Serum S-adenosylhomocysteine linked to HCC survival

In patients with hepatocellular carcinoma (HCC), higher serum S-adenosylhomocysteine (SAH) concentrations may contribute to a shorter survival, regardless of the genetic variants of one-carbon metabolism key enzyme, according to a study.

This study included 1,080 patients newly diagnosed with HCC from the Guangdong Liver Cancer Cohort. The authors measured the serum SAH, homocysteine, and S-adenosylmethionine (SAM) using high-performance liquid chromatography–tandem mass spectrometry and identified gene polymorphisms in one-carbon metabolism using kompetitive allele-specific polymerase chain reaction.

Liver cancer-specific survival (LCSS) and overall survival (OS) were the primary outcomes. Multivariate Cox proportional hazard models were utilized to calculate the hazard ratios (HRs) and 95 percent confidence intervals (CIs).

Six hundred one deaths occurred over a median follow-up of 3.6 years, of which 552 (92 percent) were due to HCC. In multivariate analysis, patients in the highest quartile of serum SAH concentrations showed a poorer survival than those in the lowest quartile (LCSS: HR, 1.58, 95 percent CI, 1.19–2.10; p=0.002; OS: HR, 1.18, 95 percent CI, 1.18–2.02; p=0.001).

No significant interactions were seen between serum SAH concentrations and genetic variants of one-carbon metabolism key enzymes. LCSS or OS also showed no significant associations with serum SAM, homocysteine, and SAM/SAH ratio.

"These findings suggest that SAH may be a novel metabolism-related prognostic biomarker for HCC,” the authors said.