In vivo induction of hepatocellular carcinoma by diethylnitrosoamine and pharmacological intervention in Balb C mice using Bergenia ciliata extracts / Indução in vivo de carcinoma hepatocelular por dietilnitrosoamina e intervenção farmacológica em camundongos balb c usando extratos de Bergenia ciliata

Abstract Background Hepatocellular carcinoma is the most frequent primary malignancy of liver and accounts for as many as one million deaths worldwide in a year. Objectives The aim of the present study was to evaluate the anti-cancerous efficiency of Bergenia ciliata rhizome against diethylnitrosoamine induced hepatocarcinogenesis in Balb C mice. Methods One percent diethylnitrosoamine was prepared by using 99 ml of normal saline NaCl (0.9 percent) solution to which was added 1 ml of concentrated diethylnitrosoamine (DEN) solution (0.01 μg/μl). Extract of Bergenia ciliata was prepared by maceration technique. Mice were classified into four groups as follows: Group 1 a control group (N=7) received saline solution (3.5 μl/mg), group 2 (N=14) received diethylnitrosoamine (3.5 μl/mg) intraperitoneally once in a week for eight consecutive weeks, group 3 (N=7) received plant extract (150 mg/kg (Body weight)) once in a week, while group 4 (N=7) was given combination of diethylnitrosoamine (3.5 μl/mg) and plant extract (150 mg/kg (Body weight)). After eight weeks of DEN induction group 2 mice were divided into two subgroups containing seven mice each, subgroup 1 was sacrificed while subgroup 2 was treated with plant extract (150 mg/kg (Body weight)) once in a week for eight consecutive weeks. Results The model of DEN injected hepatocellular carcinomic (HCC) mice elicited significant decline in levels of albumin with concomitant significant elevations in tumor markers aspartate aminotransferase, alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alpha feto protein (AFP), gamma glutamyl transferase (Y-GT), 5 nucleotidase (5NT), glucose-6-phosphate dehydrogenase (G6PDH) and bilirubin. The intraperitoneal administration of B. ciliata as a protective agent, produced significant increase in albumin levels with significant decrease in the levels of tumor markers aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alpha feto protein (AFP), gamma glutamyl transferase (Y-GT), 5 nucleotidase (5NT), glucose-6-phosphate dehydrogenase (G6PDH) and bilirubin. Conclusion Bergenia ciliata has potent antioxidant activity, radical scavenging capacity and anticancerous properties. Bergenia ciliata extracts may provide a basis for development of anti-cancerous drug.

Resumo Antecedentes O carcinoma hepatocelular é a neoplasia primária mais frequente do fígado e é responsável por até um milhão de mortes em todo o mundo em um ano. Objetivos O objetivo do presente estudo foi avaliar a eficiência anticancerígena do rizoma de Bergenia ciliata contra a hepatocarcinogênese induzida por dietilnitrosoamina em camundongos balb c. Métodos Um por cento de dietilnitrosoamina foi preparado usando 99 ml de solução salina normal (0,9 por cento) à qual foi adicionado 1 ml de solução concentrada de dietilnitrosoamina (DEN) (0,01 μg / μl). O extrato de Bergenia ciliata foi preparado pela técnica de maceração. Os ratos foram classificados em quatro grupos: Grupo 1 grupo controle (N = 7) recebeu solução salina (3,5 mL / mg), grupo 2 (N = 14) recebeu dietilnitrosoamina (3,5 mL / mg) por via intraperitoneal uma vez por semana para oito semanas consecutivas, o grupo 3 (N = 7) recebeu extrato vegetal (150 mg / kg (peso corporal)) uma vez por semana, enquanto o grupo 4 (N = 7) recebeu combinação de dietilnitrosoamina (3,5 μl / mg) e extrato (150 mg / kg (peso corporal). Após oito semanas do grupo de indução DEN 2 ratos foram divididos em dois subgrupos contendo sete ratos cada, subgrupo 1 foi sacrificado enquanto subgrupo 2 foi tratado com extrato vegetal (150 mg / kg)) uma vez por semana durante oito semanas consecutivas. Resultados O modelo de camundongos hepatocelulares carcinômicos (CHC) injetados com DEN provocou declínio significativo nos níveis de albumina com elevações significativas concomitantes nos marcadores tumorais: aspartato aminotransferase, alanina aminotransferase (ALT), lactato desidrogenase (LDH), proteína alfa feto (AFP), gama glutamiltransferase (Y-GT), 5 nucleotidase (5NT), glicose-6-fosfato ehidrogenase (G6PDH) e bilirrubina. A administração intraperitoneal de B. ciliata como agente protetor produziu um aumento significativo nos níveis de albumina com uma diminuição significativa nos níveis dos marcadores tumorais: aspartato aminotransferase, alanina aminotransferase (ALT), lactato desidrogenase (LDH), proteína alfa feto (AFP), gama glutamiltransferase (Y-GT), 5 nucleotidase (5NT), glicose-6-fosfato desidrogenase (G6PDH) e bilirrubina. Conclusão Bergenia ciliata possui atividade antioxidante potente, capacidade de eliminação de radicais livres e propriedades anticancerígenas. Extratos de Bergenia ciliata podem fornecer uma base para o desenvolvimento de drogas anti-cancerígenas.

PreoperativePredictionoftheExpressionofCK19inHepatocellularCarcinomaby Gd-EOB-DTPAEnhancedMRI / 中山大学学报(医学科学版)

@#【Objective】 To investigate the predictive value of preoperative Gd- EOB- DTPA enhanced MRI in the expression of cytokeratin 19（CK19）in hepatocellular carcinoma（HCC）.【Methods】A total of 102 patients，including 94 male and 8 female，with single HCC confirmed by pathology after operation who underwent preoperative enhanced MRI were retrospectively analyzed. A total of 25 were CK19-positive HCC and 77 were CK19-negative HCC. Two radiologists evaluated MR features including tumor size，tumor margin，intratumoral vessels，signal intensity（SI）on arterial phase （AP） ，enhancement pattern ，arterial rim enhancement ，peritumoral enhancement ，internal cystic or necrotic portion，hemorrhage，intratumoral fat，tumor capsule，vascular invasion，lymph node metastasis，intratumoral septum， target sign on diffusion weighted imaging（DWI）or hepatobiliary phase（HBP），peritumor hypointensity，SI on ADC，SI on HBP ，T1 relaxation times and T1 reduction rate between pre- and post- contrast enhancement. The associations between these imaging features and CK19 expression were investigated. 【Results】SI on AP（P = 0.013），arterial rim enhancement（P = 0.018），target sign on DWI（P = 0.001）and target sign on HBP（P = 0.005）were significantly associated with CK19 expression. Delayed enhanced intratumoral septum（P = 0.042）was associated with CK19 expression between HCCs less than 5 cm. Target sign on DWI（P = 0.001，OR = 4.875，95%CI：1.838~12.927）were independent significant factors of CK19- positive HCC.【Conclusion】Preoperative enhanced MRI with Gd- EOB- DTPA is helpful to predict CK19 expression of HCC.

TreatmentSkillsofThermalAblationinComplicatedHepatocellularCarcinomaCases / 中山大学学报(医学科学版)

@#Localthermalablationisoneofthethreecurativetreatmentmethodsforearlyhepatocellularcarcinoma. Itisperformedbyinsertionofneedle-shapedinstrumentguidedbyultrasoundorCTintothetumor.Bycausinglocal temperaturechange，necroticvolumearoundtheneedletipisachievedandthetreatmentgoalisthecoverageofthewhole lesionbythenecroticvolumes.Thoughthermalablationispreferredbecauseofitsminimalinvasivenessandlowcost，itcan stillresultinincompletetreatmentandseverecomplicationwhenthelesionisobscureorlocatedclosetoheatsensitive structuresinandaroundliver.Thisarticlereviewsthetreatmentskillsinthethermalablationofthesecomplicatedhepato⁃ cellularcarcinomacases.

ThevalueofGd-EOB-DTPA-enhanced MRIindiagnosisofhepatocellularcarcinoma / 实用放射学杂志

Objective ToexplorethediagnosticvalueofenhancedCTandGd-EOB-DTPA-enhanced MRIinthedetectionofhepatocellular carcinoma (HCC).Methods 41patientswith52HCCsunderwentenhancedCTandGd-EOB-DTPA-enhancedMRIrespectively.The imagingmanifestationswereanalyzed,andthelesionsweregrouped.Theimagingdiagnositicresultswerecomparedwiththepathologicalresults, andtheefficacyofthetwomodalitieswasevaluatedusingtheaccuracyindex.Results Ofthetotal52HCCs,42lesionswereidentifiedexactlyby enhancedCT,and51byGd-EOB-DTPA-enhancedMRI.Foralllesions,includingsmalllesions(≤2cm),theaccuracyratioofGd-EOB-DTPA-enhancedMRIwashigherthanthatofenhancedCT withastatisticallysignificantdifference(P<0.05),however,therewasnosignificant differenceforthelesionsbiggerthan2cm (P>0.05).Conclusion EnhancedCTislimitedindiagnosisoftheHCCssmallerthanor equalto2cm.ThediagnosticefficacyofGd-EOB-DTPA-enhanced MRIishigherthanthatofenhancedCT,anditcansignificantly improvethediagnosisofsmallHCC.

Consistencyanalysisofpreoperativeultrasoundand MSCTindiagnosing microvascularinvasioninhepatocellularcarcinoma / 实用放射学杂志

Objective Toinvestigatetheconsistencyofultrasoundand MSCTindiagnosing microvascularinvasion (MVI)in hepatocellularcarcinoma,andtocomparethediagnosticefficiencyofbothtwomethods.Methods TheultrasoundandMSCTdataof 82patientswithhepatocellularcarcinomawerecollected.Accordingtothepostoperativepathologicalresults,theconsistencyanddiagnostic efficiencyofultrasoundandMSCTindiagnosingMVIinhepatocellularcarcinomawerecompared.Results Accordingtothepostoperative pathologicalfindingsof82patients,30caseswerepositiveofMVI,while52caseswerenegative.ThepreoperativeMSCTandultrasound examinations had a strong consistency (Cohen’s Kappa＝0.829 ,P＜0.001 ).The sensitivity ,specificity and accuracy of preoperative ultrasoundinpredictingtheMVIinhepatocellularcarcinomawere76.67% (23/30),67.31% (35/52)and70.73% (58/82),respectively. Thesensitivity,specificityandaccuracyofpreoperativeMSCTinpredictinghepatocellularcarcinomaMVIwere83.33% (25/30),73.08%(38/52)and75.61% (63/82),respectively.Conclusion Preoperativeultrasoundand MSCThavegoodconsistencyandhighdiagnostic efficiencyindiagnosing MVIinhepatocellularcarcinoma.

Ashort-termoutcomeanalysisoftransarterialchemoembolizationcombinedwith microwaveablationformultinodularhepatocellularcarcinoma / 实用放射学杂志

Objective Toinvestigatetheshort-termefficacyoftranscatheterarterialchemoembolization(TACE)combinedwith microwaveablation (MWA;TACE-MWA)inthetreatmentofmultinodularhepatocellularcarcinoma (HCC).Methods 58patients withmultinodularHCCtreatedintheinterventionalmedicinecenterfromJanuary2015toJanuary2017wereincludedingradeAor B.34cases(groupA)receivedTACEand24cases(groupB)underwentTACE-MWAtherapy.Theshort-termefficacywasevaluatedbyfollow-upandanalysisofthetimetoprogression (TTP),localrecurrencerate,newlesionrate,andpostoperativecomplicationsinboth groups.Results TheTTPinthetwogroupswas38-240 (106.2±63.1)daysand90-630 (328.5±178.8)daysrespectively.The incidenceofpostoperativecomplicationsintwogroupswas2.9% (1/34)and4.2% (1/24)respectivelyI.ngroupA,thelocalrecurrenceratewas 52.9% (18/34)andthenewfocusratewas76% (26/34);inthegroupB,thelocalrecurrenceratewas8.3% (2/24)andthenewfocusratewas 66.7% (16/24).Thedifferenceoflocalrecurrenceratebetweenthetwogroupswasstatisticallysignificant(P<0.05),whiletheincidenceofnew lesionwasnotsignificantlydifferent (P>0.05).Conclusion TACE-MWAissafeandeffectiveinthetreatmentofmultinodular HCC.ComparingwithtraditionalTACEtreatment,TACE-MWAcansignificantlyimprovedTTPandlocalcontrolrate.

Carcinoma hepatocelular sobre enfermedad de hígado graso no alcohólico / Hepatocelular carcinoma on non alcoholic fatty liver

El carcinoma hepatocelular (CHC) es la neoplasia maligna primaria del hígado más frecuente y está asociada en la mayoría de los casos a una cirrosis hepáticaprevia o a una hepatopatía crónica independientemente de la etiología. En los países occidentales, la creciente epidemia de obesidad asociada es al origen de un aumento en la incidencia del CHC, como consecuencia de la aparición de una enfermedad del hígado graso no alcohólico (EHGNA). Se presenta el caso de una paciente de 46 años, de sexo femenino, con diagnóstico de una EHGNA portadora de un Sindrome Metabólico (SM) complicada con CHC tratada quirúrgicamente. La presentación de este caso clínico tiene como objetivo analizarla creciente problemática de salud pública que constituye el aumento en la incidencia de la obesidad y las complicaciones relacionadas de la EHGNA, transformándose actualmente en una de las causas principales del CHC y del Trasplante Hepático por cirrosis.

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and is associated in most cases with prior liver cirrhosis or chronic liver disease. In Western countries, the growing epidemic of obesity is the source of an increase incidence of HCC, as a consequence of the onset of a non-alcoholic fatty liver disease (NAFLD). We present the case of a 46-year-old female patient with a diagnosis of a NAFLD with a Metabolic Syndrome (MS) complicated by HCC treated surgically. With rhis clinical case we seek to highlight a growing problematic, the increase in the prevalence of obesity and with it the disease of non-alcoholic fatty liver, making it one of the leading cause of this hepatocellular carcinoma and Liver Transplant for cirrhosis.

Targetingc-Met by MicroRNAs:the progress for the treatment of hepatocellular carcinoma(HCC) / 医学研究生学报

Cancer is one of the world′s deadliest diseases, with low survival rates and increasing incidence in recent years. The successful application of target therapy significantly improved the treatment of tumor. However, primary and/or acquired resistance make tumor treatment facing huge challenges, and novel combinational therapies were required. RNA interference mediated gene inactivation. Alone or combined with other current therapies will be a promising approach to cancer treatment. It improves cure rate and overcomes drug resistance in current treatment options. Hepatocyte Growth Factor/c-Met signaling is one of the most frequently dysregulated pathways inhuman cancers. Abnormal c-Met activation is correlated with poor clinical outcomes and drug resistance in hepatocellular carcinoma (HCC). In recent years, a large number of studies have identified several inhibitors specifically targeting c-Met and microRNAs (miRNAs).This review discusses potential use of c-Met targeting miRNAs, suppressing aberrant c-Met signaling in HCC treatment.

In vivo induction of hepatocellular carcinoma by diethylnitrosoamine and pharmacological intervention in Balb C mice using Bergenia ciliata extracts

Abstract Background Hepatocellular carcinoma is the most frequent primary malignancy of liver and accounts for as many as one million deaths worldwide in a year. Objectives The aim of the present study was to evaluate the anti-cancerous efficiency of Bergenia ciliata rhizome against diethylnitrosoamine induced hepatocarcinogenesis in Balb C mice. Methods One percent diethylnitrosoamine was prepared by using 99 ml of normal saline NaCl (0.9 percent) solution to which was added 1 ml of concentrated diethylnitrosoamine (DEN) solution (0.01 g/l). Extract of Bergenia ciliata was prepared by maceration technique. Mice were classified into four groups as follows: Group 1 a control group (N=7) received saline solution (3.5 l/mg), group 2 (N=14) received diethylnitrosoamine (3.5 l/mg) intraperitoneally once in a week for eight consecutive weeks, group 3 (N=7) received plant extract (150 mg/kg (Body weight)) once in a week, while group 4 (N=7) was given combination of diethylnitrosoamine (3.5 l/mg) and plant extract (150 mg/kg (Body weight)). After eight weeks of DEN induction group 2 mice were divided into two subgroups containing seven mice each, subgroup 1 was sacrificed while subgroup 2 was treated with plant extract (150 mg/kg (Body weight)) once in a week for eight consecutive weeks. Results The model of DEN injected hepatocellular carcinomic (HCC) mice elicited significant decline in levels of albumin with concomitant significant elevations in tumor markers aspartate aminotransferase, alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alpha feto protein (AFP), gamma glutamyl transferase (Y-GT), 5 nucleotidase (5NT), glucose-6-phosphate dehydrogenase (G6PDH) and bilirubin. The intraperitoneal administration of B. ciliata as a protective agent, produced significant increase in albumin levels with significant decrease in the levels of tumor markers aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alpha feto protein (AFP), gamma glutamyl transferase (Y-GT), 5 nucleotidase (5NT), glucose-6-phosphate dehydrogenase (G6PDH) and bilirubin. Conclusion Bergenia ciliata has potent antioxidant activity, radical scavenging capacity and anticancerous properties. Bergenia ciliata extracts may provide a basis for development of anti-cancerous drug.

Resumo Antecedentes O carcinoma hepatocelular é a neoplasia primária mais frequente do fígado e é responsável por até um milhão de mortes em todo o mundo em um ano. Objetivos O objetivo do presente estudo foi avaliar a eficiência anticancerígena do rizoma de Bergenia ciliata contra a hepatocarcinogênese induzida por dietilnitrosoamina em camundongos balb c. Métodos Um por cento de dietilnitrosoamina foi preparado usando 99 ml de solução salina normal (0,9 por cento) à qual foi adicionado 1 ml de solução concentrada de dietilnitrosoamina (DEN) (0,01 g / l). O extrato de Bergenia ciliata foi preparado pela técnica de maceração. Os ratos foram classificados em quatro grupos: Grupo 1 grupo controle (N = 7) recebeu solução salina (3,5 mL / mg), grupo 2 (N = 14) recebeu dietilnitrosoamina (3,5 mL / mg) por via intraperitoneal uma vez por semana para oito semanas consecutivas, o grupo 3 (N = 7) recebeu extrato vegetal (150 mg / kg (peso corporal)) uma vez por semana, enquanto o grupo 4 (N = 7) recebeu combinação de dietilnitrosoamina (3,5 l / mg) e extrato (150 mg / kg (peso corporal). Após oito semanas do grupo de indução DEN 2 ratos foram divididos em dois subgrupos contendo sete ratos cada, subgrupo 1 foi sacrificado enquanto subgrupo 2 foi tratado com extrato vegetal (150 mg / kg)) uma vez por semana durante oito semanas consecutivas. Resultados O modelo de camundongos hepatocelulares carcinômicos (CHC) injetados com DEN provocou declínio significativo nos níveis de albumina com elevações significativas concomitantes nos marcadores tumorais: aspartato aminotransferase, alanina aminotransferase (ALT), lactato desidrogenase (LDH), proteína alfa feto (AFP), gama glutamiltransferase (Y-GT), 5 nucleotidase (5NT), glicose-6-fosfato ehidrogenase (G6PDH) e bilirrubina. A administração intraperitoneal de B. ciliata como agente protetor produziu um aumento significativo nos níveis de albumina com uma diminuição significativa nos níveis dos marcadores tumorais: aspartato aminotransferase, alanina aminotransferase (ALT), lactato desidrogenase (LDH), proteína alfa feto (AFP), gama glutamiltransferase (Y-GT), 5 nucleotidase (5NT), glicose-6-fosfato desidrogenase (G6PDH) e bilirrubina. Conclusão Bergenia ciliata possui atividade antioxidante potente, capacidade de eliminação de radicais livres e propriedades anticancerígenas. Extratos de Bergenia ciliata podem fornecer uma base para o desenvolvimento de drogas anti-cancerígenas.

Frequency of hepatocellular carcinoma in cirrhotic patients with hepatitis-C virus positive patients in Karachi-Pakistan.

Background: Hepatocellular Carcinoma is the 5th most common neoplasm in the world and 4th most common cancer death. Most patients with HCC have an underlying chronic liver disease (often cirrhosis), resulting mainly from chronic infection by Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), excessive alcohol consumption, and often an association of these causes. HCC has recently gained more interest due to its increasing incidence in industrialized countries. Objective: To determine the frequency of hepatocellular carcinoma in hepatitis C reactive cirrhotic patients. Methods: Place and duration of study: Department of medicine, civil hospital Karachi. Duration: Six months from 16-12-2012 to 15-6-2013. Subjects and methods: Patients admitted in medical wards of civil hospital Karachi with liver cirrhosis due to hepatitis C virus were included in the study. Investigation relevant to hepatocellular carcinoma like alpha fetoprotein and ultrasound was performed. If the Alpha fetoprotein is greater, then 200 ng/ml in the setting of a mass in a cirrhotic liver the likelihood of hepatocellular carcinoma is greater then 90% and biopsy is not required. Results: Overall mean age was 41.1 ± 7.1 years with Male:Female = 4.2:1. Out of 141 cases; hepatocellular carcinoma was diagnosed in 8 (5.7%) of patients with HCV related cirrhosis with mean age 48.6 ± 6.4 years. Proportion of hepatocellular carcinoma was high 7 (6.1%) in male. 7 (6.4%) cases had child pugh-C, 1 (5%) case had child pugh-B and while no HCC was seen in child pugh-A. Conclusion: In this study hepatocellular carcinoma was 5.7% in cases with hepatitis-C induced cirrhosis. Older age (>54 years), male sex and child pugh-C were predominant factors leading to hepatocellular carcinoma.

Efficacy and safety of laparoscopic radiofrequency ablation therapy for hepatocellular carcinoma / 国际外科学杂志

Objective To evaluate the feasibility,safety and efficacy of laparoscopic radiofrequency ablation (RFA) therapy for hepatocellular carcinoma (HCC).Methods Sixty-eight cases of liver cancer lesions were underwent laparoscopic radiofrequency ablation,and their postoperative recovery state,focal necrosis rate were observed.Results All the 68 cases were successfully performed operation,114 lesions were treated including 20 missed lesions at preoperative imaging diagnosis.There were no serious postoperative complications,the average hospital stay was (2.5 ± 1.2) days,focal necrosis rate 3 months after operation was 85.9％,lesion recurrence rate 6 months after operation was 12.2％,the 1-year survival rate was 76.47％.Conclusions Laparoscopic radiofrequency ablation in treatment of hepatocellular carcinoma has high security,few complications,short hospital stay and remarkable clinical effects.It's well worth clinical outreach.

The modified BCLC staging system improves predictability of early intrahepatic recurrence for hepatocellular carcinoma following curative hepatectomy / 中华肝胆外科杂志

ObjectiveTo evaluate the modified Barcelona Clinic Liver Cancer (BCLC) staging system for predictability of intrahepatic recurrence for patients with hepatocellular carcinoma (HCC) following curative hepatectomy.MethodsA retrospective study was conducted on 197 consecutive patients with HCC who underwent curative hepatectomy in our department from Jan.2008 to Jan.2011.Univariate and multivariate analyses using Cox proportional hazard model were used to evaluate possible association between clinicopathologic factors and early postoperative intrahepatic recurrence (ER).Receiver operating characteristics (ROC) analysis with calculation of the area under the curve (AUC),sensitivity,and specificity were applied to define the cutoff point values for possible meaningful continuous variables where appropriate.A comparison between the differences in AUC was used to assess BCLC and a modified BCLC (M-BCLC) staging system for their predictive ability of ER.Risk stratification according to calculated M-BCLC was applied to find differences of ER at various time points after curative hepatectomy.ResultsDuring follow-up,111 patients developed ER.The 6-,9-,12-,18- and 24-month cumulative recurrent rates were 26.9％ (53/197),37.6％ (74/197),45.2％(89/197),53.8％ (106/197) and 56.3％ (111/197),respectively.Multivariate analysis revealed thatthe severity of concomitant cirrhosis,elevated AFP≥185.6 μg/L and BCLC staging were risk factors of ER.A M-BCLC was proposed based on the results of multivariate analysis.The severity of cirrhosis and elevated AFP values were included in the BCLC staging.This M-BCLC exhibited better performance.It predicted at different time points of ER at postoperative 9,12,18 and 24 months to be significantly better with M-BCLC than BCLC using AUC drawn from ROC.No significant difference was found with ER prediction at 6 months.The M-BCLC also demonstrated a ER prediction with AUC of 0.710 (95％ CI,0.630-0.790) and achieved a sensitivity of 83.0％,a specificity of 51.9％as calculated from ROC with M-BCLC≥2.913.Further risk stratification according to the M-BCLC at various cutoff point values revealed the ER occurrence rates amongst the different risk groups to be significantly different when compared with the median ER time (17.9 mons,9.9 mons vs 5.7 mons,x2=25.770,P=0.000,Log-Rank test).ConclusionA modified BCLC staging system based on multivariate analysis improved the predictability of ER following curative hepatectomy for HCC.

Chemiluminescence enzyme immunoassay based on magnetic nanoparticles for detection of hepatoceUular carcinoma marker glypican-3 / 药物分析学报

Glypican-3 （GPC3） is reported as a great promising tumor marker for hepatocellular carcinoma （HCC） diagnosis. Highly sensitive and accurate analysis of serum GPC3 （sGPC3）, in combination with or instead of traditional HCC marker alpha-fetoprotein （AFP）, is essential for early diagnosis of I-ICC. Biomaterial-functionalized magnetic particles have been utilized as solid supports with good biological compatibility for sensitive immunoassay. Here, the magnetic nanoparticles （MnPs） and magnetic microparticles （MmPs） with carboxyl groups were further modified with streptavidin, and applied for the development of chemiluminescence enzyme immunoassay （CLEIA）. After comparing between MnPs- and MmPs-based CLEIA, MnPs-based CLEIA was proved to be a better method with less assay time, greater sensitivity, better linearity and longer chemiluminescence platform. MnPs-based CLEIA was applied for detection of sGPC3 in normal liver, hepatocirrhosis, secondary liver cancer and HCC serum samples. The results indicated that sGPC3 was effective in diagnosis of HCC with high performance.

Construction and expression of secreted chimericAFP-HSP70 plasmid in eukaryotic cells / 重庆医科大学学报

Objective:To construct secreted chimeric vector of AFP-HSP70 and investigate transient expression of vectors in eukaryotic cells.Methods:Vectors were constructed by routine molecular technique.Fusion genes were linked with G-S-G-G-S linker.Vectors were transfected into COS-7 cells by Lipofectamine 2000. Proteins were assayed by immunocytochemistry and RT-PCR for its RNA.Results:Proteins expressed in COS-7 were comfirmed by immunocytochemistry 48 hours later and RNA was detected by RT-PCR.Conclusion:AFP-HSP70 chimeric vector is constructed successfully and could be expressed in eukaryotic cells.

Study on the Action Mechanism of Insulin-Like Growth Factors and HBV-DNA Integration During Hepatocarcinogenesis / 中国医师杂志

Objective To observe the expressions of insulin-like growth factors(IGFs) and proliferating cell nuclear antigen(PCNA) in various kinds of liver tissues,we discussd the relationship among IGFs,PCNA and HBV-DNA integration in the process of hepatocarcinogenesis,provide some theoretical basis for the mechanism of hepatocarcinogenesis and clinical diagnosis and therapy of HCC.Methods 32 cases of HCC,32 cases of paracancerous liver tissues(PLT),12 cases of chronic active hepatitis(CAH),10 cases of fetal liver tissues(FLT) and 8 cases of normal adult liver tissues(NALT) were collected.Southern hybridization was used to detect HBV-DNA integration in various kinds of liver tissues.Then a colloid gold immunoelectron microscopic technique was used to make a systematic study on the expression and ultrastructural location of IGFs and PCNA in different liver tissues.Results The HBV-DNA integration was positively existed in 81 3%(26/32) of HCC and PLT,and 83 3%(10/12) in CAH,but the integration in NALT and FLT was no existed.PCNA was expressed by 87 5%(28/32) of HCC and 84 4%(27/32) of PLT,respectively.The postive rates of IGF-Ⅰ and IGF-ⅠR expressed by HCC were 40 6%(13/32) and 56 3%(18/32),those of IGF-Ⅰand IGF-ⅠR expressed by PLT were 50 0%(16/32) and 65 6%(21/32),respectively.The positive rates of IGF-Ⅱ and IGF-Ⅱ receptor(IGF-ⅡR) expressed by HCC were both 78 1%(25/32),and those expressed by PLT were both 81 3%(26/32).In the integration group of HBV-DNA had higher positive rates of IGF-Ⅱ and IGF-ⅡR,which were expressed by the HCC and PLT groups,than that of non-integration group of HBV-DNA(P

A Case of Acute Lung Injury Complicated by Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma / 결핵

Transcatheter arterial chemoembolization(TACE) was performed in a 61 year old male patient with hepatocellular carcinoma with 10 cc of Lipiodol and 50 mg of doxorubicin. Three days later, he complained of dyspnea and dry cough. The arterial blood gas study revealed moderate hypoxemia and hypocarbia. The chest PA showed acute pulmonary edema with bilateral pleural effusion. To rule out the possibilities of acute respiratory failure caused by infection, pulmonary embolism or congestive heart failure, we performed several laboratory studies. The blood and sputum culture studies revealed negative results for bacterial growth. The echocardiogram was normal. The abdominal CT scan and MR imaging revealed no thrombus or mass lesion in the inferior vena cava. So we concluded pulmonary oil embolism induced by lipiodol as the cause of acute lung injury. Four weeks later, clinical symptoms and chest x-ray were markedly improved with conservative care. We report a case of acute lung injury after TACE with lipiodol and doxorubicin, with review of literatures.