Transforming growth factor-beta1 gene expression in hepatocellular carcinoma: a preliminary report

The transforming growth factor [TGF]-beta signalling pathway plays a dual role in hepatocarcinogenesis. It has been recognised for its role as a tumour suppressor as well as a tumour promoter depending on the cellular context. The aim of this study was to investigate the clinical significance of serum TGF-beta1 level and TGF-beta1 messenger RNA [mRNA] in the peripheral blood of liver cirrhosis and hepatocellular carcinoma [HCC] patients as noninvasive biomarkers in diagnosing HCC. Twenty patients were allocated to each of the liver cirrhosis and HCC groups, in addition to 20 healthy volunteers. TGF-beta1 gene expression in peripheral blood was quantitated using real-time polymerase chain reaction [PCR], while serum TGF-beta1 was analysed using enzyme-linked immunosorbent assay [ELISA]. TGF-beta1 gene expression was significantly lower in HCC patients [median 0.401 [0.241-0.699] fold change] than in liver cirrhosis patients [median 0.595 [0.464-0.816]] [p = 0.042] and normal controls [median 1.00 [0.706-1.426] fold change] [p = 0.001]. TGF-beta1 gene expression showed significant positive correlation with serum TGF-beta1 [r = 0.272, p = 0.036] and significant negative correlation with alpha-fetoprotein [AFP] [r = ?0.528, p = 0.001]. Receiver operating characteristic [ROC] analysis was conducted for TGF-beta1 gene expression in comparison with AFP. The area under the curve for TGF-beta1 gene expression was 0.688 [95% CI = 0.517-0.858] [p = 0.042] and AFP was 0.869 [95% CI = 0.761-0.976] [p = 0.001]. The sensitivity and specificity of TGF-beta1 gene expression were 65% and 75%, respectively, at a cutoff value of 0.462 fold change. TGF-beta1 gene expression in the peripheral blood may be used as a molecular marker for the diagnosis of HCC. Additional studies on a large-scale population are necessary to gain greater insight into the impact of TGF-beta1 gene expression in the pathogenesis of HCC

first Egyptian experience using new self-expandable metal stents in acute esophageal variceal bleeding: pilot study

Balloon tamponade has been widely available in emergency situations of acute variceal bleeding. To lessen the complications of Balloon tamponade, a new special type of stent for exclusive use in acute variceal bleeding has been developed. This study aims to investigate the effectiveness and safety of the new self-expandable metal stents [SEMS] in the initial control of acute variceal bleeding. We also hypothesized that using SEMS can bridge the acute bleeding episode converting endoscopic management by sclerotherapy or band ligation to an elective procedure. Twenty patients with acute variceal bleeding were included in the study and 16 of them were allocated to receive stent treatment. Stent deployment was successful in 15 of 16 patients [93.75%]. Technical errors were reported in 3 [18.75%] patients. Initial control of variceal bleeding was reported in 14 [out of 16] [87.5%] patients. The mean duration of the procedure was 10 [ +/- 6] min. Mortality was reported in 4 [25.0%] patients. SEMS is a safe and effective mean to control acute variceal bleeding