Texas has the highest rates of liver cancer, also known as hepatocellular carcinoma (HCC) in the nation. Most cases of HCC arise among patients with chronic liver disease, especially cirrhosis of the liver. Fatty liver disease related to metabolic dysfunction (e.g., diabetes, obesity), also called MAFLD, has become the most common chronic liver disease in the world. Our goal is to reduce death and suffering from HCC. However, except for a small proportion of patients who are diagnosed at an early stage, a cure is not possible. Therefore, prevention of HCC is very important.

Our proposed research study investigates risk factors and novel biomarkers that can be reliably used to identify sub...

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Texas has the highest rates of liver cancer, also known as hepatocellular carcinoma (HCC) in the nation. Most cases of HCC arise among patients with chronic liver disease, especially cirrhosis of the liver. Fatty liver disease related to metabolic dysfunction (e.g., diabetes, obesity), also called MAFLD, has become the most common chronic liver disease in the world. Our goal is to reduce death and suffering from HCC. However, except for a small proportion of patients who are diagnosed at an early stage, a cure is not possible. Therefore, prevention of HCC is very important.

Our proposed research study investigates risk factors and novel biomarkers that can be reliably used to identify subgroups of MAFLD patients with cirrhosis who are at an increased risk of developing HCC, so they can be targeted for prevention and early detection. We propose to use novel techniques of examining blood samples for a wide range of metabolic substances related to MAFLD (metabolomics and lipidomics), and to use machine-learning techniques to analyze computerized tomography images of the liver (radiomics). We hypothesize that unique markers will be found that can be incorporated with clinical and demographic factors to enable clinicians and public health workers to identify groups at high risk for developing HCC.

Our proposed study builds on a unique resource of the Texas HCC Consortium (THCCC) cirrhosis cohort, which is a large, active cohort of patients with cirrhosis, mostly MAFLD-related, from 8 diverse clinical sites in Texas (funded by CPRIT). The THCCC cohort comprises 3000 patients with prospectively collected data and biospecimens and longitudinal periodic follow-up. We will compare patients who developed HCC with those who did not with respect to the biological and radiological features described above. These assets, combined with our experience in Texas-based consortia, make our study turnkey ready for high-quality implementation of the study aims.

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