High neutrophil-lymphocyte ratio indicates poor prognosis for acute-on-chronic liver failure after liver transplantation.

AIM: To investigate the significance of pre-transplant neutrophil-lymphocyte ratio (NLR) in determining the prognosis of liver transplant (LT) recipients with acute-on-chronic liver failure (ACLF). METHODS: Data were collected from the liver transplantation data bank. The NLR values and other conventional inflammatory markers were evaluated for their ability to predict the prognosis of 153 patients with ACLF after LT. The NLR cut-off value was based on a receiver operating characteristic curve analysis. A Kaplan-Meier curve analysis and univariate and multivariate Cox regression models were used to define the independent risk factors for poor outcomes. RESULTS: The optimal NLR cut-off value was 4.6. Out of 153 patients, 83 (54.2%) had an NLR ≥ 4.6. The 1-, 3-, and 5-year overall survival rates were 94.3%, 92.5% and 92.5%, respectively, in the normal NLR group and 74.7%, 71.8% and 69.8%, respectively, in patients with high NLRs (P < 0.001). Furthermore, there was a significant difference in infectious complications after LT between the high and normal NLR groups. There were no significant differences for other complications. In the multivariate Cox regression model, a high NLR was defined as a significant predictor of poor outcomes for LT. CONCLUSION: A high NLR is a convenient and available predictor for prognosis of LT patients and can potentially optimize the current criteria for LT in ACLF.

Role of overexpression of MACC1 and/or FAK in predicting prognosis of hepatocellular carcinoma after liver transplantation.

BACKGROUND: Metastasis-associated in colon cancer-1 (MACC1) acts as a promoter of tumor metastasis; however, the predictive value of MACC1 for hepatocellular carcinoma (HCC) after liver transplantation (LT) remains unclear. METHODS: We examined the expression of MACC1 and its target genes MET and FAK by quantitative PCR in 160 patients with HCC that was undergone LT. RESULTS: The patients with MACC1(high) or FAK(high) in HCCs showed a significantly shorter overall survival and higher cumulative recurrence rates after liver transplantation (LT), compared with MACC1(low) or FAK(low) group. Multivariate analysis indicated that MACC1 alone or combination of MACC1/FAK was an independent prognostic factor for overall survival and cumulative recurrence. CONCLUSIONS: MACC1 or combination of MACC1/FAK could serve as a novel biomarker in predicting the prognosis of HCC after LT.

Reduced expression of DACT2 promotes hepatocellular carcinoma progression: involvement of methylation-mediated gene silencing.

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most aggressive malignancies in humans, and its prognosis is generally poor even after surgery. Many advances have been made to understand the pathogenesis of HCC; however, the molecular mechanisms that lead to hepatocarcinogenesis and progression are still not clearly understood. METHODS: The expression of DACT2 in specimens from 30 paired HCCs and an additional 61 HCC patients after liver transplantation was evaluated by quantitative RT-PCR and immunohistochemical analysis. We investigated the methylation status of the DACT2 promoter region. We also analyzed the alterations of the cell cycle, migration and invasion after DACT2 knockdown. RESULTS: The expression level of DACT2 was significantly lower in HCC tissues than in non-cancerous tissues. Reduced DACT2 expression was associated with large tumor size. DACT2 transcripts were at low levels in hypermethylated liver cancer cells and were restored by exposure to a demethylating agent. Reduced expression of DACT2 in MHCC97L cells induced G1/S arrest, increased cell proliferation, and promoted cell invasion. CONCLUSIONS: Our study suggests that DACT2 is silenced by promoter hypermethylation, and reduced DACT2 can promote liver cancer progression. DACT2 may serve as a novel tumor suppressor gene in HCC.

Ocular axial length and its associations in Chinese: the Beijing Eye Study.

PURPOSE: To investigate the normative data of ocular axial length and its associations in Chinese. METHOD: The population-based Beijing Eye Study 2011 is a cross-sectional study performed in Greater Beijing. The study included 3468 individuals (1963 (56.6%) women) with a mean age of 64.6±9.8 years (range: 50-93 years). A detailed ophthalmic and medical examination was performed. Axial length was measured by optical low-coherence reflectometry. RESULTS: Axial length measurements were available for 3159 (91.1%) study participants. Mean axial length was 23.25±1.14 mm (range: 18.96-30.88 mm). In multivariate analysis, axial length was significantly associated with the systemic parameters of higher age (P<0.001), higher body height (P = 0.003), higher level of education (P<0.001) and urban region of habitation (P<0.001), and with the ocular parameters of thicker central cornea (P = 0.001), higher corneal curvature radius (P<0.001), deeper anterior chamber (P<0.001), thicker lens (P<0.001), more myopic refractive error (P<0.001), larger pupil diameter (P = 0.018), and higher best corrected visual acuity (P<0.001). It was additionally and negatively associated with the lens vault (P<0.001). In highly myopic eyes, axial length was significantly associated with lower level of education (P = 0.008), more myopic refractive error (P<0.001), and lower best corrected visual acuity (P = 0.034). CONCLUSIONS: Mean ocular axial length in the older adult population of Greater Beijing (23.25±1.14 mm) was similar to the value measured in other urban populations and was higher than in a rural Central Indian population. The association between axial length and older age may potentially be associated with a survival artifact. The association between axial length and body height agrees with the general association between anthropomorphic measures and eye globe size. The association with the level of education and urban region of habitation confirms with previous studies. In contrast in highly myopic eyes, axial length was negatively associated with educational level and best corrected visual acuity.