Investigation of Novel Urinary Biomarkers in Hepatocellular Carcinoma Risk in a Predominantly African American Population: A Case-Control Study

Abstract

<b><i>Introduction:</i></b> African Americans are at increased risk of hepatocellular carcinoma (HCC) compared to other racial and ethnic groups. We investigated the associations of four urinary biomarkers of prostaglandin E₂ (PGE-M), prostacyclin (PGI-M), and thromboxane (11dTxB₂) synthesis and the ratio of PGI-M to 11dTXB₂ with HCC risk in a cohort of predominantly African American populations. <b><i>Methods:</i></b> We conducted a nested case-control study (50 cases; 43 with HCC, 151 controls) in the Southern Community Cohort Study (SCCS), a large prospective cohort study including over 80,000 study participants, of whom two-thirds are African Americans. Urine samples were collected at enrollment and subsequently analyzed to assess biomarker levels. Multivariable regression models adjusted for age, race, sex, BMI, smoking status, NSAID use, education level, income, and alcohol consumption were used to assess the relationship between the biomarker and HCC risk. <b><i>Results:</i></b> Only 11dTxB₂ (OR = 11.50; 95% CI [2.34–56.47] for highest tertile vs. lowest tertile, <i>p</i> = 0.004) and the PGI-M/11dTXB₂ ratio of the second quartile (0.25–0.49) (OR = 5.16; 95% CI [1.44–18.47]; <i>p</i> = 0.01) were significantly associated with increased risk of liver cancer. <b><i>Conclusion:</i></b> 11dTXB₂ and PGI-M/11dTXB₂ ratio may be urinary markers of HCC risk, particularly among African Americans, and future prospective studies are needed to evaluate this finding further and to develop accessible methods.