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J Med Microbiol 56 (2007), 1455-1459; DOI: 10.1099/jmm.0.47151-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Prevalence of aflatoxin B1 in liver biopsies of proven hepatocellular carcinoma in India determined by an in-house immunoperoxidase test

K. G. Murugavel1, P. P. Naranatt1, E. M. Shankar1, S. Mathews2, K. Raghuram2, P. Rajasambandam2, V. Jayanthi3, R. Surendran3, A. Murali3, U. Srinivas3, K. R. Palaniswamy3, D. Srikumari4 and S. P. Thyagarajan1

1 Department of Microbiology, Faculty of Medicine, Dr ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, India

2 Medical Gastroenterology Unit of the Government General Hospital, Chennai 600 001, India

3 Medical and Surgical Gastroenterology Unit of the Government Stanley Medical College and Hospital, Chennai 600 001, India

4 Government Kilpauk Medical College and Hospital, Chennai 600 029, India

Correspondence
K. G. Murugavel
murugavel{at}yrgcare.org

Received 4 January 2007
Accepted 29 June 2007

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related death in the world. The incidence of HCC in India is reportedly low and varies from 0.2 to 1.9 %. Aflatoxins, secondary metabolites produced by Aspergillus flavus and Aspergillus parasiticus, are potent human carcinogens implicated in HCC. The prevalence of aflatoxin B1 (AFB1) as co-carcinogen was analysed using an in-house immunoperoxidase test in 31 liver biopsies and 7 liver-resection specimens from histopathologically proven HCC, and in 15 liver biopsies from cirrhosis patients (control group). Serum was tested for hepatitis B and C serological markers using commercial assays, and for AFB1 using an in-house ELISA with a sensitivity of ~1 ng ml–1 for AFB1. In spite of positive AFB1 immunostaining in HCC cases, all serum specimens, from both HCC and the control groups, were AFB1-negative. There were 18 (58.1 %) HCC cases that revealed AFB1 in liver biopsies; 68.8 % (n=11) of non-B non-C hepatitis cases with HCC and 46.1 % (n=6) of the hepatitis B surface-antigen-positive subjects were positive for AFB1. Out of the two hepatitis B/hepatitis C virus co-infected cases, one was positive for AFB1. Of seven tumour-resection samples, six were positive for AFB1. Only one case revealed AFB1 in the non-tumour area of the resected material. Thus AFB1 staining was significantly associated with tumour tissue (P=0.03). Aflatoxins proved to have a significant association with HCC in this peninsular part of the subcontinent. The impact seems to be a cumulative process, as revealed by the AFB1 deposits in HCC liver tissue, even though the serum levels were undetectable.

Abbreviations: AFB1, aflatoxin B1; DAB, 3'3'-diaminobenzidine tetrahydrochloride; HBsAg, hepatitis B surface antigen; HCC, hepatocellular carcinoma.






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