Prediction of neoplastic gallbladder polyps in patients with different age level based on preoperative ultrasound: a multi-center retrospective real-world study.

BACKGROUND: The prevalence of neoplastic polyps in gallbladder polyps (GPs) increases sharply with age and is associated with gallbladder carcinoma (GBC). This study aims to predict neoplastic polyps and provide appropriate treatment strategies based on preoperative ultrasound features in patients with different age level. METHODS: According to the age classification of WHO, 1523 patients with GPs who underwent cholecystectomy from January 2015 to December 2019 at 11 tertiary hospitals in China were divided into young adults group (n=622), middle-aged group (n=665) and elderly group (n=236). Linear scoring models were established based on independent risk variables screened by the Logistic regression model in different age groups. The area under ROC (AUC) to evaluate the predictive ability of linear scoring models, long- and short- diameter of GPs. RESULTS: Independent risk factors for neoplastic polyps included the number of polyps, polyp size (long diameter), and fundus in the young adults and elderly groups, while the number of polyps, polyp size (long diameter), and polyp size (short diameter) in the middle-aged groups. In different age groups, the AUCs of its linear scoring model were higher than the AUCs of the long- and short- diameter of GPs for differentiating neoplastic and non-neoplastic polyps (all P<0.05), and Hosmer-Lemeshow goodness of fit test showed that the prediction accuracy of the linear scoring models was higher than the long- and short- diameter of GPs (all P>0.05). CONCLUSION: The linear scoring models of the young adults, middle-aged and elderly groups can effectively distinguish neoplastic polyps from non-neoplastic polyps based on preoperative ultrasound features.

A Bayesian network model to predict neoplastic risk for patients with gallbladder polyps larger than 10 mm based on preoperative ultrasound features.

BACKGROUND: Polyp size of 10 mm is insufficient to discriminate neoplastic and non-neoplastic risk in patients with gallbladder polyps (GPs). The aim of the study is to develop a Bayesian network (BN) prediction model to identify neoplastic polyps and create more precise criteria for surgical indications in patients with GPs lager than 10 mm based on preoperative ultrasound features. METHODS: A BN prediction model was established and validated based on the independent risk variables using data from 759 patients with GPs who underwent cholecystectomy from January 2015 to August 2022 at 11 tertiary hospitals in China. The area under receiver operating characteristic curves (AUCs) were used to evaluate the predictive ability of the BN model and current guidelines, and Delong test was used to compare the AUCs. RESULTS: The mean values of polyp cross-sectional area (CSA), long, and short diameter of neoplastic polyps were higher than those of non-neoplastic polyps (P < 0.0001). Independent neoplastic risk factors for GPs included single polyp, polyp CSA ≥ 85 mm 2, fundus with broad base, and medium echogenicity. The accuracy of the BN model established based on the above independent variables was 81.88% and 82.35% in the training and testing sets, respectively. Delong test also showed that the AUCs of the BN model was better than that of JSHBPS, ESGAR, US-reported, and CCBS in training and testing sets, respectively (P < 0.05). CONCLUSION: A Bayesian network model was accurate and practical for predicting neoplastic risk in patients with gallbladder polyps larger than 10 mm based on preoperative ultrasound features.

A Bayesian network prediction model for gallbladder polyps with malignant potential based on preoperative ultrasound.

BACKGROUND: It is important to identify gallbladder polyps (GPs) with malignant potential and avoid unnecessary cholecystectomy by constructing prediction model. The aim of the study is to develop a Bayesian network (BN) prediction model for GPs with malignant potential in a long diameter of 8-15 mm based on preoperative ultrasound. METHODS: The independent risk factors for GPs with malignant potential were screened by χ2 test and Logistic regression model. Prediction model was established and validated using data from 1296 patients with GPs who underwent cholecystectomy from January 2015 to December 2019 at 11 tertiary hospitals in China. A BN model was established based on the independent risk variables. RESULTS: Independent risk factors for GPs with malignant potential included age, number of polyps, polyp size (long diameter), polyp size (short diameter), and fundus. The BN prediction model identified relationships between polyp size (long diameter) and three other variables [polyp size (short diameter), fundus and number of polyps]. Each variable was assigned scores under different status and the probabilities of GPs with malignant potential were classified as [0-0.2), [0.2-0.5), [0.5-0.8) and [0.8-1] according to the total points of [- 337, - 234], [- 197, - 145], [- 123, - 108], and [- 62,500], respectively. The AUC was 77.38% and 75.13%, and the model accuracy was 75.58% and 80.47% for the BN model in the training set and testing set, respectively. CONCLUSION: A BN prediction model was accurate and practical for predicting GPs with malignant potential patients in a long diameter of 8-15 mm undergoing cholecystectomy based on preoperative ultrasound.

Daphnetin Ameliorates the Expansion of Chemically Induced Hepatocellular Carcinoma via Reduction of Inflammation and Oxidative Stress.

Hepatocellular carcinoma (HCC) is the 5th most common cancer disease and the 3rd cause of cancer related disease. Oxidative stress and inflammatory reactions are increases due to the expansion of hepatic cancer. Daphnetin is a well-known antioxidant and anti-inflammatory drug. The current experimental study was exploring the chemoprotective effect of daphnetin against diethylnitrosamine (DEN) induced HCC in rats and scrutinizing the possible mechanism. In this experimental study, Swiss Wistar rats were used for the current protocol and intraperitoneal injection of DEN (200 mg/kg) and phenobarbital (8 mg/kg) were used for the induction and progression of HCC and after induction the HCC, the rats were received the oral administration of different doses of daphnetin. Body weight was estimated at regular time intervals. Macroscopical evaluation was done at the end of the experimental study for the confirmation of hepatic nodules. Hepatic markers, antioxidant and inflammatory mediators were estimated in the serum of experimental rats. Daphnetin treatment successfully attenuated the hepatic injury induced by DEN/Pb as shown by the suppressed the levels of biochemical parameters including alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (T-Bil) and total protein (TP). Daphnetin significantly (p < 0.001) enhanced the level of glutathione (GSH), glutathione S-transferase (GST), superoxide dismutase (SOD), catalase (CAT) and decreased the malonaldehyde (MDA) level. Daphnetin treatment significantly altered the level of phase I and phase II enzymes and also significantly (p < 0.001) decreased the level of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α); inflammatory mediators include cyclooxygenase-2 (COX-2), nuclear kappa B factor (NF-κB) and prostaglandin (PGE2). Collectively, we can say that daphnetin suggestively suppressed the hepatic cancer via suppression of antioxidant and inflammatory reactions.

Establishment of a nomogram prediction model for long diameter 10-15 mm gallbladder polyps with malignant tendency.

BACKGROUND: Surgical indications for the treatment of gallbladder polyps are controversial. Evaluation of gallbladder polyps with malignant tendency and indications for cholecystectomy in patients with long diameter polyps of 10 to 15 mm require further analysis and discussion. In this study, our objective was to re-evaluate indications for the surgical resection of gallbladder polyps and construct a nomogram model for the prediction of gallbladder polyps with malignant tendency. METHODS: Clinicopathologic data of 2,272 patients who had undergone cholecystectomy for gallbladder polyps were collected from 11 medical centers in China. Risk factor analyses and nomogram prediction model for gallbladder polyps with malignant tendency were conducted. RESULTS: Excluding 311 patients with cholelithiasis and 488 patients with long diameter polyps ≤5 and >15 mm, factors that differed significantly among patients with gallbladder polyps having a long diameter of 6 to 9 mm (885 cases) and 10 to 15 mm (588 cases) were polyp detection time, CEA and CA19-9 levels, number of polyps, fundus, echogenicity, gallbladder wall thickness and postoperative pathologic features (P < .05). Among 588 patients with gallbladder polyps with a long diameter of 10 of 15 mm, multivariate analysis indicated the following independent risk factors of gallbladder polyps with malignant tendency: single polyps (OR = 0.286/P < .001), polyps with broad base (OR = 2.644/P = .001), polyps with medium/low echogenicity (OR = 2.387/P = .003), and polyps with short diameter of 7 to 9 or 10 to 15 mm (OR = 3.820/P = .005; OR = 2.220/P = .048, respectively). The C-index of the nomogram model and internal validation were .778 and .768, respectively. In addition, a sample online calculator for the nomogram prediction model had been created (https://docliqi.shinyapps.io/dynnom/). CONCLUSION: Indications for cholecystectomy in patients with gallbladder polyps with a long diameter of 10 to 15 mm should be assessed by combining the information on short diameter, number of polyps, fundus, and echogenicity. The nomogram model can be used to predict the risk for the development of gallbladder polyps with malignant tendency.

Expression and roles of fatty acid synthase in hepatocellular carcinoma.

Cell metabolism abnormalities are closely related to tumor occurrence and development. Fatty acid synthase (FASN) is the key molecule for catalyzing fatty acid synthesis. Increasing evidence indicates that FASN is highly expressed in a number of malignant tumors; it can promote the synthesis of endogenous fatty acids in tumor cells and then the synthesized fatty acids provide energy for the proliferation of tumor cells. However, there has been no systematic study focusing on FASN expression and function in hepatocellular carcinoma (HCC). The aim of the present study was to verify the high expression of FASN in HCC cells at the histological and cellular levels, and to construct FASN shRNA eukaryotic expression vector for interfering FASN expression in HCC cell line SK-Hep-1, in an effort to explore the role of FASN in the proliferation, apoptosis, invasion and migration of HCC cells. In the present study, we demonstrated that FASN was highly expressed in HCC tissues compared with tumor-adjacent tissue and normal liver cell line 7702 (P<0.05). FASN expression in the high metastatic MHCC97H and SK-Hep-1 cell lines was increased compared with low metastatic HCC cell lines (P<0.05). Then, we constructed a FASN shRNA eukaryotic expression vector; after HCC SK-Hep-1 cells were transfected, the cell proliferation, migration and invasion were inhibited, but FASN had no impact on the apoptosis of HCC cells. Collectively, these data indicate that FASN is possibly involved in the occurrence and metastasis of HCC. Thus, inhibition of FASN may be a promising approach for the treatment of HCC.