However, most of these markers have not been integrated into clinical practice. Given the importance of liver function in metabolism, metabolite biomarkers might provide alternative biomarker candidates. In particular,

metabolite profiling provides a broad and systematic view of metabolic change in complex biological samples Inhibitors,research,lifescience,medical and can be potentially useful for identifying metabolite biomarkers. Utilizing high-throughput analytical techniques such as nuclear magnetic resonance spectroscopy (NMR) and mass spectrometry (MS), metabolite profiling provides a detailed and quantitative analysis of 10s to 100s of metabolites and has therefore been applied to numerous areas including drug response, early disease diagnosis, toxicity and nutritional Inhibitors,research,lifescience,medical studies. [15,16,17,18]. A number of biomarker candidates have been proposed for different cancers, including lung [19,20], prostate [21], colon [22], breast [23,24]

and esophageal [25,26]. Several metabolite-profiling studies have focused on detecting HCC in different patient populations. Yang et al. applied high-resolution magic-angle spinning (HRMAS) in order to study adjacent, high-grade and adjacent low-grade liver cancer tissues and found several Inhibitors,research,lifescience,medical metabolites that clearly differentiated the samples, including lactate and several amino acids [27]. NMR was also used to screen urine samples from HCC patients in a Nigerian population [28]. Multivariate, partial least squares discriminant analysis (PLS-DA) models, based on markers such as creatinine, carnitine, creatine and acetone, were found to differentiate HCC patients from both Inhibitors,research,lifescience,medical healthy controls and patients with cirrhosis with high accuracy. The use of liquid chromatography

(LC)-MS Inhibitors,research,lifescience,medical and gas chromatography (GC)-MS has also been made to discover promising metabolite marker candidates, including amino acids and lipids [29,30,31,32,33]. These studies have identified metabolites with high classification accuracy, revealing metabolite profiling to be a promising approach. However, additional studies are needed; specifically, studies focusing on metabolite Cytidine deaminase markers that distinguish patients with a risk of developing HCC. Many of the earlier studies have focused on separating HCC patients and healthy controls, which is less relevant clinically since healthy selleckchem subjects are unlikely to develop HCC. Second, several of the metabolite marker candidates were discovered based on a limited number of samples and lack sufficient validation. Additionally, only a few of these studies focus on the population of the U.S. Considering that the risk of HCC differs across regions and ethnic groups, studies on different populations are also important.