Novel Prognostic Nomograms for Hepatocellular Carcinoma Patients with Microvascular Invasion: Experience from a Single Center

BACKGROUND/AIMS: Microvascular invasion (MVI) is an established risk factor for hepatocellular carcinoma (HCC). However, prediction models that specifically focus on the individual prognoses of HCC patients with MVI is lacking. METHODS: A total of 385 HCC patients with MVI were randomly assigned to training and validation cohorts in a 2:1 ratio. The outcomes were disease-free survival (DFS) and overall survival (OS). Prognostic nomograms were established based on the results of multivariate analyses. The concordance index (C-index), calibration plots and Kaplan-Meier curves were employed to evaluate the accuracy, calibration and discriminatory ability of the models. RESULTS: The independent risk factors for both DFS and OS included age, tumor size, tumor number, the presence of gross vascular invasion, and the presence of Glisson's capsule invasion. The platelet-to-lymphocyte ratio was another risk factor for OS. On the basis of these predictors, two nomograms for DFS and OS were constructed. The C-index values of the nomograms for DFS and OS were 0.712 (95% confidence interval [CI], 0.679 to 0.745; p<0.001) and 0.698 (95% CI, 0.657 to 0.739; p<0.001), respectively, in the training cohort and 0.704 (95% CI, 0.650 to 0.708; p<0.001) and 0.673 (95% CI, 0.607 to 0.739; p<0.001), respectively, in the validation cohort. The calibration curves showed optimal agreement between the predicted and observed survival rates. The Kaplan-Meier curves suggested that these two nomograms had satisfactory discriminatory abilities. CONCLUSIONS: These novel predictive models have satisfactory accuracy and discriminatory abilities in predicting the prognosis of HCC patients with MVI after hepatectomy.

The effect of survivin antisense oligodeoxynucleotides with quercetin on HCC cell lines / 中华普通外科杂志

Objective To study the effect of survivin anfisense oligonucleotides (ASODN)combined with quercetin on proliferation, apoptosis and cell cycle of a hepatocellular carcinoma cell line SSMC-7721 cells. Methods Human hepatocellular carcinoma cell line SSMC-7721 was cultured in vitro,and cells on logarithmic growth phase were used for this experiment. Cell proliferation was measured by MTT assay. The apoptotic rate and cell cycle were examined by flow cytometer (FCM). Morphological change of apoptotic cells were observed by fluorescent microscope. The expression of survivin gene was detected by the method of immunohistochemistry staining and RT-PCR on the mRNA and protein level. Results After sealing survivin gene with ASODN, the proliferation of SSMC-7721 cells was inhibited markedly. FCM analysis showed that there appeared an obvious apoptosis peak after transfection. The inhibitory effect of combined administration of survivin ASODN and quercetin on cell proliferation was much stronger than that of the single way. The result of immunohistochemical and RT-PCR assays showed that survivin ASODN and quercetin inhibited the expression of survivin gene. Conclusion Combined survivin ASODN with quercetin significantly inhibit cell proliferation, down-regulate survivin gene expression and induce the apoptosis of SSMC-7721 cells.