Abstract
Microcystins have been reported carcinogenic by animal and cell experimentation, but there were no data on the linkage between serum microcystins and hepatocellular carcinoma (HCC) risk in human. We conducted a clinical case-control study to investigate the association between serum microcystins and HCC risk after controlling several known risk factors, such as hepatitis B virus (HBV), alcohol, and aflatoxin. From December 2013 to May 2016, 214 patients newly diagnosed with HCC, along with 214 controls (frequency-matched by age and sex) were recruited from three hospitals in Chongqing, Southwest China. Basic information on life style and history of disease was obtained via questionnaires. Blood samples were collected and analyzed for serum microcystin-LR (MC-LR) and aflatoxin albumin adduct (AFB-ALB adduct) by ELISA, and for HBsAg status by ECLIA. Binary logistic regression analyses were performed to assess the independent effects of MC and its joint effects with other factors on HCC risk. The adjusted OR (AOR) for HCC risk by serum MC-LR was 2.9 (95%CI, 1.5-5.5) in all patients. Notably, a clear relationship between increased MC-LR level (Q2, Q3 and Q4) and HCC risk was observed with the elevation AORs (1.3, 2.6, and 4.0, respectively). Positive interactions on the additive model were investigated between MC-LR and HBV infection (S=3.0; 95%CI, 2.0-4.5), and between MC-LR and alcohol (S=4.0; 95%CI, 1.7-9.5), while a negative interaction was found between microcystins and aflatoxin (S=0.4; 95%CI, 0.3-0.7). Additionally, serum MC-LR was significantly associated with tumor differentiation (r= -0.228, P<0.001). Conclusions: We firstly provided evidence that serum MC-LR was an independent risk factor for HCC in human, with an obvious positive interaction with HBV/alcohol but a negative interaction with aflatoxin. This article is protected by copyright. All rights reserved.
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