Written by James C. Morton Jr., Staff Writer. In a European prospective cohort study high selenium and selenoprotein P circulation reveals significant lower hepatocellular carcinoma risk compared to control group.
Hepatobiliary cancer, tumors of the liver and biliary tract, is the most common liver cancers worldwide. It is characterized by abnormal growth occurring in the liver, bile duct, biliary tract and tubes carrying bile from the liver to gallbladder to small intestines (1). Latest statistics state there are 35,000 new cases annually in the United States for primary liver cancer (hepatocellular carcinoma), and it’s expected to be the 3rd leading cause of death in those aged 60 to 70 (2). Health care cost for liver cancer treatment is estimated at $62,000, and liver transplant at $267,000 per patient (3).
The most popular treatment for liver cancer is radiation, chemotherapy, tumor ablation or surgery to remove abnormal cellular growth. Other treatments consist of antiviral medication (used for aflatoxins found in fungus on grains or nuts) or treatments for hepatitis conditions that can lead to liver disease. Unfortunately, most of these treatments are costly, with serious side effects or severe outcomes (4).
Fortunately, a 2016 study (5) reveals a strong association with selenium and selenoprotein P to hepatocellular carcinoma. In the European prospective cohort study, researchers studied 261 cases with 261 controls (143 men and 118 women in each group) to analyze availability of blood samples for selenium status. This related to selenoprotein P (121 for hepatocellular carcinoma), (100 for gallbladder and biliary tract cancer = 44 gallbladder, 19 ampulla of vater, 37 biliary tract), and 40 intrahepatic bile duct cancer. Selenium with fewer cases (106 hepatocellular carcinoma, 96 gallbladder & biliary tract cancer, and 36 intrahepatic bile duct cancer) due to insufficient volume of blood samples. Selenium was measured with 4µL of serum sample by X-ray flurorescence spectrometer, and Selenoprotein P was measured with 5µL serum sample by colorimetric ELISA, in addition to using conditional logistic regression model to calculate OR’s with 95% CI’s (6).
Researchers found hepatocellular carcinoma risk lower as selenium concentrations increased per 20 ug/L for 106 cases/106 controls ( ≤80.5µg/L = 60 vs control 37), 80.6-94.4µg/L = 34 vs control 30, and ≥94.5µg/L = 12 vs. control 39) significantly, p<0.001 (OR 0.41; 95% CI: 0.23, 0.72), and with increased selenoprotein per 1.5mg/L for 121 cases/121 controls (≤4.9mg/L = 64 vs control 31, 6-6.3mg/L = 42 vs control 43, ≥6.4mg/L = 15 vs control 47) significantly, p<0.001 (OR 0.37; 95% CI: 0.21, 0.63). For gallbladder and biliary tract cancer, selenium concentrations were not significantly associated (p = 0.055), though higher concentrations of selenoprotein P was significant (p = 0.016 for 100 cases/100 controls). For Intrahepatic bile duct cancer, there were no significant associations with limited analysis. No association was observed after analysis was adjusted to multivariable factors (alcohol intake, BMI, smoking, self-reported diabetes, diet, physical activity, total energy, and hoc liver score) for OR’s with 95% CI’s.
When suggesting how selenium and selenoprotein P concentrations lower risk for hepatobiliary cancers, the researchers pointed out how selenium plays a vital role in multiple metabolic processes in the liver (7), it is incorporated as the amino acid selenocycteine in selenoproteins that help prevent carcinogenesis due to protecting cells from oxidative stress, and inflammatory responses (8, 9, 10). They further concluded that optimal selenium intake should ensure a concentration of ≥ 124µg/L to express selenoproteins, and that selenium may act as biomarker of liver disease (11, 12). The main limitations are the single-time-point blood measurement per subject and short follow-up time (~6 years), and future tests are needed to assess increasing selenium with hepatitis B and C, in addition to reduction of hepatobiliary cancers.
Source: Hughes, D. Duarte-Salles, T. Hybsier, S. et al. (2016). Prediagnostic selenium status and hepatobiliary cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr doi: 10.3945/ajcn. 116.131672.
Copyright © 2016, Oxford University Press
Posted September 8, 2016.
References:
- ”Liver Cancer” posted on the Health Communities website.
- “Liver Cancer/Hepatocellular Carcinoma” posted Center for Disease Control and Prevention
- “Liver Treatment Cost” posted on the American Association Study Liver Disease website.
- “Liver Cancer Treatment” posted on American Cancer Society website.
- Hughes, D. Duarte-Salles, T. Hybsier, S. et al. (2016). Prediagnostic selenium status and hepatobiliary cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr doi: 10.3945/ajcn. 116.131672.
- Riboli E, Kaaks R. The EPIC project: rationale and study design. Int J Epidemiol 1997;26(Suppl 1):S6-14.
- Combs GF. Biomarkers of selenium status. Nutrients 2015;7:2209-36.
- Bellinger FP, Raman AV, Reeves MA, Berry MJ,. Regulation and function of selenoproteins in human disease. Biochem J 2009;422:11-22.
- Steinbrenner H, Speckmann B, Sies H. Toward understanding success and failures in the use of selenium for cancer prevention. Antioxid Redox Signal 2013;19:181-91.
- Hughes DJ, Fedirko B, Jenab M, Schomburg L, Meplan C, et al. Selenium status is associated with colorectal cancer risk in the European prospective investigation of cancer and nutrition cohort. Int J Cancer 2015;136:1149- 61.
- Burk R, Hill K, Motley A. Selenoprotein Metabolism and Function: Evidence for more than one function for Selenoprotein P. J Nutr. 2003;133:5: 1517S-1520S.
- Nangliya V, Sharma A, Yadav D, Sunder S, Nijhawan S, Mishra S. Study of trace elements in liver cirrhosis patients and their role in prognosis of disease. Biol Trace Elem Res 2015;165:35-40.
