Clinical prognosis and related molecular features of hepatitis B associated adolescent and young adult hepatocellular carcinoma

AbstractBackground Little attention has been paid on the pathogenesis of adolescent and young adult (AYA) hepatocellular carcinoma (HCC), while due to the more advanced tumor progression and poorer prognosis of AYA-HCC, together with their better tolerance ability, non-cirrhotic background and stronger willingness to treatment, therefore, related clinical and molecular biology researches are urgent and necessary, especially for those with Hepatitis B infection. Methods For clinical aspect, the overall survival, recurrence-free survival and COX analysis were performed. Then, function analysis, gene clustering, metabolic-related analysis, immune infiltration and competing endogenous RNAs (ceRNAs) construction were carried out using whole transcriptome sequencing technique. Results Based on the clinical information of our HCC cohort, the overall survival and recurrence-free survival rates were worse in the young group than in the older group as previously described. According to our whole transcriptome sequencing results, functional analysis revealed that metabolism-related pathways as well as protein translation and endoplasmic reticulum processing were enriched. Then the hub metabolism-related genes were screened by metabolite-protein interactions (MPIs) and protein-protein interactions (PPIs). Among the metabolic pathways, fatty acid metabolism is of great significance, abnormalities in which may be the reason for worse prognosis of HBV-AYA HCC. Finally, the relationship of disrupted expression of metabolism-related genes with immune infiltration was also analyzed, and the lncRNA-miRNA-mRNA related ceRNA network for HBV-AYA HCC were constructed, which may provide new cues for HBV-AHA HCC prevention. Conclusions The worse prognosis and recurrence rate of HBV-AYA HCC may be related to abnormalities in metabolism-related pathways, especially disorder of fatty acid metabolism.