Folate intake and pancreatic cancer risk: an overall and dose-response meta-analysis

OBJECTIVE

Inconsistent findings of association between supplemental folate consumption and pancreatic cancer risk have been observed in the literature. This study aims to summarize the relationship between folate intake and risk of pancreatic cancer.

STUDY DESIGN

Pertinent studies published before November 2011 were identified by searching PubMed and Embase and by reviewing the reference lists of retrieved articles. The summary relative risks were estimated by the random effects model. A linear regression analysis of the natural logarithm of the relative risk (RR) was carried out to assess a possible dose-response relationship between folate intake and pancreatic cancer risk.

RESULTS

Ten studies on dietary and supplemental folate intake and pancreatic cancer (4 case-control and 6 cohort studies) were included in the meta-analysis. The pooled RRs of pancreatic cancer for the highest vs lowest categories of dietary folate intake and supplemental folate intake were 0.66 (95% CI: 0.49-0.88) and 1.08 (95% CI, 0.82-1.41), respectively. The dose-response meta-analysis indicated that a 100 μg/day increment in dietary folate intake conferred a RR of 0.93 (95% CI: 0.90-0.97). These findings support the hypothesis that dietary folate may play a protective role in carcinogenesis of pancreatic cancer.

In situ preparation of novel p-n junction photocatalyst BiOI/(BiO)2CO3 with enhanced visible light photocatalytic activity

Novel p-n junction photocatalysts BiOI/(BiO)2CO3 with different contents of BiOI were in situ synthesized by etching (BiO)2CO3 precursor with hydroiodic acid (HI) solution. X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), Fourier transform infrared spectrometry (FT-IR), energy-dispersive spectroscopy (EDS) and UV-vis diffuse reflectance spectroscopy (DRS) were employed to study the structures, morphologies and optical properties of the as-prepared samples. Under visible light (λ>420 nm), BiOI/(BiO)2CO3 hybrid displayed much higher photocatalytic activity than pure (BiO)2CO3 and BiOI for the degradation of methyl orange (MO). The increased photocatalytic activity of BiOI/(BiO)2CO3 could be attributed to the formation of the p-n junction between p-BiOI and n-(BiO)2CO3, which effectively suppresses the recombination of photoinduced electron-hole pairs. Moreover, the tests of radical scavengers confirmed that •O2- and h+ were the main reactive species for the degradation of MO.

Visible light photocatalytic activity enhancement and mechanism of AgBr/Ag3PO4 hybrids for degradation of methyl orange

Novel AgBr/Ag(3)PO(4) hybrids were synthesized via an in situ anion-exchange method and characterized by X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), energy-dispersive spectroscopy (EDS) and UV-vis diffuse reflectance spectroscopy (DRS). Under visible light (λ>420 nm), AgBr/Ag(3)PO(4) degraded methyl orange (MO) efficiently and displayed much higher photocatalytic activity than that of pure AgBr or Ag(3)PO(4). X-ray photoelectron spectroscopy (XPS) suggests that AgBr/Ag(3)PO(4) transformed to be Ag@AgBr/Ag(3)PO(4)@Ag system while remained good photocatalytic activity after 5 times of cycle experiments. In addition, the quenching effects of different scavengers proved that reactive OH and h(+) played the major role for the MO degradation. The photocatalytic activity enhancement of AgBr/Ag(3)PO(4) is closely related to the efficient separation of electron-hole pairs derived from the matching band potentials between AgBr and Ag(3)PO(4), as well as the good electron trapping role of Ag nanoparticles in situ formed on the surfaces of AgBr and Ag(3)PO(4) particles during the photocatalytic reaction.

Structures of alkaloid biosynthetic glucosidases decode substrate specificity

Two similar enzymes with different biosynthetic function in one species have evolved to catalyze two distinct reactions. X-ray structures of both enzymes help reveal their most important differences. The Rauvolfia alkaloid biosynthetic network harbors two O-glucosidases: raucaffricine glucosidase (RG), which hydrolyses raucaffricine to an intermediate downstream in the ajmaline pathway, and strictosidine glucosidase (SG), which operates upstream. RG converts strictosidine, the substrate of SG, but SG does not accept raucaffricine. Now elucidation of crystal structures of RG, inactive RG-E186Q mutant, and its complexes with ligands dihydro-raucaffricine and secologanin reveals that it is the "wider gate" of RG that allows strictosidine to enter the catalytic site, whereas the "slot-like" entrance of SG prohibits access by raucaffricine. Trp392 in RG and Trp388 in SG control the gate shape and acceptance of substrates. Ser390 directs the conformation of Trp392. 3D structures, supported by site-directed mutations and kinetic data of RG and SG, provide a structural and catalytic explanation of substrate specificity and deeper insights into O-glucosidase chemistry.

Generation of transgenic chicks using an oviduct-specific expression system

We successfully replaced the ovalbumin gene of a magnum region in chickens with a human plasminogen activator. We constructed pL-eGFP, pL-tPAGFP and pL-2.8OVtPAGFP vectors and cultured 293FT chicken embryo fibroblasts, chicken primordial germ cells, Hela C127 cells, and oviduct epithelial cells. All vectors were expressed in the transfected cells, except pL-2.8OVtPAGFP vector, which was only expressed in oviduct epithelial cells. A lentivirus with pL-2.8OVtPAGFP was injected in fertilized eggs; 11 chicks hatched in the G₀ generation, four of them carried the tPAGFP. Two cockerels from the G₀ generation were crossed with four wild-type hens. Three chicks in G₁ carried the tPAGFP. We concluded that by using an oviduct-specific vector for transfection, human recombinant plasminogen activator protein can be expressed in the oviducts of laying hens. This character is inherited and can be reproduced with a need for repeated transfection.

Photocatalytic activity of novel AgBr/WO3 composite photocatalyst under visible light irradiation for methyl orange degradation

A novel AgBr/WO(3) composite photocatalyst was synthesized by loading AgBr on WO(3) substrate via deposition-precipitation method and characterized by XRD, SEM and DRS. The as-prepared AgBr/WO(3) was composed of monoclinic WO(3) substrate and face-centered cubic AgBr nanoparticles with crystalline sizes less than 56.8 nm. AgBr/WO(3) had absorption edge at about 470 nm in the visible light region. The optical AgBr content in AgBr/WO(3) was 0.30:1 (Ag/W) at the corresponding apparent rate, k(app), of 0.0160 min(-1) for MO degradation. The highest k(app) was 0.0216 min(-1) for 4 g/L catalyst. The OH acted as active species. Addition of H(2)O(2) within 0.020 mmol/L can efficiently trap electrons to generate more OH and further improved photocatalytic activity of AgBr/WO(3).

Does multiple sclerosis increase risk of adverse pregnancy outcomes? A population-based study

Objective

To determine whether maternal multiple sclerosis (MS) is associated with increased risk of adverse pregnancy outcomes in an East Asian country by using a nationwide population-based dataset.

Method

This study linked two nationwide population-based datasets, the birth certificate registry and the Taiwan National Health Insurance Research Dataset. We identified a total of 174 women who gave birth from 2001 to 2003, who were diagnosed with MS within the 2 years preceding the index deliveries, together with 1,392 matched women without chronic disease as a comparison cohort. Multivariate logistic regression analyses were performed for estimation.

Results

We found that compared with healthy mothers, MS was independently associated with a 2.25-fold risk of preterm birth (95% CI = 1.37–3.70) and a 1.89-fold (95% CI = 1.30–2.76) higher risk of babies small for gestational age, after adjusting for family income and maternal, paternal, and infant characteristics. Mothers with MS were also more likely to have cesarean deliveries.

Conclusion

Our study documents increased the risk of adverse pregnancy outcomes for mothers with MS, highlighting a need for more intensive monitoring and obstetric care during pregnancy. Future studies should explore the distinct manifestations and mechanisms of MS in diverse ethnic groups, so more complete information can be provided to affected women concerning pregnancy.

Biological treatment of thin-film transistor liquid crystal display (TFT-LCD) wastewater

The amount of pollutants produced during manufacturing processes of TFT-LCD (thin-film transistor liquid crystal display) substantially increases due to an increasing production of the opto-electronic industry in Taiwan. The total amount of wastewater from TFT-LCD manufacturing plants is expected to exceed 200,000 CMD in the near future. Typically, organic solvents used in TFT-LCD manufacturing processes account for more than 33% of the total TFT-LCD wastewater. The main components of these organic solvents are composed of the stripper (dimethyl sulphoxide (DMSO) and monoethanolamine (MEA)), developer (tetra-methyl ammonium hydroxide (TMAH)) and chelating agents. These compounds are recognized as non-or slow-biodegradable organic compounds and little information is available regarding their biological treatability. In this study, the performance of an A/O SBR (anoxic/oxic sequencing batch reactor) treating synthetic TFT-LCD wastewater was evaluated. The long-term experimental results indicated that the A/O SBR was able to achieve stable and satisfactory removal performance for DMSO, MEA and TMAH at influent concentrations of 430, 800, and 190 mg/L, respectively. The removal efficiencies for all three compounds examined were more than 99%. In addition, batch tests were conducted to study the degradation kinetics of DMSO, MEA, and TMAH under aerobic, anoxic, and anaerobic conditions, respectively. The organic substrate of batch tests conducted included 400 mg/L of DMSO, 250 mg/L of MEA, and 120 mg/L of TMAH. For DMSO, specific DMSO degradation rates under aerobic and anoxic conditions were both lower than 4 mg DMSO/g VSS-hr. Under anaerobic conditions, the specific DMSO degradation rate was estimated to be 14 mg DMSO/g VSS-hr, which was much higher than those obtained under aerobic and anoxic conditions. The optimum specific MEA and TMAH degradation rates were obtained under aerobic conditions with values of 26.5 mg MEA/g VSS-hr and 17.3 mg TMAH/g VSS-hr, respectively. Compared to aerobic conditions, anaerobic biodegradation of MEA and TMAH was much less significant with values of 5.6 mg MEA/g VSS-hr and 0 mg TMAH/g VSS-hr, respectively. In summary, biological treatment of TFT-LCD wastewater containing DMSO, MEA, and TMAH is feasible, but appropriate conditions for optimum biodegradation of DMSO, MEA, and TMAH are crucial and require carefully operational consideration.

UCP2 A55V variant is associated with obesity and related phenotypes in an aboriginal community in Taiwan

OBJECTIVE

Human uncoupling proteins 2 and 3 (UCP2 and UCP3) are two mitochondrial proteins that are involved in the control of metabolism of fatty acid and possibly protect against oxidative damage. The aim of this study was to analyze genetic associations of four polymorphisms of the UCP2 and UCP3 genes with insulin, leptin concentration and obesity in Taiwan aborigines.

RESEARCH METHODS

Four polymorphisms were compared in 324 obese (body mass index (BMI) > or =30 kg/m(2)) and overweight (30>BMI > or =25 kg/m(2)) subjects, and 114 normal weight subjects (BMI <25 kg/m(2)) in an aboriginal community of southern Taiwan. Anthropometric characteristics and fasting levels of insulin, leptin, triglycerides and cholesterol were measured.

RESULTS

Before and after adjusting for age distribution, only the Val55 allele in exon 4 of the UCP2 gene increased the risk of overweight and obesity (adjusted odds ratio (OR)=2.02, P=0.004) in comparison with Ala55. UCP2 V55V is also associated with higher fasting insulin levels than A55V (P=0.01) and A55A (P=0.04) in the obese/overweight group. Using the COCAPHASE program of the UNPHASED software, haplotype analysis of three single nucleotide polymorphisms (A55V-G866A-C-55T) revealed that A-G-C (73% in obese subjects and 77% in controls) was the most common haplotype and that the haplotype V-A-T (13% in obese subjects and 5% in controls) was significantly increased in obese and overweight subjects (BMI > or =25 kg/m(2)) (OR=2.62, P<0.001).

DISCUSSIONS

UCP2 A55V variant might predispose to obesity and Val55 allele to confer population-attributable risk for 9.5% of obese disorders and increase insulin concentrations. The V-A-T haplotype within UCP2-UCP3 gene cluster is also significantly associated with obesity in Paiwan aborigines.

Chemoprevention of gastric cancer by celecoxib in rats

BACKGROUND

Overexpression of cyclooxygenase 2 (COX-2) is frequently detected in gastric cancer and is believed to play a crucial role in gastric carcinogenesis.

AIM

We examined the chemopreventive effect of a COX-2 inhibitor in an animal model of stomach carcinogenesis.

METHODS

Eighty six male Wistar rats were divided into six different treatment groups: group A, water alone (n = 5); group B, N-methyl-N'-nitro-N-nitrosoguanidine (MNNG 100 micro g/ml) (n = 16); group C, indomethacin (3 mg/kg/day) (n = 16); group D, celecoxib (5 mg/kg/day) (n = 17); group E, celecoxib (10 mg/kg/day) (n = 16); and group F, celecoxib (20 mg/kg/day) (n = 16). Group B-F animals were treated with 10% sodium chloride (in the initial six weeks) and MNNG in drinking water to induce adenocarcinoma in the stomach. All animals received treatment for 40 weeks, and were sacrificed after death or at 48 weeks. Gastric neoplasm was evaluated by histology.

RESULTS

The incidences of gastric cancer were 0% in group A, 75% in group B, 68.8% in group C, 70.6% in group D, 18.8% in group E, and 31.3% in group F (p = 0.002, ANOVA). Compared with MNNG controls, treatment with celecoxib 10 mg/kg/day also showed lower tumour multiplicity (0.19 (0.40) v 1.00 (0.73); p = 0.004) and lower mean tumour volume (2.4 v 2805 mm(3); p = 0.02). Although tumours had significantly higher COX-2 expression than their adjacent normal tissues (p<0.02), there was no significant difference in COX-2 levels among tumours in the different treatment groups. The lowest tumour prostaglandin E(2) level was found in the indomethacin treated group, suggesting that the chemopreventive effect of celecoxib may be mediated by a COX independent pathway.

CONCLUSION

While treatment with indomethacin had no significant effect on tumour development, treatment with celecoxib reduced gastric cancer incidence and growth in rats.

Molecular cloning and expression of woodchuck granulocyte-macrophage colony stimulating factor

Granulocyte-macrophage colony stimulating factor (GM-CSF) has immunoregulatory and antiviral effects, and may thus be promising for the treatment of chronic hepatitis B. Using woodchuck hepatitis virus (WHV)-infected woodchuck as an animal model to test the efficacy and safety of GM-CSF on the therapy of chronic hepatitis B, woodchuck GM-CSF will be required due to the apparent species-specific activity of GM-CSF. The cDNA of woodchuck GM-CSF was cloned using reverse transcription-polymerase chain reaction (RT-PCR) with primers deriving from highly conserved regions of GM-CSF genes from other species. The deduced amino acids, including the signal peptide, is 138 in length and its identities to human, murine, canine and bovine GM-CSFs are 63, 49, 63, and 63% respectively. The genomic DNA of woodchuck GM-CSF was also cloned by PCR. Its organization is highly homologous to that of human and murine GM-CSF genes, consisting of four exons and three introns. Cloned woodchuck GM-CSF was expressed transiently in 293T cells. The recombinant protein expressed was found to stimulate the growth and differentiation of woodchuck bone marrow cells, indicating the protein expressed by the cloned gene is functional. These results pave the way for future studies on the potential role of GM-CSF for the treatment of chronic hepatitis B by using this animal model.

Diagnosis of congenital hypothyroidism from human anagen scalp hair by infrared microspectroscopy

A highly efficient Fourier transform infrared (FT-IR) microscopy was used to determine the biophysical structure of anagen scalp hair roots of neonates suffering from congenital hypothyroidism (CH) due to ectopic thyroid. The present results indicate that the lower composition near 1,053 cm(-1) (also assigned to the aromatic iodide stretching band) in the infrared (IR) spectra of the hair roots for CH patients was directly associated with the lower serum level of T4 and fT4, and the elevated TSH levels determined by RIA method. This strongly implies the lower evidence of the aromatic iodide stretching band in the IR spectra of hair roots. These findings suggest that FT-IR microscopy has the potential to become a good diagnostic tool and that hair can be useful as a genetic marker.

2-Methoxyestradiol-induced caspase-3 activation and apoptosis occurs through G(2)/M arrest dependent and independent pathways in gastric carcinoma cells

BACKGROUND

2-Methoxyestradiol (2-Me), one of the estrogen metabolites, has recently been found to possess anti-angiogenesis activity in vivo. Many chemotherapeutic agents, such as taxol, docetaxel, and vinblastine, interact with microtubules and then induce apoptosis. It has been suggested that 2-Me acts on microtubules and results in G(2)/M-cycle arrest of tumor cells. Whether 2-Me induces apoptosis in gastric carcinoma cell lines is not known. Moreover, reactive oxygen species (ROS) produced by 2-Me may be involved in cytotoxicity of tumor cells. Thus, another objective of this study was to evaluate the relation between cell cycle arrest, ROS formation, and caspase activity levels after 2-Me treatment in gastric carcinoma cells.

METHODS

It was determined whether 2-Me directly induced apoptosis in two gastric carcinoma cell lines (SC-M1 and NUGC-3) through caspase-3 and caspase-8 activation and, eventually, induced DNA fragmentation. To clarify the effect of 2-Me-induced G(2)/M arrest in apoptosis, calcium ionophore, A23187, and thapsigargin were used to modulate 2-Me-induced cell cycle responses. Moreover, the role of 2-Me-induced ROS formation in the cell cycle responses also was evaluated.

RESULTS

It was found that 2-Me treatment resulted in G(2)/M-cycle arrest, caspase-8 and caspase-3 activation, and DNA fragmentation. In addition, the 2-Me induced, concomitant increases of peroxide and superoxide anions were correlated with G(2)/M-cycle arrest. Treatment with calcium ionophore A23187 and thapsigargin partially reversed the 2-Me-induced G(2)/M-cycle arrest, with a concomitant decrease in both peroxide and superoxide levels. Moreover, A23187 blocked the 2-Me-induced caspase-3 activation, whereas thapsigargin had no effect. Treatment with calcium channel blockers did not affect 2-Me-induced cell cycle arrest or caspase-3 activation.

CONCLUSIONS

These results suggest that the 2-Me-induced apoptosis of gastric carcinoma cells by DNA fragmentation accompanied caspase activation. Elevation of free radicals was associated with G(2)/M-cycle arrest. The induction of G(2)/M-cycle arrest is not a prerequisite for caspase activation.

2-Methoxyestradiol-induced caspase-3 activation and apoptosis occurs through G(2)/M arrest dependent and independent pathways in gastric carcinoma cells

BACKGROUND

2-Methoxyestradiol (2-Me), one of the estrogen metabolites, has recently been found to possess anti-angiogenesis activity in vivo. Many chemotherapeutic agents, such as taxol, docetaxel, and vinblastine, interact with microtubules and then induce apoptosis. It has been suggested that 2-Me acts on microtubules and results in G(2)/M-cycle arrest of tumor cells. Whether 2-Me induces apoptosis in gastric carcinoma cell lines is not known. Moreover, reactive oxygen species (ROS) produced by 2-Me may be involved in cytotoxicity of tumor cells. Thus, another objective of this study was to evaluate the relation between cell cycle arrest, ROS formation, and caspase activity levels after 2-Me treatment in gastric carcinoma cells.

METHODS

It was determined whether 2-Me directly induced apoptosis in two gastric carcinoma cell lines (SC-M1 and NUGC-3) through caspase-3 and caspase-8 activation and, eventually, induced DNA fragmentation. To clarify the effect of 2-Me-induced G(2)/M arrest in apoptosis, calcium ionophore, A23187, and thapsigargin were used to modulate 2-Me-induced cell cycle responses. Moreover, the role of 2-Me-induced ROS formation in the cell cycle responses also was evaluated.

RESULTS

It was found that 2-Me treatment resulted in G(2)/M-cycle arrest, caspase-8 and caspase-3 activation, and DNA fragmentation. In addition, the 2-Me induced, concomitant increases of peroxide and superoxide anions were correlated with G(2)/M-cycle arrest. Treatment with calcium ionophore A23187 and thapsigargin partially reversed the 2-Me-induced G(2)/M-cycle arrest, with a concomitant decrease in both peroxide and superoxide levels. Moreover, A23187 blocked the 2-Me-induced caspase-3 activation, whereas thapsigargin had no effect. Treatment with calcium channel blockers did not affect 2-Me-induced cell cycle arrest or caspase-3 activation.

CONCLUSIONS

These results suggest that the 2-Me-induced apoptosis of gastric carcinoma cells by DNA fragmentation accompanied caspase activation. Elevation of free radicals was associated with G(2)/M-cycle arrest. The induction of G(2)/M-cycle arrest is not a prerequisite for caspase activation.

Folate depletion and elevated plasma homocysteine promote oxidative stress in rat livers

This study was designed to determine whether nutritional folate depletion exerts hepatic oxidative stress in relation to elevated plasma homocysteine. To mimic various extents of folate depletion status in vivo, male Wistar rats were fed an amino acid-defined diet containing either 8 (control), 2, 0.5, or 0 mg folic acid/kg diet. After a 4-wk feeding period, the plasma and hepatic folate concentrations of the rats decreased significantly with each decrement of dietary folate. Folate depletion did not significantly affect two major liver antioxidants: reduced glutathione and alpha-tocopherol. Conversely, folate depletion decreased Cu-Zn superoxide dismutase and glutathione peroxidase activities, but had no effect on catalase activity in liver homogenates. Lipid peroxidation products, as measured by thiobarbituric acid-reactive substances, were significantly higher in livers of folate-depleted rats than in those of the controls. This occurrence of hepatic oxidative stress in folate-depleted rats was confirmed by demonstrating an increased susceptibility of livers of folate-depleted rats to lipid peroxidation induced by additional H2O2 or Fe(2+) treatments compared with the controls. Decreasing dietary folate intake resulted in graded increases in plasma homocysteine concentrations of folate-depleted rats. Elevated plasma homocysteine and decreased plasma and hepatic folate concentrations in folate-depleted rats were all strongly and significantly correlated with increased liver lipid peroxidation (/r/ > or = 0.58, P < 0.0003). These data demonstrate that folate depletion and elevated plasma homocysteine promote oxidative stress in rat livers.

Differentiation of hair growth cycle from scalp hair roots for the diagnosis of glucose-6-phosphate dehydrogenase deficiency in neonates

Hair analysis can be used as a screening tool in the diagnosis of genetic diseases. The scalp hair roots of 67 normal neonates and 39 neonates with glucose-6-phosphate dehydrogenase (G6PD) deficiency were analysed using Fourier transform infrared (FT-IR) microspectroscopy to differentiate the stages of the hair growth cycle and to diagnose the genetic disorder on the basis of spectral differences. We have demonstrated that FT-IR microspectroscopy is a rapid and effective noninvasive diagnostic method to differentiate scalp hair roots of normal neonates into the anagen, catagen or telogen phases of the hair growth cycle, using IR spectral differences within the 3000-2800 cm(-1) region and the IR peak area ratio of 2854 cm(-1)/2873 cm(-1) or 1084 cm(-1)/amide II band (p<0.001). Moreover, G6PD-deficient neonates could be accurately diagnosed from telogen phase hair roots owing to significant differences in IR peak area ratios of 2854 cm(-1)/2873(-1) or 1084 cm(-1)/amide II band compared to normal values in healthy neonates. The result suggests that the application of FT-IR microspectroscopy may be capable not only of differentiating the hair growth cycle into anagen, categen or telogen phases but also of detecting G6PD deficiency. Hair root analysis promises to be a useful complement to serum and urine analysis in the diagnosis of genetic diseases.

Effect of skin-penetrating enhancers on the thermophysical properties of cholesteryl oleyl carbonate embedded in a thermo-responsive membrane

The effect of skin-penetrating enhancers such as propylene glycol (PG), Azone and ethanol on the thermophysical properties of cholesteryl oleyl carbonate (COC) was investigated using differential scanning colorimetry (DSC) and microscopic Fourier-transform infrared (FT-IR) spectroscopy. The results indicate that PG did not influence the DSC thermograms and IR spectra of COC in the different ratios of COC and PG mixture; whereas Azone interacted with COC not only to lower the semectic-cholesteric phase transition temperature of COC but also to induce a new IR spectral peak at 1653 cm(-1) which shifted from the carbonyl stretching band (1636 cm(-1)) of Azone. Ethanol did not interact with COC, but it influenced the IR spectral peak intensity of COC at 1253 cm(-1). The peak intensity at 1253 cm(-1) gradually rose with the time of ethanol evaporation and was similar to that of the temperature effect. The solubility parameter was also used to explain the miscibility and interaction between COC and PG, Azone or ethanol.

Male predominance in hepatocellular carcinoma: new insight and a possible therapeutic alternative

Hepatocellular carcinoma is one of the most common cancers in the world. The male to female ratio is 3-6 to 1 in patients with hepatocellular carcinoma. Although steroid hormones and receptors have been examined extensively for their role in the growth regulation of hepatocellular carcinoma, the direct stimulation of hepatocellular carcinoma by steroid hormones still awaits elucidation. On the other hand, clinical trials using antagonists for steroid hormones to treat hepatocellular carcinoma were found to be mostly ineffective. Recently it has been found that 2-methoxyestradiol - an estrogen metabolite - is effective in growth inhibition of various tumor cells as well as in angiogenesis inhibition. Since estrogen is metabolized in the liver, it is conceivable that females with menstruation cycles have more estrogen metabolized in their liver, consequently more 2-methoxyestradiol produced which could inhibit tumor growth in situ. We propose that the low incidence and mortality of hepatocellular carcinoma found in females may have resulted from the high levels of 2-methoxyestradiol produced in the liver during their reproductive years. Consequently, the growth of hepatocellular carcinoma in females is delayed significantly as compared to males. The potential of using 2-methoxyestradiol for treatment of patients with hepatocellular carcinoma after resection of tumor should be explored.