Aflatoxin Exposure, Chronic Hepatitis Infection, and HLA Diversity Converge to Shape Patient Survival in Hepatocellular Carcinoma.

ABSTRACT:

Background

Aflatoxin remains an underrecognized hepatocellular carcinoma (HCC) risk factor in the United States, where the permissible food limit (20 ppb) is fivefold higher than in Europe.

Methods

We analyzed 350 The Cancer Genome Atlas HCC cases with whole-exome sequencing, RNA sequencing, and clinical data. Aflatoxin burden was quantified by single-base substitution signature 24. HLA diversity was quantified from RNA sequencing reads using the Shannon diversity index. Multivariable Cox models estimated HRs for disease-specific survival (DSS) with aflatoxin-virus interactions, adjusting for tumor stage, age, sex, race, alcohol use, fatty liver disease, aristolochic acid signature, and HLA diversity. Linear regression evaluated the association between HLA diversity and afla

SUBMITTER: Guo Y 

PROVIDER: S-EPMC12445043 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature