cfDNA and associated risk factors in the early diagnosis of cancers in Côte d’Ivoire: The case of primary liver cancer related to viral hepatitis B

Introduction: In Côte d'Ivoire (CI), according to Globocan 2020 primary liver cancer (PLC) had an incidence of 10.1/1.0E+05 inhabitants in men (2nd rank) and 5.5/1.0E+05 inhabitants among women (4th rank). This situation has so far been favored by late diagnosis and ignorance of the risk factors responsible for the tumor in people at risk.

Objective: To detect free circulating DNA (cfDNA) and evaluate its possible diagnostic role in order to contribute to the prevention of PLC in CI.

Methodology: Prospective experimental study carried out at the Institut Pasteur in CI in patients coming for alfa-fetoprotein assay. Sociodemographic, clinical, paraclinical and epidemiological data were collected. A blood sample was taken for biological analysis. Data collected in Excel and processed with the GraphPad Prism 5.

Results: 142 predominantly male patients with an average age of 45 were included. More than 50% had the same dietary habits including the consumption of tap water, rice, cassava, plantain, millet, maize and yam and 18% regularly consumed alcohol. 66.66% were carriers of chronic viral hepatitis B (HVB) including 2.81% at the cirrhosis stage and 0.70% at the PLC stage. 20% had a history of familial hepatitis and 9.6% a notion of familial cancer. The cfDNA concentration ranged from 38ng/ml to 10763ng/ml for an average of 571ng/ml. The elevation of AFP and transaminase levels was related to the presence of HBsAg (P˂0.001; P=0.02). In addition, the concentration of cDNA was strongly linked to HBsAg carriage as well as to other factors including the notion of familial cancer (P=0.03), and consumption of alcohol (p =0.04) and/or tobacco (p=0.02). Conclusion: HVB remains the predominant risk factor that can lead to PLC. The dosage of cfDNA and the monitoring of food and life hygiene in a chronic carrier of HVB could contribute to the prevention of PLC in the latter.