Metabolic profiling study of early and late recurrence of hepatocellular carcinoma based on liquid chromatography-mass spectrometry

• Preoperative metabolic profile of late and early recurrent HCC patients was investigated.
• Bile acids, steroids and fatty acids have the most evident deviation extents.
• Decreased EPA, DHA and linolenic acid are specific metabolic alteration.
• The combination of methionine, GCDCA and cholesterol sulfate has good predictivity.

The objectives of this pilot study were to predict early postoperative recurrence in hepatocellular carcinoma (HCC) patients based on metabolic features and to explore the related metabolic disturbances. Liquid chromatography-mass spectrometry-based metabolic profiling was performed on the plasma of 18 late recurrent and 22 early recurrent HCC patients. Metabolic differences were found to be related to amino acid, bile acid, cholesterol, fatty acid, phospholipid and carbohydrate metabolism. Bile acids, steroids and fatty acids showed significant variation in the early recurrent HCC group compared to the late recurrence group. Decreased levels of polyunsaturated eicosapentaenoic acid, docosahexaenoic acid and linolenic acid were found to be specific metabolic features for early recurrence. With the combination of methionine, GCDCA and cholesterol sulfate, 85% of the early recurrent HCCs can be predicted correctly with the corresponding area under the curve (AUC) equal to 0.95 in the training set, and 80% of the early recurrent HCCs can be predicted correctly with the corresponding AUC equal to 0.91 in the test set.