About the Lab

The Hepatobiliary Cancer Laboratory of Lewis R. Roberts, M.B., Ch.B., Ph.D., at Mayo Clinic in Rochester, Minnesota, studies primary liver cancers, including hepatocellular carcinoma, bile duct cancer (cholangiocarcinoma) and gallbladder cancer.

The long-term objective of Dr. Roberts and his research team in the Hepatobiliary Cancer Laboratory is to understand the molecular basis of these cancers and translate new research findings into improvements in prevention, early diagnosis, prognostic prediction and treatment of these cancers.

Incidence and progression of hepatobiliary cancers

Liver cancer is the second leading cause of cancer death worldwide. It accounts for an estimated 750,000 to 1 million deaths a year, representing 10 percent of all deaths from cancer. In part because of the difficulty of early diagnosis of liver and biliary cancers, less than 1 percent of all patients are treated with potentially curative treatments, such as liver transplant or surgery.

The major causes of hepatocellular carcinoma include chronic infection with hepatitis B or hepatitis C, alcoholic cirrhosis, nonalcoholic fatty liver disease, dietary exposure to fungal aflatoxins, immune-related disorders such as primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis, and genetic disorders such as hemochromatosis and alpha-1-antitrypsin deficiency.

The incidence of hepatocellular carcinoma in the United States has increased markedly during the past 20 years, mostly due to the increase in chronic hepatitis C. As treatment for hepatitis C has improved and the prevalence of obesity and obesity-related fatty liver disease increases in the United States, Dr. Roberts and his Hepatobiliary Cancer Laboratory are observing a major shift from hepatitis C to fatty liver disease as the major cause of liver disease in the country.

Bile duct cancer is the second most common primary liver cancer and one of the most fatal cancers. During the past several decades, the incidence has been increasing worldwide with no clear explanation. There is a very strong association of cholangiocarcinoma with primary sclerosing cholangitis, an immune-mediated inflammatory disease.

Recent studies have found additional associations of cholangiocarcinoma with other chronic inflammatory diseases of the liver, such as cirrhosis, chronic viral hepatitis B and hepatitis C infection, alcohol use and the metabolic syndrome spectrum, including diabetes.

Identifying and characterizing cancer genes and inherited genetic risk

The genetic changes underlying the development and progression of hepatobiliary cancers are complex and incompletely understood.

The Hepatobiliary Cancer Lab is interested in the mechanisms by which cancers develop, grow and spread to other organs. Dr. Roberts' research goals include identifying genes involved in these processes and determining strategies by which they can be targeted to prevent, diagnose and treat hepatobiliary cancers.

The lab is actively engaged in research projects that are exploring the inherited tendencies of individuals and families toward the development of liver cancer and biliary tract cancers using the techniques of genome-wide association studies and whole-exome sequencing.

Bringing science to communities in need

Minnesota is home to the largest Somali population, the second-largest Hmong population and the third-largest Laotian population in the United States. The prevalence of hepatitis B and hepatitis C infection is higher among these populations than among Caucasians.

Through his Hepatobiliary Cancer Lab, Dr. Roberts is collaborating and building strong relationships with these communities to address these health concerns.

To help address the health needs of minority communities in Minnesota, the lab is collaborating with the Somali Health Advisory Committee, an established community advisory board, and with Hepatitis B-Initiative, Minnesota (HBI-MN), a nonprofit organization that focuses on viral hepatitis screening in the Asian community.

Under the guidance of Dr. Roberts, the lab's research team aims to develop culturally appropriate health education interventions for hepatitis B and hepatitis C. Through early detection and prevention of disease transmission, the Hepatobiliary Cancer Lab intends to decrease the burden of chronic liver disease on these communities.