Haznadar M, Diehl CM, Parker AL, et al. - In search of early, inexpensive and clinically useful diagnostic biomarkers for liver cancer, researchers analyzed urine samples from the NCI-MD cohort, including 98 hepatocellular carcinoma cases, 101 high-risk individuals, and 95 controls, to quantify 4 metabolites, creatine riboside (CR), N-acetylneuraminic acid, cortisol sulfate, and a lipid molecule designated as 561+. They used the TIGER-LC cohort for validation. Compared with high-risk individuals and controls in the NCI-MD study, a significant increase in all profiled metabolites was found in liver cancer. There was a link between high levels of CR and poorer prognosis in intrahepatic cholangiocarcinoma (ICC). In combination with the clinically used marker CA19-9, these 4 metabolites were found to be robust at classifying ICC.