Ultrasonic guided percutaneous ethanol injection with or without combined radiofrequency ablation for hepatocellular carcinomas

OBJECTIVE

The aim of this retrospective study was to evaluate whether radiofrequency ablation (RFA) combined percutaneous ethanol injection (PEI) in the management of hepatocellular carcinoma (HCC) improves treatment outcomes.

PATIENTS AND METHODS

We retrospectively included 66 HCC patients who received RFA or RFA plus PEI from February 2011 to January 2014 in Jingmen No. 1 People's Hospital. Moreover, 31 cases received RFA plus PEI as the experiment group and 35 subjects treated with RFA aloe as the control group. The overall survival and treatment related complications were compared between the two groups.

RESULTS

For RFA group, the 1-year, 2-year, and 3-year survival rate were 82.0%, 69.3%, and 30.7%, respectively, with the median survival time of 27.1 months. For RFA plus PEI group, the 1-year, 2-year, and 3-year survival rate were 97.1%, 73.9%, and 37.5%, respectively, with the median survival time of 33.6 months. The overall survival of the two groups was not statistical different with the hazard ratio of 1.48 (P > 0.05); three cases of treatment associated complications were found in RFA group with 1 abscess, 1 pleural effusion, and 1 portal vein thrombosis. Moreover, 2 cases of complication were recorded in RFA plus PEI group with 1 pleural effusion and 1 portal vein thrombosis. The complicated incidence rate was not statistical different between the two groups (P < 0.05).

CONCLUSION

The combination treatment of HCC was safe and had a slightly higher primary effectiveness rate than RFA alone.

[Clinical effects of different modes of ultra pulse carbon dioxide fractional laser used in combination on the treatment of hypertrophic scar on face and neck]

OBJECTIVE

To explore the clinical effects of ultra pulse mode of ultra pulse carbon dioxide fractional laser combined with Deep FX mode or Scaar FX mode on the treatment of patients with hypertrophic scars on face and neck.

METHODS

One hundred and fifty-eight patients with hypertrophic scars on face and neck who met the inclusion criteria were admitted to Hunan Provincial People's Hospital from January 2012 to January 2015. Firstly, the scar areas were cleaned and given compound lidocaine cream for surface anesthesia. Then the scar areas were treated with ultra pulse mode of ultra pulse carbon dioxide fractional laser, with energy from 150 to 175 mJ, frequency of 40 Hz, hole to hole distance of 4 mm or 5 mm, and the treatment time of each hole of 2 s or 3 s. For mild scar, Deep FX mode was added for treatment with energy from 30 to 50 mJ, frequency of 300 Hz, and density of 5%; for moderate and severe scar, Scaar FX mode was additionally used for therapy, with energy from 80 to 150 mJ, frequency of 300 Hz, and density of 3%. The above-mentioned treatments were performed per three months, totally for 3 times, 10-15 min per treatment. After each treatment, wounds were moisturized and given sun protection. Before the first treatment and 6 months after treatment of 3 times, the curative effect was assessed by Vancouver Scar Scale (VSS) and University of North Carolina Scar Scale. Six months after treatment of 3 times, satisfaction degree of patient and loss of working time were recorded. The adverse effects of whole treatment course were recorded. Data were processed with t test.

RESULTS

(1) Six months after treatment of 3 times, VSS score of patients was (3.1±1.0) points, which was significantly lower than that before the first treatment [(9.4±1.8) points, t=53.096, P<0.05]; University of North Carolina Scar Scale score of patients was (1.6±0.7) points, which was significantly lower than that before the first treatment[(8.0±1.4) points, t=63.730, P<0.05]. (2) Six months after treatment of 3 times, 150 patients were very satisfied with the curative effect, 6 patients were satisfied, and 2 patients were relatively satisfied. The loss of working time of patients was 10-15 (10.5±0.3) d. (3) During the treatment, mild erythema appeared in 5 patients which disappeared without treatment; pigmentation appeared in 6 patients 2 weeks after the first treatment, and pruritus and rash appeared in 2 patients 3 days after the first treatment, which were all improved with pharmaceutical therapy.

CONCLUSIONS

Ultra pulse mode of ultra pulse carbon dioxide fractional laser combined with Deep FX mode or Scaar FX mode has definitely clinical effect on patients with hypertrophic scars on face and neck with few adverse effects, which is worth to popularize and apply for clinic.

EGFR-targeted mAb therapy modulates autophagy in head and neck squamous cell carcinoma through NLRX1-TUFM protein complex

EGFR-targeted therapy in head and neck squamous cell carcinoma (HNSCC) patients frequently results in tumor resistance to treatment. Autophagy is an emerging underlying resistance mechanism, however, the molecular autophagy machinery in HNSCC cells and potential biomarkers of patient response to EGFR-targeted therapy remain insufficiently characterized. Here we show that the EGFR blocking with cetuximab leads to varied autophagic responses, which modulate cancer cell susceptibility to EGFR inhibition. Inhibition of autophagy sensitizes HNSCC cells to EGFR blockade. Importantly, we identify a novel signaling hub centering on the NLRX1-TUFM protein complex, promoting autophagic flux. Defects in the expression of either NLRX1 or TUFM result in compromised autophagy when treated with EGFR inhibitors. As a previously undefined autophagy-promoting mechanism, we found that TUFM serves as a novel anchorage site, recruiting Beclin-1 to mitochondria, promoting its polyubiquitination, and interfering with its interaction with Rubicon. This protein complex is also essential for endoplasmic reticulum (ER) stress signaling induction, possibly as an additional mechanism to promote autophagy. Utilizing tumor specimens from a novel neoadjuvant clinical trial, we show that increased expression of the autophagy adaptor protein, SQSTM1/p62, is associated with poor response to cetuximab therapy. These findings expand our understanding of the components involved in HNSCC autophagy machinery that responds to EGFR inhibitors, and suggest potential combinatorial approaches to enhance its therapeutic efficacy.

Characterizing the activation of the Wnt signaling pathway in hilar cholangiocarcinoma using a tissue microarray approach

Hilar cholangiocarcinoma (HCCA) is an invasive hepatic malignancy that is difficult to biopsy; therefore, novel markers of HCCA prognosis are needed. Here, the level of canonical Wnt activation in patients with HCCA, intrahepatic cholangiocarcinoma (IHCC), and congenital choledochal cysts (CCC) was compared to understand the role of Wnt signaling in HCCA. Pathology specimens from HCCA (n=129), IHCC (n=31), and CCC (n=45) patients were used to construct tissue microarrays. Wnt2, Wnt3, β-catenin, TCF4, c-Myc, and cyclin D1 were detected by immunohistochemistry. Parallel correlation analysis was used to analyze differences in protein levels between the HCCA, IHCC, and CCC groups. Univariate and multivariate analyses were used to determine independent predictors of successful resection and prognosis in the HCCA group. The protein levels of Wnt2, β-catenin, TCF4, c-Myc, and cyclin D1 were significantly higher in HCCA compared to IHHC or CCC. Wnt signaling activation (Wnt2+, Wnt3+, nuclear β-catenin+, nuclear TCF4+) was significantly greater in HCCA tissues than CCC tissues. Univariable analyses indicated that expression of cyclin D1 as well as Wnt signaling activation, and partial Wnt activation (Wnt2+ or Wnt3+ and nuclear β-catenin+ or nuclear TCF4+) predicted successful resection, but only cyclin D1 expression remained significant in multivariable analyses. Only partial Wnt activation was an independent predictor of survival time. Proteins in the canonical Wnt signaling pathway were present at higher levels in HCCA and correlated with tumor resecility and patient prognosis. These results suggest that Wnt pathway analysis may be a useful marker for clinical outcome in HCCA.

HBV-induced ROS accumulation promotes hepatocarcinogenesis through Snail-mediated epigenetic silencing of SOCS3

Interleukin-6 (IL-6) has been demonstrated to be involved in Hepatitis B virus (HBV)-associated hepatocarcinogenesis through activation of the STAT3 pathway. The sustained activation of the IL-6/STAT3 pathway is frequently associated with repression of SOCS3, which is both a target gene and a negative regulator of STAT3. However, the silencing mechanism of SOCS3 in hepatocellular carcinoma (HCC) remains to be elucidated. Here, we showed that the repression of SOCS3 and sustained activation of IL-6/STAT3 pathway in HBV-producing HCC cells were caused by HBV-induced mitochondrial ROS accumulation. Mechanistic studies revealed that ROS-mediated DNA methylation resulted in the silencing of SOCS3. Decreased SOCS3 expression significantly promoted the proliferation of HCC cells and growth of tumor xenografts in mice. Further studies revealed that HBV-induced ROS accumulation upregulated the expression of the transcription factor, Snail, which bound to the E-boxes of SOCS3 promoter and mediated the epigenetic silencing of SOCS3 in association with DNMT1 and HDAC1. In addition, we found that the expression of Snail and SOCS3 were inversely correlated in HBV-associated HCC patients, suggesting that SOCS3 and/or Snail could be used as prognostic markers in HCC pathogenesis. Taken together, our data show that HBV-induced mitochondrial ROS production represses SOCS3 expression through Snail-mediated epigenetic silencing, leading to the sustained activation of IL-6/STAT3 pathway and ultimately contributing to hepatocarcinogenesis.

No influence of CYP2D6*10 genotype and phenotype on the pharmacokinetics of nebivolol in healthy Chinese subjects

WHAT IS KNOWN AND OBJECTIVE

Nebivolol, a clinically important antihypertensive drug, mainly metabolized by cytochrome P450 (CYP) 2D6, shows wide interindividual variability in pharmacokinetics. The CYP2D6*10 allele (100C>T; rs1065852), present at a high frequency in the Chinese population, is associated with alteration in the pharmacokinetics of many drugs, but its effect on the pharmacokinetics of nebivolol is unknown. The aim of our study was to investigate whether the CYP2D6*10 genotype and phenotype are associated with changes in the pharmacokinetics of nebivolol in Chinese subjects.

METHODS

Twenty-four healthy subjects were divided into three groups according to CYP2D6*1/*1 (n = 7), CYP2D6*1/*10 (n = 5) and CYP2D6*10/*10 (n = 12) genotypes. The *1/*1 homozygotes and *1/*10 heterozygotes were C allele carriers. All subjects received oral single dose of nebivolol and dextromethorphan. Blood and urine samples were gathered at various times.

RESULTS

There were no statistically significant differences in the pharmacokinetics of nebivolol between the three CYP2D6*10 genotypes, and no gene-dose effect was seen. The pharmacokinetic parameters of CYP2D6*10/*10 subjects were also similar to those of CYP2D6*1 carriers. A weak relationship between CYP2D6 phenotype and nebivolol clearance was found.

WHAT IS NEW AND CONCLUSION

The CYP2D6*10 genotype and phenotype were not associated with significant alterations in the pharmacokinetics of nebivolol. CYP2D6*10 alone does not account for the large interindividual differences observed in the disposition of nebivolol among Chinese healthy subjects.

Intraoperative detection of sentinel lymph node metastases in breast carcinoma by Fourier transform infrared spectroscopy

Background

Sentinel lymph node (SLN) biopsy is a routine surgical staging procedure in clinically lymph node-negative breast cancer. Fourier transform infrared (FTIR) spectroscopy, a technique based on the biochemical composition of the tissue, has previously been found to be capable of differentiating between normal and malignant tissue. The aim of the present study was to explore the intraoperative use of FTIR spectroscopy for rapidly identifying metastatic SLNs, and distinguishing between metastatic and non-metastatic tissue.

Methods

Freshly removed SLNs from patients with breast cancer were analysed. Samples were measured by FTIR spectroscopy before histopathological diagnosis. The FTIR spectrum of each sample identified ten bands from 2000 to 900 cm−1. The peak position, intensity and full width at half maximum of each absorbent band were measured, and the relative intensity ratios calculated. Canonical discriminant analysis was performed to discriminate between metastatic and non-metastatic samples.

Results

A total of 149 SLNs were removed from 49 patients. Histopathological examination confirmed 38 metastatic and 111 non-metastatic SLNs. Eighteen of 29 parameters were significantly different between the metastatic and non-metastatic SLNs. Five parameters were selected as independent factors to form discriminant functions. The sensitivity, specificity and accuracy of this method were 94·7, 90·1 and 91·3 per cent respectively. The accuracy of histological analysis of frozen sections was 100 per cent.

Conclusion

FTIR spectroscopy is a promising technique for the real-time diagnosis of SLN metastasis during breast cancer surgery. Surgical relevanceSentinel lymph node (SLN) biopsy is a highly accurate predictor of overall axillary status and has become the standard in disease staging in clinically node-negative breast cancer. A rapid and accurate intraoperative assessment of metastatic spread to the SLN provides the necessary information for the surgeon to proceed with immediate axillary dissection.The results of this research indicate that Fourier transform infrared (FTIR) spectroscopy is a rapid, accurate, non-destructive and cost-effective molecular method that can be used to detect SLN metastasis during surgery.FTIR analysis could be useful for the intraoperative diagnosis of lymph node metastases at large institutions, thereby reducing the workload of pathologists, as well as in regions lacking pathologists such as in developing countries.

miR-448 negatively regulates ovarian cancer cell growth and metastasis by targeting CXCL12

OBJECTIVES

The purpose of the study is to investigate the roles of miR-448 in ovarian cancer.

METHODS

miR-448 and CXCL12 mRNA expression were examined using qRT-PCR. CXCL12 promoter activity was detected by luciferase activity system. Cell proliferation was assayed by MTT or colony formation. Migration and invasion was assayed by transwell chamber.

RESULTS

miR-448 expression was usually under-expressed in ovarian cancer tissues and cell lines compared with their normal ones. Ectopic expression of miR-448 inhibited cell proliferation, migration and invasion in ovarian cancer cells. Moreover, bioinformatic prediction suggested that CXCL12 was a target gene of miR-448. We also demonstrated that restored expression of CXCL12 dampened miR-448-mediated suppression of tumor progression, which suggests the important role of miR-448 in tumor progression.

CONCLUSION

Our data indicate that miR-448 functions as a tumor suppressor in ovarian cancer, which exerts its activity by suppressing the expression of CXCL12.