purposes. Nevertheless, the usage of spectroscopic methods offers a new perspective, as its potential use would provide cheap, fast analysis of samples such as blood plasma.
We employed a combination of conventional and chiroptical spectroscopic methods to study differences between the blood plasma of obese cirrhotic patients with and without HCC. We included 20 subjects with HCC and 17 without evidence of liver cancer, all of them with body mass index ≥ 30.
Sensitivities and specificities reached values as follows: 0.780 and 0.905 for infrared spectroscopy, 0.700 and 0.767 for Raman spectroscopy, 0.840 and 0.743 for electronic circular dichroism, and 0.805 and 0.923 for Raman optical activity. The final combined classification model based on all spectroscopic methods reached a sensitivity of 0.810 and a specificity of 0.857, with the highest area under the receiver operating characteristic curve among all models (0.961).
We suggest that this approach can be used effectively as a diagnostic tool in patients who are not examinable by liver ultrasonography.
NCT04221347.
肝细胞癌（HCC）是全球最常见的癌症之一。相当一部分 HCC 是由与代谢功能相关的脂肪性肝炎（MASH）相关的肝硬化引起的。由于代谢综合征的患病率不断增加，据估计，MASH 相关 HCC 将成为 HCC 最常见的病因。目前，HCC 的筛查基于肝脏超声检查；然而，在肥胖患者中，超声对早期 HCC 阶段的敏感性仅达到 23%。迄今为止，没有研究生物标志物显示出足够的筛查效果。然而，光谱方法的使用提供了一个新的视角，因为其潜在的用途将提供廉价、快速的血浆等样本分析。
我们采用常规和手性光学光谱方法相结合，研究肥胖性肝硬化患者 HCC 与无 HCC 患者的血浆差异。我们纳入了 20 名 HCC 患者和 17 名无肝癌证据的患者，所有患者的体重指数均≥30。
红外光谱、拉曼光谱、电子圆二色性和拉曼光学活性的灵敏度和特异性分别达到 0.780 和 0.905、0.700 和 0.767、0.840 和 0.743、0.805 和 0.923。基于所有光谱方法的最终综合分类模型的灵敏度为 0.810，特异性为 0.857，在所有模型中具有最高的受试者工作特征曲线下面积（0.961）。
我们建议，这种方法可以有效地用作不能进行肝脏超声检查的患者的诊断工具。
NCT04221347。
