Heidi Spratt, PhD
Associate Professor
UTMB Bioinformatics Program
The University of Texas Medical Branch
Development of a Metabolic Biomarker Panel for the Early Diagnosis of Hepatocellular Carcinoma in Hepatitis C Infected Populations
Hepatocellular carcinoma (HCC) is the fifth most common cause of cancer and also one of the deadliest. It has recently shown an upward trend in the number of diagnoses per year. One of the precursors to HCC infection is the Hepatitis C virus (HCV). According to the NIH, HCV is one of the main causes of chronic liver disease in the United States. About one-third of HCV patients will develop cirrhosis of the liver. Of those, about 1-2% annually will develop HCC. Ultimately, 80% of HCC cases are developed from liver cirrhosis. Hepatitis C causes an estimated ten to twelve thousand deaths each year in the U.S. alone; the virus varies greatly in both its course and disease outcome. Many patients infected with HCV are asymptomatic and have some degree of chronic hepatitis, often associated with some degree of fibrosis of the liver. The prognosis for patients with early-stage fibrosis is frequently good. At the other end of the spectrum are patients with severe HCV who experience all the classic symptoms of the disease, and who ultimately develop liver cirrhosis. The prognosis for such patients is slim and mortality is usually the result. Little is known about how HCV infection progresses to HCC in patients with advanced fibrosis, so the main goal of this project is to discover biomarkers for the detection of early stage liver cancer. Patients with HCV and HCC co-infection will be compared to HCV only infected patients to develop a biomarker panel for the detection of early stage liver cancer. For the development of such biomarkers, nuclear magnetic resonance metabolomics experiments will be conducted on urine samples from infected patients. Machine learning techniques such as multivariate adaptive regression splines will be used to create a biomarker panel that has the ability to predict HCC infection.