Prevalence of aflatoxin B1 in liver biopsies of proven hepatocellular carcinoma in India determined by an in-house immunoperoxidase test

Abstract

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related death in the world. The incidence of HCC in India is reportedly low and varies from 0.2 to 1.9 %. Aflatoxins, secondary metabolites produced by Aspergillus flavus and Aspergillus parasiticus, are potent human carcinogens implicated in HCC. The prevalence of aflatoxin B1 (AFB1) as co-carcinogen was analysed using an in-house immunoperoxidase test in 31 liver biopsies and 7 liver-resection specimens from histopathologically proven HCC, and in 15 liver biopsies from cirrhosis patients (control group). Serum was tested for hepatitis B and C serological markers using commercial assays, and for AFB1 using an in-house ELISA with a sensitivity of~1 ng ml "1 for AFB1. In spite of positive AFB1 immunostaining in HCC cases, all serum specimens, from both HCC and the control groups, were AFB1-negative. There were 18 (58.1 %) HCC cases that revealed AFB1 in liver biopsies; 68.8 % (n511) of non-B non-C hepatitis cases with HCC and 46.1 % (n56) of the hepatitis B surface-antigen-positive subjects were positive for AFB1. Out of the two hepatitis B/hepatitis C virus co-infected cases, one was positive for AFB1. Of seven tumour-resection samples, six were positive for AFB1. Only one case revealed AFB1 in the nontumour area of the resected material. Thus AFB1 staining was significantly associated with tumour tissue (P50.03). Aflatoxins proved to have a significant association with HCC in this peninsular part of the subcontinent. The impact seems to be a cumulative process, as revealed by the AFB1 deposits in HCC liver tissue, even though the serum levels were undetectable.

Risk Factors for Hepatocellular Carcinoma in India

“…Murugavel et al 67 from South India revealed that liver biopsies of HCC, the aflatoxin was detected in 58% of cases and no cirrhosis case was found to be positive for aflatoxin. It was therefore the patients had a possible history of AFB1-contaminated foodstuffs, which has acted either as a primary or additional risk factor for HCC.…”

“…59 In India the prevalence of Figure 1 Hepatitis C and diabetes mellitus. 67 [(AFR, African; AMR, The Americas; EMR, Eastern Mediterranean; EUR, European; SEAR, South-East Asian; and WPR, Western Pacific), as defined in the GBD 2000 project. Each region is designated by the three-or four-letter region code followed by a one-letter suffix, corresponding to the mortality pattern of its member countries: A = very low child, low adult mortality; B = low child, low adult mortality; C = low child, high adult mortality; D = high child, high adult mortality; and E = high child, very high adult mortality].…”

“…45 The risk of HCC is greatly increased in chronic viral carriers exposed to other recognized risk factors, including exposure to aflatoxin B1 (AFB1). 66,67 Aflatoxins, a secondary metabolite produced by Aspergillus flavus and Aspergillus parasiticus, are potent human carcinogens implicated in HCC 68 and also it is proved to Figure 2 Spectrum of relationship between NAFLD and diabetes. 64 have a significant association with HCC in India.…”

Characterization of small RNA populations in non-transgenic and aflatoxin-reducing-transformed peanut

“…Periodic outbreaks of aflatoxicosis occur due to ingestion of contaminated food and result in hundreds of human deaths in Asia and Africa [5,6]. Furthermore, 58% of liver biopsies in cases of hepatocellular carcinoma have shown presence of aflatoxin B 1 (AfB 1 ) [7,8].…”

Pharmacological Evaluation of Gatifloxacin in Chemically Induced Hepatocarcinogenesis: A New Tool for Hepatocellularcarcinoma Treatment

“…Primary human liver cancer, of which hepatocellular carcinoma (HCC) is the predominant type, is a major cause of cancer death worldwide [1], accounts for about 90% of all cases of liver cancer and is the fourth most common cause of cancer mortality [2]. In 2009 liver cancer incidence in lower middle income countries accounts 10.2% of the total health care cost while in upper middle countries liver cancer resulting 1.9% and in high income countries the number of liver incidence which is accounting 2.7% of economic burden [3].…”