Clinical validation of peripheral blood mononuclear cell DNA methylation markers for accurate early detection of hepatocellular carcinoma in Asian patients

David Cheishvili; Chifat Wong; Mohammad Mahbubul Karim; Mohammad Golam Kibria; Nusrat Jahan; Pappu Chandra Das; Abul Khair Yousuf; Atikul Islam; Dulal Chandra Das; Sheikh Mohammad Noor-E-Alam; Sarwar Alam; Mustafizur Rahman; Wasif A Khan; Mamun Al-Mahtab; Moshe Szyf

doi:10.1038/s43856-024-00652-2

Clinical validation of peripheral blood mononuclear cell DNA methylation markers for accurate early detection of hepatocellular carcinoma in Asian patients

Commun Med (Lond). 2024 Oct 30;4(1):220. doi: 10.1038/s43856-024-00652-2.

Authors

David Cheishvili^{1

2}, Chifat Wong¹, Mohammad Mahbubul Karim³, Mohammad Golam Kibria³, Nusrat Jahan³, Pappu Chandra Das³, Abul Khair Yousuf⁴, Atikul Islam⁴, Dulal Chandra Das⁴, Sheikh Mohammad Noor-E-Alam⁴, Sarwar Alam⁵, Mustafizur Rahman³, Wasif A Khan³, Mamun Al-Mahtab⁴, Moshe Szyf⁶

Affiliations

¹ HKG Epitherapeutics Ltd. Unit 313-315, 3/F Biotech Center 2, 11 Science Park West Avenue, Shatin, Hong Kong, SAR, China.
² Gerald Bronfman Department of Oncology, McGill University Montreal, Montreal, Canada.
³ International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh.
⁴ Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.
⁵ Department of Clinical Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
⁶ HKG Epitherapeutics Ltd. Unit 313-315, 3/F Biotech Center 2, 11 Science Park West Avenue, Shatin, Hong Kong, SAR, China. [email protected].

Abstract

Background: Hepatocellular carcinoma (HCC), a leading cause of cancer-related deaths globally, poses significant challenges in early detection. Improved diagnostic accuracy can drastically influence patient outcomes, emphasizing the need for innovative, non-invasive biomarkers.

Methods: This study utilized a cohort of 402 participants, including healthy controls, chronic hepatitis patients, and HCC patients from Bangladesh, to evaluate DNA methylation signatures in peripheral blood mononuclear cells (PBMC). We performed targeted next-generation sequencing on selected genes previously identified to assess their methylation dynamics. The development of M8 and M4 scores was based on these dynamics, using Receiver Operating Characteristic (ROC) analysis to determine their effectiveness in detecting early-stage HCC alongside existing markers such as epiLiver and alpha-fetoprotein (AFP).

Results: Integration of M8 and M4 scores with epiLiver and AFP significantly enhances diagnostic sensitivity for early-stage HCC. The M4+epiLiver score achieves a sensitivity of 79.4% in Stage A HCC, while combining M4 with AFP increases sensitivity to 88.2-95.7% across all stages, indicating a superior diagnostic performance compared to each marker used alone.

Conclusions: Our study confirms that combining gene methylation profiles with established diagnostic markers substantially improves the sensitivity of detecting early-stage HCC. This integrated diagnostic approach holds promise for advancing non-invasive cancer diagnostics, potentially leading to earlier treatment interventions and improved survival rates for high-risk patients.

Plain language summary

Liver cancer is one of the top causes of cancer death worldwide, and finding it early is crucial for successful treatment. This research focuses on using a simple blood test to look for specific DNA changes that signal the early stages of liver cancer. We tested this method on a diverse group of people from Bangladesh, including those already at high risk for liver cancer due to chronic liver infections. By combining this new blood test with other existing tests, we were able to detect liver cancer more accurately and earlier than by using traditional methods alone. This approach could make it easier and less invasive to find liver cancer early, offering a better chance for effective treatment and a hopeful prognosis for those at risk.