Estimating the Level of Amino Acids Using Amino Acid Analyzer to Foresee the Carcinoma Development of Hepatic Cells for Patients Suffer from Chronic Hepatitis B Virus Infection in Iraq

Abstract

The most common type of primary liver cancer is the hepatocellular carcinoma (HCC), mostly occurs in patients have chronic liver diseases, such as cirrhosis caused by hepatitis B(CHB) or hepatitis C(CHC) infection. However, approximately 25% of patients haven’t liver cirrhosis history and haven’t risk factors for it. The carcinoma of hepatic cell (HCC) classified according to the tumor characteristics including size, number, and vascular invasion, as well as lymph node involvement and metastatic disease into 3 groups, early stage (Group A), intermediate stage (Group B), advanced stage (Group C). In spite of there are more than 700 different amino acids are found in nature, but about 20 of them only are involved in protein synthesis in the cells. The liver has an essential function such as synthesis of protein, detoxification and degradation and also metabolism of amino acid. Many non-essential amino acids, such as (Glutamate, Alanine, Glycine, aspartate and serine) and other amino acids are essential, such as (Threonine and Histidine) are found in the liver, and involved in lipids and nucleotides synthesis, detoxification reactions and in various cellular metabolisms, the estimation of amino acids levels is very important to know the pathogenesis of liver and the liver disease severity. The purpose of the study is to estimate the differences in serum amino acids (AA) profiles in both of the chronic hepatitis B viral infection patients and in the hepatocellular carcinoma patients within different stages to detect the hepatocellular carcinoma development in patients with chronic HBV Infection, as well as to predict the stage of hepatocellular carcinoma using amino acid analyzer. Amino acid analyzer model Young Lin (Korea) used to estimate the level of amino acids for both HCC patients and CHB patient to compare between them and normal level of amino acid for healthy control male. There are 80 patients(male) with CHB,80 patients(male) with HBV-associated HCCwith different stages ,80 control(healthy) male were enrolled in this case control study. We indicated that a significant lowering in serum amino acids in liver diseased patient than healthy subjects (p<0.001). The serum levels of some amino acids such as lysine, leucine, tryptophan, threonine, serotonin, valine, were presented less in hepatocellular carcinoma patients than in (chronic) hepatitis B patients (CHB), while the phenylalanine’s level in serum was elevated more in hepatocellular carcinoma patients. The serum levels of serotonin and valine were less in hepatocellular carcinoma patients type C than type B and type A. In both of (hepatocellular)carcinoma and(chronic) hepatitis B patients there was increased phenylalanine serum level. phenylalanine’s level in serum was more significantly increased in the patients have (decompensated) hepatocellular carcinoma (HCC)than (compensated) stage of HCC(p<0.01), while the serum levels of serotonin and leucine were significantly decreased(p<0.01). In addition to that, it was shown that there is a significantly decreased in (BCAAs/tyrosine, branched-chain amino acids (BCAA)/aromatic amino acids, serotonin-to-tryptophan (STR), tryptophan) ratios and Fischer’s ratios more in HBV associated (hepatocellular) carcinoma patients than in patients with (chronic) hepatitis B infection (CHB)whereas increased tyrosine ratio more in patients   with (hepatocellular) carcinoma than in patients with (chronic) hepatitis B. There are many changes in the level of some amino acids among healthy and patients with chronic hepatitis B (CHB)disease and patients with HBV associated hepatocellular carcinoma (HCC), which may help us to know the early-stage development of (hepatocellular)carcinoma (HCC).