Yes-Associated Protein in Hepatocellular Carcinoma is Associated with Tumor Differentiation and Patient Age at Diagnosis, but not Markers of HBV Infection.

BACKGROUND: It was necessary to assess the relationship between Yes-associated protein (YAP) and some clinical features of hepatocellular carcinoma (HCC), especially hepatitis B virus (HBV) correlation factors as they relate to tumorigenesis. METHODS: A tissue microarray including 84 HCC samples was retrospectively analyzed by immunohistochemistry. RESULTS: This study showed that YAP expression was associated with HCC differentiation and the patient age at diagnosis of HCC. The mean age at diagnosis of YAP(+) HCC patients was 46.19 ± 9.45 years old, which is youn- ger than 51.40 ± 12.51 years old found for YAP(-) HCC patients (< 0.048). There was no significant correlation between YAP expression and HBV correlation factors (HBsAg, HBV DNA, and the duration of hepatitis B infec- tion). CONCLUSIONS: YAP(+) HCC patients had a younger mean age at diagnosis and more poor-differentiation charac- teristics of HCC. However, there were no independent HBV correlation factors.

Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study.

AIM: To assess the efficiency and safety of radiofrequency-assisted hepatectomy in patients with hepatocellular carcinoma (HCC) and cirrhosis. METHODS: From January 2010 to December 2013, 179 patients with HCC and cirrhosis were recruited for this retrospective study. Of these, 100 patients who received radiofrequency-assisted hepatectomy (RF+ group) were compared to 79 patients who had hepatectomy without ablation (RF- group). The primary endpoint was intraoperative blood loss. The secondary endpoints included liver function, postoperative complications, mortality, and duration of hospital stay. RESULTS: The characteristics of the two groups were closely matched. The Pringle maneuver was not used in the RF+ group. There was significantly less median intraoperative blood loss in the RF+ group (300 vs 400 mL, P = 0.01). On postoperative days (POD) 1 and 5, median alanine aminotransferase was significantly higher in the RF+ group than in the RF- group (POD 1: 348.5 vs 245.5, P = 0.01; POD 5: 112 vs 82.5, P = 0.00), but there was no significant difference between the two groups on POD 3 (260 vs 220, P = 0.24). The median AST was significantly higher in the RF+ group on POD 1 (446 vs 268, P = 0.00), but there was no significant difference between the two groups on POD 3 and 5 (POD 3: 129.5 vs 125, P = 0.65; POD 5: 52.5 vs 50, P = 0.10). Overall, the rate of postoperative complications was roughly the same in these two groups (28.0% vs 17.7%, P = 0.11) except that post hepatectomy liver failure was far more common in the RF+ group than in the RF- group (6% vs 0%, P = 0.04). CONCLUSION: Radiofrequency-assisted hepatectomy can reduce intraoperative blood loss during liver resection effectively. However, this method should be used with caution in patients with concomitant cirrhosis because it may cause severe liver damage and liver failure.

Ethanol preconditioning reduces hepatic I/R injury by inhibiting the complement system activation.

BACKGROUND: Ethanol preconditioning (EtOH-PC) refers to a phenomenon in which cerebral, intestinal, and myocardial tissues are protected from the deleterious effects of ischemia/reperfusion (I/R) by prior ingestion of ethanol at low to moderate levels. Whether EtOH-PC can offer protective effects against hepatic I/R injury and whether these effects are associated with inhibition of complement activation were investigated. METHODS: Male SD rats were divided into four groups, i.e., sham operation, ethanol control, IR, and ethanol-pretreatment I/R (EIR) groups. EtOH-PC was induced by gavaging rats with 40% ethanol at a dose of 5 g/kg body weight 24 h prior to experiment. Animal survival rate was compared. Liver function, hepatic MDA level, plasma complement C3 level, and serum hemolytic activity were determined. Histologic changes and complement C3 deposition in liver section were examined. Expression of liver complement 3 mRNA was analyzed by quantitative real-time -PCR. RESULTS: The 14-d survival rates were remarkably higher in the EIR groups than in the corresponding IR groups when hepatic ischemia time was 110, 120, and 130 min. Serum ALT, AST, IL-1ß, and liver tissue MDA were significantly lower, and histopathologic changes significantly milder in the EIR group than in the IR group (P <0.05). Compared with the IR group, both the reduction in CH50 and plasma C3 were significantly suppressed, and the staining of C3 in liver tissue significantly reduced in the EIR group. There were no significant differences of hepatic C3 mRNA among four groups. CONCLUSIONS: Ethanol preconditioning reduces hepatic I/R injury, and the effect is associated with inhibition of complement activation.

[Experimental study on tolerance time limits from warm ischemia to cold preservation of liver grafts].

OBJECTIVE: To investigate the tolerance time limits from warm ischemia to cold preservation of liver grafts. METHODS: Orthotopic liver transplantations (OLTs) were performed on Bama miniature swine. Morphological and functional changes of the liver grafts and biliary tracts after 10 minutes of warm ischemia followed by different durations of cold preservation and its reversibility were investigated. RESULTS: When the grafts were subjected to 10 minutes of warm ischemia followed by less than 16 hours of cold preservation, all animals could survive 1 week and there was no animal death from biliary necrosis. However, when the cold preservation time exceeded 16 hours, the incidence of biliary necrosis was significantly increased (P<0.05), and recipient death from bile leaks occurred. With further prolongation of the cold preservation time, primary graft nonfunction and intraoperative or early postoperative deaths occurred and the living animals all developed biliary necrosis. When compared with the less than 16 hours cold preservation group, the morphological scores and apoptosis index of the epithelial cells of bile ducts in grafts after reperfusion were significantly elevated in the more than 16 hours cold preservation group (P<0.05) and the activity of Na+-K+-ATPase and Ca2+-ATPase of bile ducts in grafts were also significantly reduced (P<0.05). Liver function tests showed that the recoveries of AST, AST, GGT and ALP were quicker in the 16 hours cold preservation group then those over 16 hour preservation ones. Correlation analysis revealed that the incidence of biliary necrosis was significantly correlated with the morphological score (r = 0.972) and with the apoptosis index of the epithelial cells of bile ducts in grafts after reperfusion (r = 0.931) and also correlated negatively (P<0.01) with the activity of Na+-K+-ATPase (r = -0.973) and Ca2+-ATPase (r = -0.973). CONCLUSIONS: It is concluded that with 10 minutes of warm ischemia, cold preservation of the grafts should not be longer than 16 hours in order to avoid early biliary necrosis, and the corresponding tolerance time limit of the livers to the cold preservation was less than 20 hours.

[Tolerance enhancement on the liver ischemia-reperfusion injuries in rats by ethanol pretreatment].

OBJECTIVE: To investigate the feasibility and efficacy of the ethanol pretreatment. Study was designed to confirm the proper range of the ethanol according to the toxicity and mortality, and then evaluate the possibility of application of the ethanol pretreatment. METHODS: (1) Thirty six male adult wistar rats pretreated with 40% ethanol were divided randomizely into six groups by different dosage: group A (8 g/kg), group B (7 g/kg), group C (6 g/kg), group D (5 g/kg), group E (4 g/kg), normal control group (0 g/kg). The safe dosage range of ethanol in rats was predicted by the observation of the symptoms after ethanol administration and pathological changes after 24 h. (2) Based on the results of experiment (1), this experiment were set as follows: 78 wistar rats were divided randomizely into 4 groups: normal control group, ethanol group, ischemia/reperfusion group (IR), ethanol pretreatment group (EP), in each group, the specimen were harvested from the rats at 3, 6, 12, 24 h after reperfusion and then were determined by different methods. (3) Based on the three variant factors (concentration, dosage and proper time for ethanol pretreatment), a orthogonal test were designed to optimize the ethanol pretreatment. 54 wistar rats used in this step were all subjected to hepatic schema procedure for 90 min and the specimens were harvested at 24 h after reperfusion. RESULTS: Less than 5 g/kg ethanol is safe to the rat, and it can reduce the 90 minutes IR injuries to the liver. Under the mode of A1B1C3, the more protection can be got for hepatic ischemia/reperfusion injuries. CONCLUSION: Proper dose of ethanol gavages to the rat is a safe pretreatment method, it maybe enhance the tolerance of rat liver to the I/R injuries.