Liver resection versus transarterial chemoembolization for the treatment of intermediate-stage hepatocellular carcinoma

BACKGROUND

The role of transarterial chemoembolization (TACE) as the standard treatment for intermediate-stage hepatocellular carcinoma (HCC) is being challenged by increasing studies supporting liver resection (LR); but evidence of survival benefits of LR is lacking. We aimed to compare the overall survival (OS) of LR with that of TACE for the treatment of intermediate-stage HCC in cirrhotic patients.

METHODS

A Markov model, comparing LR with TACE over 15 years, was developed based on the data from 31 literatures. Additionally, external validation of the model was performed using a data set (n = 1735; LR: 701; TACE: 1034) from a tertiary center with propensity score matching method. We conducted one-way and two-way sensitivity analyses, in addition to a Monte Carlo analysis with 10 000 patients allocated into each arm.

RESULTS

The mean expected survival times and survival rates at 5 years were 77.8 months and 47.1% in LR group, and 48.6 months and 25.7% in TACE group, respectively. Sensitivity analyses found that initial LR was the most favorable treatment. The 95% CI for the difference in OS was 2.42-2.46 years between the two groups (P < 0.001). In the validation set, the 5-year survival rates after LR were significantly better than those after TACE before (40.2% vs. 25.9%, P < 0.001) and after matching (43.2% vs 30.9%, P < 0.001), which was comparable to the model results.

CONCLUSIONS

For cirrhotic patients with resectable intermediate-stage HCC, LR may provide survival benefit over TACE, but large-scale studies are required to further stratify patients at this stage for different optimal treatments.

Genetic diversity and maternal origin of Northeast African and South American donkey populations

To investigate the mtDNA variation and origin of maternal lineages in South American donkeys and to reassess the domestication of donkeys in northeast Africa, we analyzed sequences (489 bp of the D-loop) from 323 domestic donkeys sampled from Peru, Brazil, Ethiopia and Egypt. Altogether, the 323 sequences displayed 53 different haplotypes (45 in Ethiopia, 14 in Egypt, eight in Peru and six in Brazil). Among the four populations, Egyptian donkeys possessed the highest haplotype diversity (0.910 ± 0.032), followed by Brazilian donkeys (0.879 ± 0.060). The Clade I haplotypes dominated in Peruvian donkeys (65%), whereas Clade II haplotypes dominated in Brazilian donkeys (67%). Estimates of F_ST values showed a high genetic differentiation between Peruvian and Brazilian donkey populations (F_ST  = 0.4066), which could be explained by the complex introduction history of South American donkeys. Phylogeographic analysis indicates that northeast Africa could be the most probable domestication center for Clade I donkeys. Analysis of molecular variance confirmed a weak genetic structure in domestic donkey populations among four continents (Europe, Asia, Africa and South America).

A reversed approach for simultaneous mandibular symphyseal split osteotomy and genioplasty

Performing a mandibular symphyseal split and genioplasty simultaneously and accurately is a technical challenge for the surgeon. The aim of this study was to validate a reversed approach for simultaneous symphyseal split and genioplasty. A cutting guide and a repositioning guide were designed and printed three-dimensionally in titanium. The symphyseal split and genioplasty were performed successfully. The accuracy of the technique appears to be appropriate for clinical application.

Abstract P2-14-30: Survival outcomes of breast conserving surgery versus mastectomy for ultrasound detected non-palpable breast cancer in hospital-based screening among Chinese women

Background: Some population-base studies have reported similar or improved survival for breast-conserving surgery (BCS) plus radiotherapy compared with mastectomy (Mx) in early breast cancer [PMID: 22373563, 27344114]. Among the screening detected early breast cancer, ultrasound (US) could detect more invasive non-palpable breast cancer (NPBC) with positive lymph nodes in hospital-based asymptomatic Chinese women, who could achieve comparable 10-year DFS and OS as mammography (MG)-detected NPBC [2016 SABCS P5-02-05, PMID: 27689334]. However, there is little data about the surgical outcomes of BCS verse Mx in the low-risk screening detected NPBC with US as the initial imaging test.

Methods: From 2001 to 2017, 6,423 consecutive asymptomatic women underwent mammography or ultrasound guided biopsy in Peking Union Medical College Hospital. Among them, 1130 NPBC including 914 US-detected and 216 MG-detected NPBC were diagnosed and treated. There were 349 (30.9%) patients underwent BCS including 286 (25.3%) patients received radiation therapy and 63 (5.6%) elderly patients (&gt;70 years) who did not. The clinicopathological features, treatment choice, 10-year disease-free survival (DFS) and overall survival (OS) were compared between breast conservingsurgery (BCS) versus mastectomy(Mx) in all NPBC and between the US-detected and MG-detected NPBC.

Result: Compared to those who received BCS, the 781 (69.1%) patients who underwent Mx had more cancers with relatively higher histologic grade (p=0.003), positive lymph node (18.8% vs 12.0%, p=0.005), ER-negative (22.5% vs 11.5%, p&lt;0.001), PR-negative (29.6% vs 16.3, p&lt;0.001), Her2-positive (16.3% vs 8.9%, p=0.001), and received chemotherapy (37.6% vs 28.7%, p=0.003). The breast conserving rates of US-NPBCwere higher than that of MG-NPBC (32.6% vs 23.6%, p=0.010), but the breast conserving rates were similar between ductal carcinoma in situ (DCIS) and invasive cancers. The 10-year DFS and OS were similar among BCS with radiation therapy, BCS without radiation therapy and Mx as well as among US-NPBC with BCS, US-NPBC with Mx, MG-NPBC with BCS and MG-NPBC with Mx. However, MG-NPBC with Mx had favorable 10-year DFS than that of MG-NPBC with BCS (p=0.041).

Table 1.Kaplan-Meier estimated 10-year DFS and OS of all NPBC§Patients (No.)NPBC GroupNumber (%)10-year DFS (%)P value10-year OSP valueAll NPBC (1130)BCS without Radiotherapy63 (5.6)85.00.10592.30.722 BCS with Radiotherapy286 (25.3)92.7 99.5  Mastectomy781 (69.1)93.2 98.7        All NPBC (1130)US+BCS298 (26.4)90.40.24896.30.542 US+Mx616 (64.5)92.4 98.4  MG+BCS51 (4.5)90.3 100.0  MG+Mx165 (14.6)96.1 100.0 § Kaplan-Meier survival curves would be displayed in the poster.

Conclusion: The 10-year DFS and OS of breast conserving surgery versus mastectomy were similar among all NPBC patients. As the current initial imaging test, US-detected NPBC patients would receive significantly more BCS compared to MG. There was no significant difference in surgical outcomes among BCS and Mx in US-detected NPBC. However, among MG-detected NPBC, patients with Mx reached a better DFS but a similar OS than those with BCS. The radiation therapy could be safely omitted in the elderly patients (&gt;70 years) with NPBC.

Citation Format: Yao R, Pan B, Xu Y, Zhou Y, Zhu Q, Zhang J, Wu H, Mao F, Lin Y, Shen S, Sun Q. Survival outcomes of breast conserving surgery versus mastectomy for ultrasound detected non-palpable breast cancer in hospital-based screening among Chinese women [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-30.

Abstract P1-02-02: Is ultrasound screening justified for non-palpable breast cancer in asymptomatic Chinese women: A real-world study based on long-term survival of consecutive cohort (2001-2017)

Background: Ultrasound (US) is an effective initial screening test for breast cancer both in Caucasian and Chinese women [PMID: 26712110, 26715161, and 25668012]. The real-world modality of breast cancer screening in the China is hospital-based screening among asymptomatic self-referred women. In our previous study, we showed that US and mammography (MG) detected non-palpable breast cancer (NPBC) had similar long-term survival and that US detected more invasive NPBC with positive lymph node [2016 SABCS P5-02-05, PMID: 27689334]. This study was to investigate whether these findings would be still true with more NPBC cases included and longer follow-up in the consecutive hospital cohort.

Methods: From 2001 to 2017, 5,264 asymptomatic women with positive (BI-RADS 4 and 5) initial screening US underwent biopsies in PUMC Hospital, and 914 US-NPBC in 883 women were diagnosed. Meanwhile, women without dense breasts (defined as BI-RADS category C and D) also received screening MG after physical examination and US. There were 1,159 patients with positive (BI-RADS 4 and 5) MG and normal US (BI-RADS 1, 2 and 3) underwent MG-guided biopsies and 216 MG-NPBC were diagnosed in 214 women. The clinicopathological characteristics and 10-year disease-free survival (DFS) and overall survival (OS) were reviewed and compared between the US-NPBC and MG-NPBC. Prognostic factors of NPBC were identified by univariate and multivariate Cox analysis.

Result: Compared to MG, US could detect more invasive (81.2% vs 48.6%, p&lt;0.001), lymph node positive (18.3% vs 10.2%, p&lt;0.001), stage II+III (21.7% vs 12.5%, p&lt;0.001) and low grade cancer (p=0.001).Between invasive US-NPBC and MG-NPBC, no significant difference was identified for lymph node status, TNM stage or subtype.US-NPBC received more breast conserving surgery (32.6% vs 24.1%, p&lt;0.001) and chemotherapy (37.5% vs 23.6%, p&lt;0.001). There was no significant difference in DFS or OS between US- vs MG-NPBC among ductal carcinoma in situ (DCIS), invasive and all NPBC. For the US-NPBC, the DFS factors included TNM stage and Hormone receptor status whereas OS-predictors were pN and subtype.

Table 1.Kaplan-Meier estimates of DFS and OS between US-NPBC and MG-NPBC§Patients (No.) 10-year DFS (%)P value10-year OS (%)P valueAllUS-NPBC (914)92.40.57098.20.143 MG-NPBC (216)94.7 100.0 DCISUS-NPBC (172)97.70.170100.0- MG-NBPC (111)95.3 100.0 InvasiveUS-NPBC (742)91.20.45897.90.251 MG-NPBC (105)94.4 100.0 § Kaplan-Meier survival curves between each two subgroups would be displayed in the poster.

Conclusion: Overall, US could detect more invasive NPBC patients with positive lymph node and advanced stage compared to MG, and screen invasive NPBC at similar TNM stage and subtype distribution as MG. US-NPBC patients received more breast conserving surgery and chemotherapy, and could achieve comparable 10-year DFS and OS as MG-detected NPBC. Hence US is justified in the real-world as the initial imaging modality in hospital-based screening Chinese women.

Citation Format: Yao R, Pan B, Xu Y, Zhou Y, Zhu Q, Zhang J, Wu H, Mao F, Lin Y, Shen S, Sun Q. Is ultrasound screening justified for non-palpable breast cancer in asymptomatic Chinese women: A real-world study based on long-term survival of consecutive cohort (2001-2017) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-02.

Abstract PD6-10: Association between adherence to cardiovascular medications and cardiovascular events following a diagnosis of early stage breast cancer

Background: Studies show that patients diagnosed with early-stage breast cancer (BC) are more likely to die from cardiovascular disease (CVD) than BC. Adherence to CVD medications, such as statins and antihypertensives, is poor in BC survivors, particularly in the year following diagnosis. The impact of non-adherence to CVD medications on cardiovascular events in BC survivors is unknown.

Methods: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked dataset, we evaluated patients with non-metastatic BC who were diagnosed between 2006-2014. Prescriptions were identified for the treatment of hypertension, hyperlipidemia and diabetes. The pre-cancer diagnosis study period for adherence was defined as 1 year prior to the diagnosis of cancer. The follow up adherence period was between years 1 and 2 following the diagnosis of cancer, so the BC treatment period was not included. Adherence was defined as a medication possession ratio of 380%. A CVD event was defined as an ischemic event or acute heart failure. Patients with a CVD event prior to diagnosis were excluded. Logistic regression was performed for each non-cancer condition to define factors associated with medication non-adherence. Cox regression was used to calculate the association between CVD medication adherence and time-to-subsequent cardiac events, adjusted for baseline factors. Cox regression was performed separately for each non-cancer condition.

Results: Among 23,080 women with BC in the cohort, 15,576 were adherent to at least one CVD medication prior to diagnosis, and of these, 2732 (17.5%) were non-adherent to at least one medication following treatment. Among the women adherent to medications prior to diagnosis, 19.2% were non-adherent to hypertension medications, 26.2% were non-adherent to cholesterol medications, and 30.6% were non-adherent to diabetes medications following the first year of BC treatment. Factors that were associated with non-adherence to anti-hypertensives included receipt of chemotherapy (OR 1.24, p&lt;0.001), other comorbidities (OR 1.34, p&lt;0.001), higher stage (OR 1.18, p &lt;0.001) and hormone receptor negative tumors (OR 1.15, p&lt;0.001). Similar factors were associated with non-adherence to cholesterol medications, whereas only stage and tumor type were associated with non-adherence to diabetes medications. Non-adherence to hypertension medications compared to adherence following diagnosis was associated with an increased risk of having a CVD event (HR 1.33, 95% CI 1.18-1.51, p&lt;0.001; 5-year cumulative incidence of 32% vs 26%, respectively, p&lt;0.001). Similar results were seen for adherence to cholesterol medications (HR 1.21, 95% CI 1.05-1.40, p=0.009) and diabetes medications (HR 1.31, 95% CI 1.09-1.56, p=0.003).

Conclusions:In summary, we found that a large proportion of women who were previously adherent to their medications to prevent CVD events prior to their breast cancer diagnosis were non-adherent following treatment. Of concern, non-adherence to any of these classes of medications resulted in an increased risk of having a cardiovascular event. Improving outcomes and reducing morbidity following a breast cancer diagnosis also requires focused attention on non-breast cancer conditions.

Citation Format: Hershman DL, Accordino M, Shen S, Buono D, Crew KD, Kalinsky K, Trivedi MS, Unger JM, Wright JD. Association between adherence to cardiovascular medications and cardiovascular events following a diagnosis of early stage breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD6-10.

Overexpression of FoxM1 predicts poor prognosis of intrahepatic cholangiocarcinoma

FoxM1 is an oncoprotein that is significantly overexpressed in many malignancies including hepatocellular carcinoma, but its role in intrahepatic cholangiocarcinoma (ICC) remains unclear. This study explores the expression of FoxM1 in human ICC, its relationships with clinical outcomes, and its role in the proliferation, migration, and invasion of ICC in vitro and in vivo. The results show that FoxM1 was markedly elevated in tumor tissues versus the paired peritumoral tissues. Overexpression of FoxM1 was correlated with multiple tumor nodules, tumor size > 5 cm, positive lymph node metastasis and advanced TNM stage. Cox analysis revealed that overexpression of FoxM1 is an independent prognostic indicator for both the overall survival and disease-free survival of ICC patients after hepatectomy. Furthermore, up/downregulation of FoxM1 markedly promoted/inhibited ICC cell proliferation, migration, and invasion in vitro and in vivo. Bioinformatic analysis indicated that overexpression of FoxM1 resulted in the dysregulation of multiple signaling pathways in ICC, and selected components of some key signaling pathways such as c-Myc signaling were confirmed in vitro. In addition, overexpression of FoxM1 enhanced MMP-9 and MMP-2 protein expression in ICC cells. In conclusion, FoxM1 promotes ICC progression and is a reliable predictor of poor prognosis in ICC.

[A progress of macrolides therapy for chronic rhinosinusitis]

Macrolides are a type of antibiotics with macrocyclic lactone ring, which have been commonly used in the treatment of diffuse panbronchiolitis, chronic obstructive pulmonary disease, bronchial asthma, cystic fibrosis and other diseases. Macrolides not only have effect on antibacterial, but also effect on anti-inflammatory and immunoregulation. Chronic rhinosinusitis (CRS) is a common disease entity of infectious and inflammatory diseases that involved in nasal cavity and nasal sinuses, with various clinical phenotypes. With the high prevalence of CRS, it seriously affects the quality of patients' life. In recent years, a large number of studies have shown that long-term low-dose macrolides are effective in parts of patients with CRS. Although the mechanism of macrolides for CRS has not yet been clarified. According to recent studies, it might be related with anti-inflammatory or immunoregulation of macrolides and the different phenotypes of CRS. The safety and mechanism of long-term macrolides are needed further clarification.

Maxillary reconstruction using rectus femoris muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle

BACKGROUND

Maxillary reconstruction using various pedicled and free-tissue transfer techniques with bone graft or without bone graft has some drawbacks. In this study, we demonstrate maxillary reconstruction using femoris rectus muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle through the modified lateral lip-submandibular approach.

MATERIAL AND METHODS

Nine patients suffering from maxillary defects secondary to maxillary cancer ablation, who underwent maxillary reconstruction using rectus femoris muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle, were enrolled into this study between November 2015 and August 2017.

RESULTS

All patients who underwent the maxillary reconstruction using femoris rectus muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle presented satisfactory postoperative function, with adequate mouth opening, optimal esthetic outcome and no restrictions on the diet. Every rectus femoris muscle flaps mucosalized well within five weeks. No donor site functional impairment or complications were observed.

CONCLUSIONS

The technique is a feasible and acceptable technique for the maxillary reconstructions. It is safe, quick and simple to harvest. It also presents an optimal esthetic and satisfactory functional outcome with the advantage of low morbidity of the donor site. Combined with the three-dimension reconstruction, this technique can improve the postoperative outcomes.

miR-300 regulates the epithelial-mesenchymal transition and invasion of hepatocellular carcinoma by targeting the FAK/PI3K/AKT signaling pathway

Several microRNAs (miRNAs) have been closely correlated with the development of hepatocellular carcinoma (HCC). However, the involvement of miR-300 in the development of HCC remains unknown. This study elucidated the potential molecular mechanisms of miR-300 in the modulation of the epithelial-mesenchymal transition (EMT) and invasion of HCC. The expression levels of miR-300 in HCC cells and clinical samples were detected by quantitative real-time PCR and in situ hybridization. The in vitro function of miR-300 in HCC was evaluated using a migration/invasion assay. Quantitative real-time PCR, western blotting, immunofluorescence and immunohistochemistry were used to validate the roles of miR-300 and FAK/PI3K/AKT in EMT progression. A dual-luciferase reporter assay was performed to confirm the target gene. miR-300 was down-regulated in HCC and significantly correlated with a poor prognosis in HCC patients. The down-regulation of miR-300 increased the invasiveness of the HCC cells, and promoted the EMT in both HCC tissues and HCC cells. In contrast, up-regulation of miR-300 led to the opposite results. Ectopic overexpression of miR-300 reversed TGF-β1-induced EMT in SMMC-7721 cells, and according to a dual-luciferase reporter assay and rescue assay, miR-300 inhibits the EMT-mediated migration and invasion of HCC cells via the targeted modulation of FAK and the downstream PI3K/AKT signaling pathway. miR-300 targeting modulates FAK, and the PI3K/AKT signaling pathway inhibits the EMT and suppresses the migration and invasion of HCC cells. Thus, miR-300 represents a promising therapeutic target for HCC.

A Preliminary Study of the Fixation Mechanism of Collagen Reaction with a Polyepoxy Fixative

A new biomaterial has been developed by fixing native collagens with a polyepoxy compound (PC) fixative. Prior studies have shown that this biomaterial has comparable properties as compared to collagen fixed with glutaraldehyde (GA) and thus has a great promise for use as an implantable bioprosthesis. The purpose of this study was to understand the mechanism of the amino acids-PC reactions in the fixation process. Bovine arteries were fixed with PC under various pH, concentration and temperature conditions as a function of fixation time. Individual amino acid components in the fresh and the fixed arteries were assayed using a Beckman amino acid analyzer to determine the degree of tanning. The denaturation temperature (Td) was also measured on each sample. Since the denaturation temperature is a direct indication of cross-linking of individual amino acids with the fixative, the difference in the degree of tanning for the same increase in Td may be indicative of the quantity of the masked, non-cross-linked amino acids. The fixation reaction data indicated that not all amino acids were cross-linked upon contacting the PC fixative. Masking appeared to be more substantial with a fixation at higher pH values.

Ethnic variation in deep lateral orbital anatomy and its implications on decompression surgery

AIM

To describe differences in the deep lateral orbital wall (specifically, trigone) between Chinese, Malay, Indian and Caucasian subjects Methods: Single-centre retrospective Computed Tomogram (CT)-based study; 20 subjects of each ethnicity were used from existing databases, matched for gender, average age and laterality. Subjects below 16 years of age were excluded. DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) and OsiriX version 7.5 (Pixmeo., Switzerland) were used to measure deep lateral wall length, thickness and volume, as well as orbital depth and statistical analyses performed using Statistical Package for Social Sciences version 21 (IBM, USA).

RESULTS

In each group, there were 12 males (60%) and average age was not significantly different (p = 0.682-0.987). Using Chinese subjects as a reference, in Chinese, Malay, Indian and Caucasian subjects, mean trigone thickness was 13.68, 14.02, 11.60 (p < 0.001) and 13.80 mm, curved total wall length 45.23, 42.29 (p = 0.048), 41.91 (p = 0.020) and 45.00 mm, curved trigone length 23.03, 22.61, 17.19 (p = 0.011) and 18.76 mm (p = 0.030) and trigone volume 3120.97, 3221.01, 1613.66 (p < 0.001), 2498.46 mm³ (p = 0.059) respectively. Similarly, perpendicular orbital depth was 27.54, 24.97, 22.12 (p = 0.001) and 25.93 mm and diagonal orbital depth was 34.19, 33.27, 29.48 (p = 0.01) and 34.63 mm respectively.

CONCLUSIONS

Indian and, to a lesser extent, Caucasian subjects have smaller trigones compared to their Chinese and Malay counterparts. Indian subjects also have shallower orbits and due care should be taken during decompression surgery.

Risks of diabetic foot syndrome and amputation associated with sodium glucose co-transporter 2 inhibitors: A Meta-analysis of Randomized Controlled Trials

BACKGROUND

The U.S. Food and Drug Administration recently issued a safety communication requiring new warnings of increased leg and foot amputation risk be added to canagliflozin drug labelling. However, the risk associated with other sodium-glucose co-transporter 2 inhibitors (SGLT2i) remains uncertain.

AIM

This meta-analysis aimed to evaluate the potential risks of diabetic foot syndrome (DFS) and amputation associated with SGLT2i.

METHODS

Relevant databases were searched from inception to June 14, 2017 to identify randomized controlled trials (RCTs) that evaluated risks of DFS and amputation associated with SGLT2i use. A random effects model was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) using STATA 14.

RESULTS

Fourteen RCTs involving 26,167 patients were eligible for this meta-analysis. SGLT2i were not significantly associated with increased risk of DFS compared with placebo (OR 1.05, 95% CI: 0.58-1.89). No significant association was observed in the subgroup and sensitivity analysis on DFS risk either. Although SGLT2i, as a class, were not significantly associated with amputation risk (OR 1.40, 95% CI: 0.81-2.41), subgroup analysis showed an increased incidence of amputation in participants using canagliflozin (OR 1.89, 95% CI: 1.37-2.60), compared with oral anti-diabetic drugs and placebo, but not in those using empagliflozin (OR 1.02, 95% CI: 0.71-1.48).

CONCLUSION

Current evidence from RCTs suggests that canagliflozin may be positively associated with an increased risk of amputation. Due to limited data, large-scale studies are required to further clarify the association between amputation and individual SGLT2i drugs.

Screening for immune-potentiating antigens from hepatocellular carcinoma patients after radiofrequency ablation by serum proteomic analysis

Background

Radiofrequency ablation (RFA) can not only effectively kill hepatocellular carcinoma (HCC) tumour cells but also release tumour antigens that can provoke an immune response. However, there is no consensus regarding which antigens could constitutively be generated after RFA and could potentiate the immune response. The aim of this study was to identify these immune-potentiating antigens.

Methods

We performed two-dimensional electrophoresis (2-DE) and MALDI-TOF-MS/MS analyses on serum obtained before and after RFA from 5 HCC patients. Further validation for selected proteins was performed utilizing ELISA analysis on another 52 HCC patients. Disease-free survival (DFS) analysis according to the differential expression of the interested protein before and after RFA was performed.

Results

Twelve decreased and 6 increased proteins after RFA were identified by MS. Three proteins, including clusterin, Ficolin-3, and serum retinol binding protein-4, were further verified by ELISA on the 52 HCC patients. Only Ficolin-3 proved to be significantly changed after RFA. The 52 patients were divided into two groups according to the expression of Ficolin-3 before and after RFA. The 1-, 2- and 3-year DFS rates were 59.1%, 31.8%, and 22.7%, respectively, for patients in the low Ficolin-3 group (22 patients) and 73.3%, 60.0%, and 50.0%, respectively, for patients in the high Ficolin-3 group (30 patients) (P = 0.038).

Conclusions

In conclusion, Ficolin-3 was overexpressed in the serum of most HCC patients after RFA. Ficolin-3 might be a biomarker for RFA treatment efficacy and a potential target for HCC immunotherapy.

NEK2 promotes hepatocellular carcinoma migration and invasion through modulation of the epithelial-mesenchymal transition

Never in mitosis gene-A (NIMA)-related expressed kinase 2 (NEK2) has been recently reported to play a role in tumor progression, drug resistance and tumorigenesis. However, little is known about the effects of NEK2 in hepatocellular carcinoma (HCC) metastasis and the underlying mechanism. NEK2 expression levels were examined by immunochemistry, qRT-PCR and western blot analyses in HCC cell lines and HCC tissues. A Transwell assay was used to determine the migration and invasion capacity of NEK2-silenced or NEK2-overexpressing HCC cells. Cell proliferation was investigated by MTT [(3-(4,5)-dimethylthiazol(-z-y1)-3,5-di-phenytetrazolium bromide] assay. The expression levels of epithelial-mesenchymal transition (EMT) markers in NEK2-silenced or NEK2-overexpressing HCC cells were examined by western blot analyses and qRT-PCR. The correlations between NEK2 expression and clinicopathological characteristics were further analyzed. Gene microarray was further used to analyze the effect of NEK2 expression on downstream cell signals. Our study showed that NEK2 was overexpressed in human HCC (37.84%; 98/259). NEK2 overexpression was significantly associated with liver non-capsulation and predicted poor survival outcomes in HCC patients after hepatectomy. In addition, NEK2 significantly enhanced HCC cell invasive ability. Mechanistically, we found that the epithelial-mesenchymal transition (EMT) plays a pivotal role in the NEK2-mediated promotion of HCC cell invasion. Furthermore, we provided evidence that signaling through the Wnt, NF-κB, focal adhesion, VEGF, Hippo and p53 pathways may be downstream of NEK2. Our findings highlight the importance of NEK2 in HCC metastasis and suggest that NEK2 is a reliable prognostic marker for HCC patients after hepatectomy.

Prevalence of chronic kidney disease in patients with chronic hepatitis B: A cross-sectional survey

Renal safety is a major concern during long-term antiviral treatment for chronic hepatitis B (CHB). This study aimed to investigate the prevalence of chronic kidney disease (CKD) in patients with CHB that had been treated with antiviral therapy. This was a single-centre, cross-sectional study in a real-life cohort in which all patients received antiviral treatment. Serum creatinine-based equations from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) were used to estimate the glomerular filtration rate (GFR). CKD was defined as an eGFR <60 mL/min/1.73 m² or a urinary albumin to creatinine ratio ≥ 3 mg/mmol (defined as albuminuria). Univariate and multivariate analyses were conducted to determine the risk factors of CKD. A total of 1985 patients were included in the analysis from February 2015 to December 2015. The mean age and median duration of antiviral treatment was 42.20 years and 17.05 months, respectively. The overall prevalence of CKD was 7.9% (157/1985), with 44 patients experiencing decreased renal function (eGFR less than 60 mL/min/1.73 m²) and 129 patients with albuminuria. Patients with cirrhosis had a higher prevalence of a decreased GFR (4.3% vs 1.6%, P<.001) and albuminuria (11.1% vs 5.2%, P<.001) than those without cirrhosis. In the multivariate analysis, hypertension (Odds Ratio [OR] 4.564, P<.001), diabetes mellitus (OR 2.688, P<.001) and cirrhosis (OR 1.918, P<.001) were independent factors associated with the presence of CKD. CKD was a clinically significant comorbidity in patients with CHB. Special attention should be paid to cirrhotic patients and patients with the metabolic syndrome.

The effect of cation doping on the morphology, optical and structural properties of highly oriented wurtzite ZnO-nanorod arrays grown by a hydrothermal method

Undoped and C-doped (C: Mg²⁺, Ni²⁺, Mn²⁺, Co²⁺, Cu²⁺, Cr³⁺) ZnO nanorods were synthesized by a hydrothermal method at temperatures as low as 60 °C. The effect of doping on the morphology of the ZnO nanorods was visualized by taking their cross section and top SEM images. The results show that the size of nanorods was increased in both height and diameter by cation doping. The crystallinity change of the ZnO nanorods due to each doping element was thoroughly investigated by an x-ray diffraction (XRD). The XRD patterns show that the wurtzite crystal structure of ZnO nanorods was maintained after cation addition. The optical Raman-active modes of undoped and cation-doped nanorods were measured with a micro-Raman setup at room temperature. The surface chemistry of samples was investigated by x-ray photoelectron spectroscopy and energy-dispersive x-ray spectroscopy. Finally, the effect of each cation dopant on band-gap shift of the ZnO nanorods was investigated by a photoluminescence setup at room temperature. Although the amount of dopants (Mg²⁺, Ni²⁺, and Co²⁺) was smaller than the amount of Mn²⁺, Cu²⁺, and Cr³⁺ in the nanorods, their effect on the band structure of the ZnO nanorods was profound. The highest band-gap shift was achieved for a Co-doped sample, and the best crystal orientation was for Mn-doped ZnO nanorods. Our results can be used as a comprehensive reference for engineering of the morphological, structural and optical properties of cation-doped ZnO nanorods by using a low-temperature synthesis as an economical mass-production approach.

Mechanisms of OGT2115 inhibition of invasion and migration in KB oral cancer cells

The article "Mechanisms of OGT2115 inhibition of invasion and migration in KB oral cancer cells" by S. Shen, J.-X. Tang, published in Eur Rev Med Pharmacol Sci 2017; 21 (1): 55-60 has been withdrawn.