Haznadar M, Diehl CM, Parker AL, et al. - Using the NCI-MD cohort including hepatocellular carcinoma (HCC) cases (n = 98), high-risk individuals (n = 101), and 95 controls, researchers assessed the diagnostic and prognostic value of urinary metabolites: creatine riboside, N-acetylneuraminic acid, cortisol sulfate, and a lipid molecule designated as 561+. These metabolites were quantified in urine samples using ultra-performance liquid chromatography tandem mass-spectrometry. They used TIGER-LC cohort including 370 HCC and intrahepatic cholangiocarcinoma (ICC) cases, 471 high-risk individuals, 251 controls, for validation. Findings revealed that the four metabolites were significantly increased in HCC and ICC. Together with a clinically utilized marker CA19-9, these metabolites strongly classified ICC. Findings are suggestive of the possible utility of non-invasive urinary metabolite biomarkers for diagnostic and prognostic evaluation of ICC.