Low glucose metabolism in hepatocellular carcinoma with GPC3 expression.

AIM: To investigate the relationship between glucose metabolism and glypican-3 (GPC3) expression in hepatocellular carcinoma (HCC). METHODS: Immunohistochemical staining of pathological samples for GPC3 and glucose transporter 1 (GLUT1), and whole-body 18F-FDG PET/CT for measuring tumour glucose uptake were performed in 55 newly diagnosed HCC patients. The maximum standard uptake value (SUVmax) and tumour-to-non-tumourous liver uptake (T/NT) ratio were used to quantify 18F-FDG uptake. In vitro18F-FDG uptake assay of GPC3-expressing HepG2 and non-GPC3-expressing RH7777 cells was used to examine the effect of GPC3 in cellular glucose metabolism. The relationships between GPC3 expression and 18F-FDG uptake, GLUT1 expression, tumour differentiation, and other clinical indicators were analysed using Spearman rank correlation, univariate and multiple logistic regression analyses. RESULTS: Positive GPC3 expression was observed in 67.3% of HCC patients, including 75.0% of those with well or moderately differentiated HCC and 36.4% of those with poorly differentiated HCC. There was an inverse relationship between GPC3 expression and SUVmax (Spearman correlation coefficient = -0.281, P = 0.038) and a positive relationship between GLUT1 expression and SUVmax (Spearman correlation coefficient = 0.681, P < 0.001) in patients with HCC. Univariate analysis showed that two glucose metabolic parameters (SUVmax and T/NT ratio), tumour differentiation, lymph node metastasis, and TNM stage were all significantly associated with GPC3 expression (P < 0.05), whereas GLUT1 expression, sex, age, tumour size, intrahepatic lesion number, and distant metastasis showed no statistical association (P > 0.05). Further multivariate analysis revealed that only the T/N ratio was significantly correlated with GPC3 expression in patients with HCC (P < 0.05). In vitro assay revealed that the uptake of 18F-FDG in GPC3-expressing HepG2 cells was significantly lower than that of non-GPC3-expressing RH7777 cells (t = -20.352, P < 0.001). CONCLUSION: The present study demonstrated that GPC3 expression is inversely associated with glucose metabolism, suggesting that GPC3 may play a role in regulating glucose metabolism in HCC.

Effect of primary percutaneous coronary intervention on serum collagen biomarkers following acute myocardial infarction.

OBJECTIVE: The aim of this study was to investigate the effect of primary percutaneous coronary intervention (PCI) on serum collagen biomarkers following acute myocardial infarction (AMI). METHODS AND RESULTS: Thirty-eight patients were enrolled into a primary PCI (n = 16) and a control (n = 22) group. The PCI group received successful PCI within 6 h of MI, whereas the control group received no PCI or thrombolytic therapy. Serum type I procollagen (PICP) and type III procollagen (PIIINP) were measured by enzyme-linked immunosorbent assay (ELISA). The baseline characteristics were similar between the PCI and control groups. There was no significant difference in left ventricular end-systolic, end-diastolic volume or ejection fraction between the two groups 30 min after MI (P > 0.05). A significant increase in PICP and PIIINP was noted in both groups 3 days after MI (P < 0.01). PICP and PIIINP in the PCI group declined overtime to the pre-PCI level, whereas they remained high in the control group. In the PCI group, the mean serum PICP and PIIINP on day 7, 14 and 30 was lower than in the control group (P < 0.01). CONCLUSIONS: AMI is associated with an increase in serum biomarkers of collagen synthesis. Early and successful PCI is associated with a reduction in serum collagen biomarkers.

Effects of adrenomedullin on the cell numbers and apoptosis of endothelial progenitor cells.

PURPOSE: To investigate the effect of adrenomedullin on the cell numbers and apoptosis of endothelial progenitor cells (EPCs). METHODS: Mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation. The cells were stimulated with adrenomedullin, before and after the treatment of adrenomedullin-receptor antagonist, adrenomedullin 22-52, or a PI3K inhibitor LY294002. RESULTS: Adrenomedullin dose-dependently increased the number of EPCs (P < 0.05). Adrenomedullin also significantly decreased apoptosis rate of EPCs in a concentration-dependent manner (P < 0.05). In the isolated human mononuclear cells pretreated with adrenomedullin 22-52 or LY294002, adrenomedullin failed to increase the number of EPCs or to reduce the level of apoptosis. CONCLUSIONS: Adrenomedullin increases the number of EPCs and decreases their apoptosis. These actions are likely mediated by PI3K signaling pathways. The clinical importance of these favourable effects on EPCs remains to be determined.

[Childhood thyroid carcinoma: clinical analyses of 22 cases].

BACKGROUND & OBJECTIVE: Thyroid carcinoma is rarely occurred in children. Clinicopathologic characteristics, therapy and prognosis of childhood thyroid carcinoma patients are different from those of adult patients, and the treatment of this disease is controversial. This study was to explore the clinicopathologic characteristics, diagnosis and therapy of thyroid carcinoma in children. METHODS: Clinical data of 22 children under the age of 14, diagnosed as thyroid carcinoma between Jan. 1980 and Dec. 2000, were reviewed. RESULTS: According to UICC clinical and histopathologic classification(2002), 19 cases were classified as stageI (2 cases of T1-4N0M0 and 17 cases of T1-4N1M0) and 3 cases as stage II (T1-4N1-4M1). Of the 22 patients, 8 (36.4%) had papillary carcinoma, 8 (36.4%) had follicular carcinoma, 5(22.7%) had mixed papillary-follicular carcinoma, and 1 (4.5%) had medullary carcinoma. All patients had received operation and postoperative thyroxin therapy. Unilateral and bilateral neck dissection had been performed in 12 and 7 patients, respectively; 19 patients had cervical lymph node metastasis. The follow-up period was 6 to 26 years (median, 14.83 years). The 5-and 10-year survival rates were 100% and 95.5%, respectively. CONCLUSIONS: Childhood thyroid carcinomas are mostly differentiated carcinomas, with high frequency of cervical lymph node metastases. The optimal treatment for thyroid carcinoma in children may improve the quality of life and decrease the incidence of complications.

[Treatment and prognosis of stage IV glottic laryngeal cancer].

BACKGROUND & OBJECTIVE: The prognosis of stage IV glottic cancer is poor. This study was to explore the impacts of different treatment modalities, cervical lymph node status and surgical margin on the prognosis of stage IV glottic cancer. METHODS: Clinical data of 88 patients with stage IV glottic cancer were reviewed. The correlations of different treatment modalities, cervical lymph node status, and surgical margin to the prognosis of stage IV glottic cancer were analyzed. RESULTS: The overall 3-and 5-year survival rates of the 88 patients were 71.6% and 63.0%. There was no significant difference in survival rate among the patients received operation, operation plus postoperative radiotherapy, chemoradiotherapy, and operation plus chemotherapy (P=0.729). The overall survival rate was significant lower in patients with lymph node metastasis than in those without lymph node metastasis (P=0.015); for stage cN0 patients, there was no significant difference between the patients with and without occult lymph node metastasis (P=0.474). There was no significant difference between the patients with positive surgical margin and those with negative surgical margin (P=0.016). CONCLUSIONS: N stage is the important prognostic factor for stage IV glottic cancer. The prognosis of patients with lymph node metastasis is poor. The survival rate of the patients with positive surgical margin is lower than that of those with negative surgical margin.

[Prognostic factors of medullary thyroid carcinoma].

OBJECTIVE: To investigate prognostic factors of medullary thyroid carcinoma. METHODS: By using univariate analysis and multivariate analysis, the prognostic factors were investigated in 102 patients with medullary thyroid carcinoma treated at this hospital. RESULTS: Overall survival rates of 5-year, 10-year and 15-year were 87.4%, 74.6% and 54.2% respectively by Kaplan-Meier method analysis. In univariate analysis, gender, age, bilateral thyroid lobe tumors, tumor size > 4 cm, invasion of thyroid capsule, distant metastasis, and non-radical tumor resection were significant poor prognostic factors. In multivariate analysis, tumor size > 4 cm (chi(2) = 7.43, P = 0.0035), distant metastasis (chi(2) = 23.50, P = 0.0000), and non-radical tumor resection (chi(2) = 25.90, P = 0.0000) remained as independent prognostic factors. CONCLUSIONS: Tumor size > 4 cm, distant metastasis, and non-radical tumor resection are the independent predictors of patients survival. Early diagnosis and early therapy can improve significantly the prognosis of medullary thyroid carcinoma.

[Correlation of cervical lymphatic metastasis to prognosis of glottic carcinoma: a report of 333 cases].

BACKGROUND & OBJECTIVE: Cervical lymph node metastasis rate of glottic carcinoma is low. How to deal with cervical adenopathy remains controversial. This study was to explore the factors relate to cervical lymphatic metastasis of glottic carcinoma. METHODS: Clinical data of 333 patients with glottic carcinoma, treated at Cancer Center of Sun Yat-sen University from Jan. 1, 1992 to Dec. 31, 2000, were reviewed. Distribution of cervical adenopathy, prognosis, and neck management were analyzed. RESULTS: The overall lymphatic metastasis rate was 9.61% (32/333); the occult lymphatic metastasis rate was 6.24% (20/321). Most metastatic lymph nodes located at ipsilateral levels II, III and IV (28/32). The pathologic grade had no correlation to the overall lymphatic metastasis rate (P=0.092), and occult lymphatic metastasis rate (P=0.067). The overall lymphatic metastasis rate (P=0.002) and occult lymphatic metastasis rate (P=0.015) rose up following with increased T stage. Neck selective radiotherapy for the patients at stage cN0 had no significant impact on occult lymph node metastasis rate (P=0.363). The 3-and 5-year survival rates were significantly lower in cN+ patients than in cN0 patients (56.25% vs. 88.70%, 46.67% vs. 85.37%, P<0.001), significantly lower in the cN+ patients with occult lymph node metastasis than in the cN+ patients without lymph node metastasis (68.18% vs. 89.00%, 63.31% vs. 85.55%, P=0.005), and significantly lower in naive cN+ patients than in the naive cN0 patients with occult lymph node metastasis (41.67% vs. 68.18%, 16.67% vs. 63.31%, P=0.004). CONCLUSIONS: Most metastatic lymph nodes of glottic carcinoma locate at ipsilateral levels II, III and IV, especially at level II. Cervical lymphatic metastasis affects the prognosis of glottic carcinoma.