Objective To investigate the relationship between syndecan-1 protein and malignant phenotypes of hepatocellular carcinoma (HCC). Methods forty-seven formalin-fixed sections were obtained. The syndecan-1 was measured with immunohistochemistry assay (ABC method). Results Among 47 HCC tissues, 28 (59.6%) show negative staining, the syndecan-1 negative rate in HCC with poor differentiation was higher than those with good differentiation (78.3% vs 41.7%, Ｐ＜0.05), and negative rate in large HCC was higher than in small HCC (81.0% vs 42.3%, Ｐ＜0.01), and negative rate in HCC with the presence of tumor-cells in blood was greater than in those without tumor-cells in blood (84.2% vs 42.9%, P＜0.01). No correlation was found between syndecan-1 expression and serum AFP level and Child class. Conclusion Syndecan-1 expression is correlated with the growth, differentiation, invasiveness, metastasis and progression of HCC. It is possible that syndecan-1 is a negative regulator of these malignant phenotypes of HCC, can be regarded as suppressive gene.
Objective To evaluate the effect of methylation determination about the peripheral plasma DNA in diagnose of hepatocellular carcinoma （HCC） and select the highly sensitive and specific methylated cancer suppressor genes. Methods Methylation-specific PCR （MSP） was used to detect the degree of methylation about SLIT2 and DAPK genes in peripheral plasma and associated cancer tissues of 34 patients with HCC confirmed by pathology, then analyzed their relationship to clinicopathologic feature. Results The positive rate of the promoter methylation of SLIT2 and DAPK genes in cancer tissues in 34 cases were 70.6% （24/34） and 79.4% （27/34）, while the relevant promoter methylation rate in plasma were 44.1% （15/34） and 50.0% （17/34） correspondingly. The sensitivity of detection of DNA methylation about SLIT2 and DAPK genes in plasma was 62.5% and 63.0%, respectively；both of the specificity for them were 100%. The negative predicted value was 52.6% and 41.2%, respectively；while both of the positive predicted value were 100%. There were no significant correlation between the clinicopathologic features and the methylation rate in cancer tissues and plasma （P＞0.05）. In plasma of patients whose AFP＜400 μg/L, the positive rate of combined detection of DNA methylation of SLIT2 and DAPK was 61.1% （11/18）. Conclusions The detection rate of DNA methylation of SLIT2 and DAPK genes in plasma is higher, and there is a significant correlation between the DNA methylation in HCC tissue and plasma, based on MSP method. DNA methylation in plasma, as an non-invasive method, could be used to diagnose HCC, especially for the patients whose AFP is negative. HBV infection may be only associate with DNA methylation of part gene.
ObjectiveTo compare the efficacy and safety of Huaier and Sorafenib in treatment of small hepatocellular carcinoma(HCC)following radical resection. MethodsEighty-two patients with small HCC accepted radical liver resection and then taken Huaier or Sorafenib were collected retrospectively. These patients were divided into Huaier group(51 cases)and Sorafenib group(31 cases)according to the different administration drugs after operation. The baseline characteristics, tumor characteristics, survival rate, tumor recurrence rate, and side effects were compared between two groups. Results①There were no significant differences on the baseline demographic characteristics, liver function, and tumor characteristics between two groups(P > 0.05).②The overall survival rate and tumor-free survival rate had no significant differences between the Huaier group and the Sorafenib group(P=0.737, P=0.699).③The rate of recurrence or metastasis had no significant difference between the Huaier group and Sorafenib group(37.3% versus 32.3%, P=0.648). The most common site of the recurrence or metastasis was the liver and the lung followed.④There were only 5 cases suffered side effects after taking Huaier and no case needed Huaier discontinuance. However, 11 cases suffered side effects after taking Sorafenib and 3 cases needed Sorafenib discontinuance, and the rate of the side effect in the Sorafenib group was much higher than that in the Huaier group(35.5% versus 9.8%, P=0.026). ConclusionFor the small HCC who accepted radical liver resection, Huaier seems to be an effective and safe drug.
Objective To evaluate the prognostic and pathobiologic significance of DNA content. Methods DNA content was conducted on 140 hepatocellular carcinoma patients by flow cytometry. Cancer recurrence was followed up after the patients were discharged. The statistical software used was SPSS. Results DNA ploidy did not correlate with clinicobiologic features, except with the age of the patients (Ｐ＜0.05), tumor size and AFP level (Ｐ＜0.01). The mean following up time of the patients with diploid was 31.2 months. The recurrence rate was 23.1%. In aneuploid group the mean following up time was 22.6 months. The recurrence rate was 50.0%. Ploidy correlated significantly with recurrence rate, the recurrence rate for patients with aneuploid were significantly higher than for those of diploid (Ｐ=0.013), also the recurrence rate of aneuploid within one year (37.9%) was much higher than that of diploid (4.3%) Ｐ=0.002. In a Logistic multivariate analysis of DNA content, the grade of cirrhosis severity and the tumor size were considered to be independent factors that related with recurrence. Conclusion FCM DNA analysis of radically resected HCC is a simple and valid method to predict the recurrence.
Objective To systematically review the efficacy and safety of laparoscopic hepatectomy (LH) and open hepatectomy (OH) for patients with hepatocellular carcinoma (HCC). Methods PubMed, EMbase, The Cochrane Library, CBM, WanFang Data, CNKI databases were electronically searched to collect the case-control studies about LH vs. OH for patients with HCC from inception to December, 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then meta-analysis was performed by using RevMan 5.3 software. Results A total of 28 studies involving 1 908 patients were included. The results of meta-analysis showed that: the LH group was superior to OH group on complications (OR=0.35, 95%CI 0.26 to 0.48, P<0.000 01), hospital stay (MD=–4.18, 95%CI (–5.08, –3.29),P<0.000 01), and five years overall survival rate (OR=1.65, 95%CI 1.23 to 2.19,P=0.000 7) and disease-free survival rate (OR=1.51, 95%CI 1.12 to 2.03, P=0.006). However, no significant differences were found in one year and three years overall survival rate, disease-free survival rate, and postoperative recurrence rate. Conclusion Current evidence shows that the LH is superior to OH for the treatment of HCC, and may be amenable to surgery because of its safety and longtime efficacy. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
【 Abstract 】 Objective To probe into the role of inositol 1, 4, 5-trisphosphate (IP3) and bax gene expression in apoptosis of HepG2 cells induced by genistein (Gen). Methods HepG2 cells were treated with different concentrations including 20, 40, 60 and 80 μ mol/L Gen as HepG2 cells cultured with 0 μmol/L Gen for 72 h was control; HepG2 cells were treated with 60 μmol/L Gen for 6, 12, 24, 48 and 72 h as HepG2 cells treated with 60 μmol/L Gen for 0 h was control. IP3 content, bax mRNA expression and apoptosis rate were assayed by IP3- ［ 3H ］ Birtrak assay, RT-PCR and flow cytometry, respectively. ResultsHepG2 cells incubated with each concentration of Gen for 72 h ， IP3 content was lower than that of control 〔 (17.7 ± 1.3), (11.2 ± 0.9), (4.9 ± 0.5), (4.8 ± 0.3) pmol/106 cells vs (29.4 ± 0.5) pmol/106 cells 〕 , P ＜ 0.01 ； bax mRNA expression (RI which was the gray degree multiply area of bax/the gray degree multiply area of β -actin) was higher than that of control (0.26 ± 0.02, 0.33 ± 0.05, 0.35 ± 0.06, 0.38 ± 0.05 vs 0.09 ± 0.01), P ＜ 0.01 ； The apoptosis rate was higher than that of control 〔 (10.1 ± 0.9)%, (18.7 ± 1.6)%, (28.7 ± 2.5)%, (27.9 ± 2.0)% vs (2.6 ± 0.1)% 〕 , P ＜ 0.01. HepG2 cells were incubated with 60 μ mol/L Gen for 6, 12, 24, 48 and 72 h ， IP3 content was lower than that of control 〔 (22.6 ± 0.9), (12.0 ± 1.4), (7.5 ± 0.8), (5.6 ± 0.5), (4.3 ± 0.6) pmol/106 cells vs (29.2 ± 0.6) pmol/106 cells 〕 , P ＜ 0.01 ； bax mRNA expression was higher than that of control incubated with 60 μ mol/L Gen for above 12 h (0.25 ± 0.06, 0.29 ± 0.02, 0.30 ± 0.02, 0.35 ± 0.04 vs 0.09 ± 0.01), P ＜ 0.01 ； The apoptosis rate in groups incubated with 60 μ mol/L Gen for 24, 48 and 72 h was significantly higher than that in control 〔 (7.4 ± 0.5)%, (20.5 ± 2.0)%, (30.7 ± 1.6)% vs (2.6 ± 0.1)% 〕 , P ＜ 0.01. ConclusionGen induces apoptosis of HepG2 cells by reducing IP3 production and increasing bax gene expression.
Objectives To train postgraduate medical students the ability of effectively using network resources and independently studying, and to explore new model of clinical liver cancer teaching. Methods The teaching model of problembased learning (PBL) to clinical liver cancer teaching was applied. Results The teaching model of PBL changed graduate student the status of passive acceptance to active participation. The teaching process was full of livingness, and the teaching quality was improved.Conclusion The teaching model of PBL can break through the limitations of passive acceptance of book knowledge in traditional teaching model and improve the ability to handle the comprehensive clinical knowledge of liver cancer, which provides a new model to the teaching of liver cancer to graduate medical students in clinic.
ObjectiveTo discuss the clinical value of internal radiation therapy with hepatic intraarterial iodine131 labeled material for the treatment of hepatocellular carcinoma (HCC). MethodsThis summarized paper was made on literature review. ResultsIodine131lipiodol and several reported iodine131labeled antibodies to HCC associated antigens were concentrated in the foci of HCC with a high tumortonormaltissue absorbed dose ratios. No severe side effects occurred. It was used in various kinds of HCC patients, and mostly showed a significant tumor response. Survival rate of HCC patients was raised in several clinical trials.Conclusion Internal radiotherapy with hepatic intraarterial iodine131 labeled material may be considered as an effective method to treat HCC.
Objective To investigate the relationship between changes of vascular elasticity and spontaneous rupture of hepatocellular carcinoma (HCC). Methods We examined the semiquantitatively expression of related angiogenesis factors including von Willebrand factor, elastin and neutrophil elastase in 30 specimens of HCC with spontaneous rupture by immunohistochemistry compared with 30 specimens of HCC without rupture. Results The results showed that there was a significant decrease of von Willebrand factor, overproliferation of elastin and abnormal distribution of neutrophil elastase around the small artery in ruptured HCC. These changes exacerbated weakness of the blood vessels and destroyed function of coagulation. The blood vessels split easily when the vascular load increased from hypertension or minor mechanical trauma. Conclusion The spontaneous rupture of HCC may be related to the vascular dysfunction.
ObjectiveTo evaluate the safety and technical feasibility of salvage liver transplantation (SLT) after liver resection, and its influence on prognosis. MethodsThe clinical data of 289 patients who underwent liver transplantation by cadaveric grafts treating for hepatocellular carcinoma met the UCSF criteria from June 2001 to December 2008 were analyzed retrospectively. Among them, 242 patients underwent primary liver transplantation (PLT, PLT group), and 47 patients underwent SLT for recurrence (SLT group). Perioperative factors and survival were compared between two groups. ResultsThere were no significant differences of age, gender, and pathology of tumor between two groups (Pgt;0.05). The operation time in the SLT group was significantly longer than that in the PLT group 〔(7.1±1.8) h versus (6.4±1.4) h， P=0.004〕. The differences of intraoperative blood loss 〔(2 560.5±2 683.6) ml versus (2 042.9±2 006.2) ml， P=0.173〕 and blood transfusion 〔(13.8±12.9) U versus (9.9±12.6) U， P=0.087〕 were not significant between two groups. The mean interval time from resection to transplantation was (32.8±32.4) months. The median followup was 38.7 months, 3year overall and diseasefree survivals were not significantly different (82.3% versus 75.5%, P=0.312; 78.8% versus 70.1%, P=0.755, respectively) between the SLT group and PLT group. According to intentiontotreat analysis, the 3year overall survival in the SLT group was significantly longer than that in the PLT group (88.4% versus 76.2%, P=0.047). ConclusionsIn selected patients, liver resection prior to transplantation neither increases operative morbidity nor impairs prognosis following liver transplantation. SLT after liver resection, can be an alterative treatment for HCC.