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Sim YK, Chong MC, Gandhi M, Pokharkar YM, Zhu Y, Shi L, Lequn L, Chen CH, Kudo M, Lee JH, Strasser SI, Chanwat R, Chow PK. Real-World Data on the Diagnosis, Treatment, and Management of Hepatocellular Carcinoma in the Asia-Pacific: The INSIGHT Study. Liver Cancer 2024; 13:298-313. [PMID: 38756144 PMCID: PMC11095624 DOI: 10.1159/000534513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/14/2023] [Indexed: 05/18/2024] Open
Abstract
Introduction Hepatocellular carcinoma (HCC) is the sixth most commonly diagnosed cancer and the third leading cause of cancer death worldwide. While there has been rapid evolution in the treatment paradigm of HCC across the past decade, the extent to which these newly approved therapies are utilized in clinical practice in the real world is, however, unknown. The INSIGHT study was an investigator-initiated, multi-site longitudinal cohort study conducted to reflect real-world epidemiology and clinical practice in Asia-Pacific in the immediate 7-year period after the conclusion of the BRIDGE study. Methods Data were collected both retrospectively (planned 30% of the total cohort size) and prospectively (planned 70%) from January 2013 to December 2019 from eligible patients newly diagnosed with HCC from 33 participating sites across 9 Asia-Pacific countries. Results A total of 2,533 newly diagnosed HCC patients (1,052 in retrospective cohort and 1,481 in prospective cohort) were enrolled. The most common risk factor was hepatitis B in all countries except Japan, Australia, and New Zealand, where the prevalence of hepatitis C and diabetes were more common. The top three comorbidities reported in the INSIGHT study include cirrhosis, hypertension, and diabetes. We observe high heterogeneity in the first-line treatment recorded across countries and across disease stages, which significantly affects survival outcomes. Stratification by factors such as etiologies, tumor characteristics, the presence of extrahepatic metastases or macrovascular invasion, and the use of subsequent lines of treatment were performed. Conclusion The INSIGHT study describes a wide spectrum of clinical management practices in HCC, where patient demographics, differential costs, and patient access to therapies may lead to wide geographical variations through the patient's treatment cycle, from diagnosis to clinical outcome. The high heterogeneity in patient outcomes demonstrates the need for more robust and clinical management strategies to be designed and adopted to bring about better patient outcomes.
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Affiliation(s)
- Yu Ki Sim
- Programme in Translational and Clinical Liver Research, National Cancer Centre Singapore, Singapore, Singapore
| | - Ming Chuen Chong
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mihir Gandhi
- Department of Biostatistics, Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation Singapore, Singapore, Singapore
- Centre for Quantitative Medicine and Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Tampere University, Tampere, Finland
| | - Yogesh Mahadev Pokharkar
- Department of Biostatistics, Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation Singapore, Singapore, Singapore
| | - Yanan Zhu
- Department of Epidemiology, Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation Singapore, Singapore, Singapore
| | - Luming Shi
- Department of Epidemiology, Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation Singapore, Singapore, Singapore
| | - Li Lequn
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Centre, Nanning, China
| | - Chien-Hung Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Hospital, Osaka, Japan
| | - Joon Hyeok Lee
- Division of Gastroenterology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Simone I. Strasser
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Rawisak Chanwat
- Department of Surgery, National Cancer Institute, Bangkok, Thailand
| | - Pierce K.H. Chow
- Programme in Translational and Clinical Liver Research, National Cancer Centre Singapore, Singapore, Singapore
- Department of Hepatopancreatobiliary and Transplant Surgery, National Cancer Centre Singapore and Singapore General Hospital, Singapore, Singapore
- Surgery Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - on behalf of the Asia-Pacific Hepatocellular Carcinoma Trials Group
- Programme in Translational and Clinical Liver Research, National Cancer Centre Singapore, Singapore, Singapore
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Biostatistics, Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation Singapore, Singapore, Singapore
- Centre for Quantitative Medicine and Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Tampere University, Tampere, Finland
- Department of Epidemiology, Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation Singapore, Singapore, Singapore
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Centre, Nanning, China
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Gastroenterology and Hepatology, Kindai University Hospital, Osaka, Japan
- Division of Gastroenterology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Department of Surgery, National Cancer Institute, Bangkok, Thailand
- Department of Hepatopancreatobiliary and Transplant Surgery, National Cancer Centre Singapore and Singapore General Hospital, Singapore, Singapore
- Surgery Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
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Yalcin S, Lacin S, Kaseb AO, Peynircioğlu B, Cantasdemir M, Çil BE, Hurmuz P, Doğrul AB, Bozkurt MF, Abali H, Akhan O, Şimşek H, Sahin B, Aykan FN, Yücel İ, Tellioğlu G, Selçukbiricik F, Philip PA. A Post-International Gastrointestinal Cancers' Conference (IGICC) Position Statements. J Hepatocell Carcinoma 2024; 11:953-974. [PMID: 38832120 PMCID: PMC11144653 DOI: 10.2147/jhc.s449540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/14/2024] [Indexed: 06/05/2024] Open
Abstract
Hepatocellular carcinoma (HCC), the most prevalent liver tumor, is usually linked with chronic liver diseases, particularly cirrhosis. As per the 2020 statistics, this cancer ranks 6th in the list of most common cancers worldwide and is the third primary source of cancer-related deaths. Asia holds the record for the highest occurrence of HCC. HCC is found three times more frequently in men than in women. The primary risk factors for HCC include chronic viral infections, excessive alcohol intake, steatotic liver disease conditions, as well as genetic and family predispositions. Roughly 40-50% of patients are identified in the late stages of the disease. Recently, there have been significant advancements in the treatment methods for advanced HCC. The selection of treatment for HCC hinges on the stage of the disease and the patient's medical status. Factors such as pre-existing liver conditions, etiology, portal hypertension, and portal vein thrombosis need critical evaluation, monitoring, and appropriate treatment. Depending on the patient and the characteristics of the disease, liver resection, ablation, or transplantation may be deemed potentially curative. For inoperable lesions, arterially directed therapy might be an option, or systemic treatment might be deemed more suitable. In specific cases, the recommendation might extend to external beam radiation therapy. For all individuals, a comprehensive, multidisciplinary approach should be adopted when considering HCC treatment options. The main treatment strategies for advanced HCC patients are typically combination treatments such as immunotherapy and anti-VEGFR inhibitor, or a combination of immunotherapy and immunotherapy where appropriate, as a first-line treatment. Furthermore, some TKIs and immune checkpoint inhibitors may be used as single agents in cases where patients are not fit for the combination therapies. As second-line treatments, some treatment agents have been reported and can be considered.
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Affiliation(s)
- Suayib Yalcin
- Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sahin Lacin
- Department of Medical Oncology, Koç University Faculty of Medicine, İstanbul, Turkey
| | - Ahmed Omar Kaseb
- Department of Gastrointestinal Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Bora Peynircioğlu
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Barbaros Erhan Çil
- Department of Radiology, Koç University Faculty of Medicine, İstanbul, Turkey
| | - Pervin Hurmuz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Bülent Doğrul
- Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Murat Fani Bozkurt
- Department of Nuclear Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hüseyin Abali
- Department of Medical Oncology, Bahrain Oncology Center, Muharraq, Bahrain
| | - Okan Akhan
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Halis Şimşek
- Department of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Berksoy Sahin
- Department of Medical Oncology, Cukurova University Faculty of Medicine, Adana, Türkiye
| | - Faruk N Aykan
- Department of Medical Oncology, Istinye University Faculty of Medicine Bahçeşehir Liv Hospital, İstanbul, Turkey
| | - İdris Yücel
- Medicana International Hospital Samsun, Department of Medical Oncology, Samsun, Turkey
| | - Gürkan Tellioğlu
- Department of General Surgery, Koç University Faculty of Medicine, İstanbul, Turkey
| | - Fatih Selçukbiricik
- Department of Medical Oncology, Koç University Faculty of Medicine, İstanbul, Turkey
| | - Philip A Philip
- Department of Medicine, Division of Hematology-Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
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Alemayehu E, Fasil A, Ebrahim H, Mulatie Z, Bambo GM, Gedefie A, Teshome M, Worede A, Belete MA. Circulating microRNAs as promising diagnostic biomarkers for hepatocellular carcinoma: a systematic review and meta-analysis. Front Mol Biosci 2024; 11:1353547. [PMID: 38808007 PMCID: PMC11130514 DOI: 10.3389/fmolb.2024.1353547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/30/2024] [Indexed: 05/30/2024] Open
Abstract
Introduction: Hepatocellular carcinoma (HCC), the most common type of liver cancer, is a major global health problem, ranking as the third leading cause of cancer-related death worldwide. Early identification and diagnosis of HCC requires the discovery of reliable biomarkers. Therefore, the study aimed to assess the diagnostic accuracy of miRNAs for HCC. The protocol was registered on PROSPERO website with the registration number CRD42023417494. Method: A literature search was conducted in PubMed, Scopus, Embase, Wiley Online Library, and Science Direct databases to identify pertinent articles published between 2018 and 30 July 2023. Stata 17.0 software was employed to determine the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), and area under the curve (AUC) for evaluating the accuracy of miRNAs in diagnosing HCC. The assessment of heterogeneity among studies involved the use of the Cochran-Q test and I2 statistic tests. Due to the observed significant heterogeneity, the random-effect model was chosen. Subgroup analysis and meta-regression analysis were also undertaken to explore potential sources contributing to heterogeneity. Deeks' funnel plot was used to assess publication bias. In addition, Fagan's nomogram and likelihood ratio scattergram were utilized to assess the clinical validity of miRNAs for HCC. Result: Twenty-four articles were included, involving 1,668 individuals diagnosed with HCC and 1,236 healthy individuals. The findings revealed pooled sensitivity of 0.84 (95% CI: 0.80-0.88), specificity of 0.81 (95% CI: 0.77-0.84), PLR of 4.36 (95% CI: 3.59-5.30), NLR of 0.19 (95% CI: 0.15-0.25), DOR of 22.47 (95% CI: 14.47-32.64), and an AUC of 0.89 (95% CI: 0.86-0.91) for the diagnosis of HCC using miRNAs. Furthermore, results from the subgroup analysis demonstrated that superior diagnostic performance was observed when utilizing plasma miRNAs, a large sample size (≥100), and miRNA panels. Conclusion: Hence, circulating miRNAs demonstrate substantial diagnostic utility for HCC and can serve as effective non-invasive biomarkers for the condition. Additionally, miRNA panels, miRNAs derived from plasma, and miRNAs evaluated in larger sample sizes (≥100) demonstrate enhanced diagnostic efficacy for HCC diagnosis. Nevertheless, a large pool of prospective studies and multi-center research will be required to confirm our findings in the near future.
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Affiliation(s)
- Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alebachew Fasil
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hussen Ebrahim
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zewudu Mulatie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Getachew Mesfin Bambo
- Department of Medical Laboratory Science, College of Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mulugeta Teshome
- Department of Medical Laboratory Science, Dessie Health Science College, Dessie, Ethiopia
| | - Abebaw Worede
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Ashagrie Belete
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Çağlayan Arslan Z, Okan M, Külah H. Pre-enrichment-free detection of hepatocellular carcinoma-specific ctDNA via PDMS and MEMS-based microfluidic sensor. Mikrochim Acta 2024; 191:229. [PMID: 38565645 PMCID: PMC10987365 DOI: 10.1007/s00604-024-06315-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024]
Abstract
The growing interest in microfluidic biosensors has led to improvements in the analytical performance of various sensing mechanisms. Although various sensors can be integrated with microfluidics, electrochemical ones have been most commonly employed due to their ease of miniaturization, integration ability, and low cost, making them an established point-of-care diagnostic method. This concept can be easily adapted to the detection of biomarkers specific to certain cancer types. Pathological profiling of hepatocellular carcinoma (HCC) is heterogeneous and rather complex, and biopsy samples contain limited information regarding the tumor and do not reflect its heterogeneity. Circulating tumor DNAs (ctDNAs), which can contain information regarding cancer characteristics, have been studied tremendously since liquid biopsy emerged as a new diagnostic method. Recent improvements in the accuracy and sensitivity of ctDNA determination also paved the way for genotyping of somatic genomic alterations. In this study, three-electrode (Au-Pt-Ag) glass chips were fabricated and combined with polydimethylsiloxane (PDMS) microchannels to establish an electrochemical microfluidic sensor for detecting c.747G > T hotspot mutations in the TP53 gene of ctDNAs from HCC. The preparation and analysis times of the constructed sensor were as short as 2 h in total, and a relatively high flow rate of 30 µl/min was used during immobilization and hybridization steps. To the best of our knowledge, this is the first time a PDMS-based microfluidic electrochemical sensor has been developed to target HCC ctDNAs. The system exhibited a limit of detection (LOD) of 24.1 fM within the tested range of 2-200 fM. The sensor demonstrated high specificity in tests conducted with fully noncomplementary and one-base mismatched target sequences. The developed platform is promising for detecting HCC-specific ctDNA at very low concentrations without requiring pre-enrichment steps.
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Affiliation(s)
- Zeynep Çağlayan Arslan
- Department of Electrical and Electronics Engineering, METU, Ankara, Turkey
- METU MEMS Research and Application Center, Ankara, Turkey
| | - Meltem Okan
- Department of Micro and Nanotechnology, METU, Ankara, Turkey
- METU MEMS Research and Application Center, Ankara, Turkey
| | - Haluk Külah
- Department of Electrical and Electronics Engineering, METU, Ankara, Turkey.
- Department of Micro and Nanotechnology, METU, Ankara, Turkey.
- METU MEMS Research and Application Center, Ankara, Turkey.
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Andre M, Caobi A, Miles JS, Vashist A, Ruiz MA, Raymond AD. Diagnostic potential of exosomal extracellular vesicles in oncology. BMC Cancer 2024; 24:322. [PMID: 38454346 PMCID: PMC10921614 DOI: 10.1186/s12885-024-11819-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 01/02/2024] [Indexed: 03/09/2024] Open
Abstract
Liquid biopsy can detect circulating cancer cells or tumor cell-derived DNA at various stages of cancer. The fluid from these biopsies contains extracellular vesicles (EVs), such as apoptotic bodies, microvesicles, exomeres, and exosomes. Exosomes contain proteins and nucleic acids (DNA/RNA) that can modify the microenvironment and promote cancer progression, playing significant roles in cancer pathology. Clinically, the proteins and nucleic acids within the exosomes from liquid biopsies can be biomarkers for the detection and prognosis of cancer. We review EVs protein and miRNA biomarkers identified for select cancers, specifically melanoma, glioma, breast, pancreatic, hepatic, cervical, prostate colon, and some hematological malignancies. Overall, this review demonstrates that EV biomolecules have great potential to expand the diagnostic and prognostic biomarkers used in Oncology; ultimately, EVs could lead to earlier detection and novel therapeutic targets. Clinical implicationsEVs represent a new paradigm in cancer diagnostics and therapeutics. The potential use of exosomal contents as biomarkers for diagnostic and prognostic indicators may facilitate cancer management. Non-invasive liquid biopsy is helpful, especially when the tumor is difficult to reach, such as in pancreatic adenocarcinoma. Moreover, another advantage of using minimally invasive liquid biopsy is that monitoring becomes more manageable. Identifying tumor-derived exosomal proteins and microRNAs would allow a more personalized approach to detecting cancer and improving treatment.
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Affiliation(s)
- Mickensone Andre
- Herbert Wertheim College of Medicine at, Department of Immunology and Nanomedicine, Florida International University, Miami, 33199, FL, USA
| | - Allen Caobi
- Herbert Wertheim College of Medicine at, Department of Immunology and Nanomedicine, Florida International University, Miami, 33199, FL, USA
| | - Jana S Miles
- Herbert Wertheim College of Medicine at, Department of Immunology and Nanomedicine, Florida International University, Miami, 33199, FL, USA
| | - Arti Vashist
- Herbert Wertheim College of Medicine at, Department of Immunology and Nanomedicine, Florida International University, Miami, 33199, FL, USA
| | - Marco A Ruiz
- Herbert Wertheim College of Medicine at, Department of Immunology and Nanomedicine, Florida International University, Miami, 33199, FL, USA
- Medical Oncology, Baptist Health Miami Cancer Institute, Miami, 33176, FL, USA
| | - Andrea D Raymond
- Herbert Wertheim College of Medicine at, Department of Immunology and Nanomedicine, Florida International University, Miami, 33199, FL, USA.
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Syaiful RA, Mazni Y, Siagian NKP, Putranto AS, Jeo WS, Rahadiani N, Ibrahim F, Sihardo L, Marbun VMG, Lalisang ANL, Lalisang TJM. Surgical resection for hepatocellular carcinoma: a single-centre's one decade of experience. Ann Med Surg (Lond) 2024; 86:1289-1296. [PMID: 38463050 PMCID: PMC10923277 DOI: 10.1097/ms9.0000000000001746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/10/2024] [Indexed: 03/12/2024] Open
Abstract
Background and aims Liver cancer is the third leading cause of global cancer deaths, and hepatocellular carcinoma is its most common type. Liver resection is one of the treatment options for hepatocellular carcinoma (HCC). This study aims to explore our hospital's more than a decade of experience in liver resection for HCC patients. Methods This is a retrospective cohort study on HCC patients undergoing resection from 2010 to 2021 in a tertiary-level hospital in Jakarta, Indonesia. Mortality rates were explored as the primary outcome of this study. Statistical analysis was done on possible predictive factors using Pearson's χ2. Survival analysis was done using the Log-Rank test and Cox Regression. Results Ninety-one patients were included in this study. The authors found that the postoperative mortality rates were 8.8% (in hospital), 11.5% (30 days), and 24.1% (90 days). Excluding postoperative mortalities, the long-term mortality rates were 44.4% (first year), 58.7% (3 years), and 69.7% (5 years). Cumulatively, the mortality rates were 46.4% (1 year), 68.9% (3 years), 77.8% (5 years), and 67.0% (all time). Significant predictive factors for cumulative 1-year mortality include large tumour diameter [odds ratio (OR) 14.06; 95% CI: 2.59-76.35; comparing <3 cm and >10 cm tumours; P<0.01], positive resection margin (OR 2.86; 1.17-77.0; P=0.02), and tumour differentiation (P=0.01). Multivariate analysis found hazard ratios of 6.35 (2.13-18.93; P<0.01) and 1.81 (1.04-3.14; P=0.04) for tumour diameter and resection margin, respectively. Conclusion The mortality rate of HCC patients undergoing resection is still very high. Significant predictive factors for mortality found in this study benefit from earlier diagnosis and treatment; thus, highlighting the importance of HCC surveillance programs.
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Affiliation(s)
| | - Yarman Mazni
- Digestive Surgery Division, Department of Surgery
| | | | | | | | - Nur Rahadiani
- Department of Anatomical Pathology, Cipto Mangunkusumo Hospital
| | | | - Lam Sihardo
- Digestive Surgery Division, Department of Surgery
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Kildisiute G, Kalyva M, Elmentaite R, van Dongen S, Thevanesan C, Piapi A, Ambridge K, Prigmore E, Haniffa M, Teichmann SA, Straathof K, Cortés-Ciriano I, Behjati S, Young MD. Transcriptional signals of transformation in human cancer. Genome Med 2024; 16:8. [PMID: 38195504 PMCID: PMC10775554 DOI: 10.1186/s13073-023-01279-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND As normal cells transform into cancers, their cell state changes, which may drive cancer cells into a stem-like or more primordial, foetal, or embryonic cell state. The transcriptomic profile of this final state may encode information about cancer's origin and how cancers relate to their normal cell counterparts. METHODS Here, we used single-cell atlases to study cancer transformation in transcriptional terms. We utilised bulk transcriptomes across a wide spectrum of adult and childhood cancers, using a previously established method to interrogate their relationship to normal cell states. We extend and validate these findings using single-cell cancer transcriptomes and organ-specific atlases of colorectal and liver cancer. RESULTS Our bulk transcriptomic data reveals that adult cancers rarely return to an embryonic state, but that a foetal state is a near-universal feature of childhood cancers. This finding was confirmed with single-cell cancer transcriptomes. CONCLUSIONS Our findings provide a nuanced picture of transformation in human cancer, indicating cancer-specific rather than universal patterns of transformation pervade adult epithelial cancers.
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Affiliation(s)
- Gerda Kildisiute
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Maria Kalyva
- EMBL-EBI, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Rasa Elmentaite
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Stijn van Dongen
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Christine Thevanesan
- University College London Cancer Institute and Great Ormond Street Biomedical Research Centre, London, UK
| | - Alice Piapi
- University College London Cancer Institute and Great Ormond Street Biomedical Research Centre, London, UK
| | - Kirsty Ambridge
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Elena Prigmore
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Muzlifah Haniffa
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
- Biosciences Institute and Newcastle NIHR-BRC Dermatology, Newcastle University, Newcastle Upon Tyne, UK
| | - Sarah A Teichmann
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
- Cavendish Laboratory, University of Cambridge, JJ Thomson Ave, Cambridge, UK
| | - Karin Straathof
- University College London Cancer Institute and Great Ormond Street Biomedical Research Centre, London, UK
| | | | - Sam Behjati
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK.
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
- Department of Paediatrics, University of Cambridge, Cambridge, UK.
| | - Matthew D Young
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, UK.
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Chen J, Xu Z, Huang H, Tang Y, Shan H, Xiao F. SETD1A drives stemness by reprogramming the epigenetic landscape in hepatocellular carcinoma stem cells. JCI Insight 2023; 8:e168375. [PMID: 37581938 PMCID: PMC10561725 DOI: 10.1172/jci.insight.168375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/08/2023] [Indexed: 08/17/2023] Open
Abstract
Cancer stem cells (CSCs) are responsible for tumor progression and recurrence. However, the mechanisms regulating hepatocellular carcinoma (HCC) stemness remain unclear. Applying a genome-scale CRISPR knockout screen, we identified that the H3K4 methyltransferase SETD1A and other members of Trithorax group proteins drive cancer stemness in HCC. SET domain containing 1A (SETD1A) was positively correlated with poor clinical outcome in patients with HCC. Combination of SETD1A and serum alpha fetoprotein substantially improved the accuracy of predicting HCC relapse. Mechanistically, SETD1A mediates transcriptional activation of various histone-modifying enzymes, facilitates deposition of trimethylated H3K4 (H3K4me3) and H3K27me3, and activates oncogenic enhancers and super-enhancers, leading to activation of oncogenes and inactivation of tumor suppressor genes simultaneously in liver CSCs. In addition, SETD1A cooperates with polyadenylate-binding protein cytoplasmic 1 to regulate H3K4me3 modification on oncogenes. Our data pinpoint SETD1A as a key epigenetic regulator driving HCC stemness and progression, highlighting the potential of SETD1A as a candidate target for HCC intervention and therapy.
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Affiliation(s)
- Jianxu Chen
- Guangdong Provincial Engineering Research Center of Molecular Imaging
- Department of Infectious Diseases
- Department of Gastroenterology, and
| | - Zhijie Xu
- Guangdong Provincial Engineering Research Center of Molecular Imaging
- Department of Infectious Diseases
| | - Hongbin Huang
- Guangdong Provincial Engineering Research Center of Molecular Imaging
- Department of Infectious Diseases
| | - Yao Tang
- Guangdong Provincial Engineering Research Center of Molecular Imaging
- Department of Infectious Diseases
| | - Hong Shan
- Guangdong Provincial Engineering Research Center of Molecular Imaging
- Center for Interventional Medicine, the Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, China
| | - Fei Xiao
- Guangdong Provincial Engineering Research Center of Molecular Imaging
- Department of Infectious Diseases
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Sasaki M, Yamamoto K, Ueda T, Irokawa H, Takeda K, Sekine R, Itoh F, Tanaka Y, Kuge S, Shibata N. One-carbon metabolizing enzyme ALDH1L1 influences mitochondrial metabolism through 5-aminoimidazole-4-carboxamide ribonucleotide accumulation and serine depletion, contributing to tumor suppression. Sci Rep 2023; 13:13486. [PMID: 37596270 PMCID: PMC10439146 DOI: 10.1038/s41598-023-38142-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/04/2023] [Indexed: 08/20/2023] Open
Abstract
Tumor cells generally require large amounts of nucleotides, and thus activate de novo purine synthesis (dnPS). In the dnPS reactions, 10-formyltetrahydorofolate (10-fTHF) supplied by one-carbon metabolism is utilized as a formyl group donor. We focused on aldehyde dehydrogenase 1 family member L1 (ALDH1L1), which metabolizes 10-fTHF to tetrahydrofolate and whose expression is often attenuated in hepatocellular carcinoma (HCC). We generated ALDH1L1-expressing HuH-7 cells to perform metabolome analysis and found that intracellular levels of serine were reduced and glycine was increased. In addition, 5-aminoimidazole-4-carboxamide ribonucleotide (ZMP), a dnPS intermediate, accumulated due to the consumption of 10-fTHF by ALDH1L1, which inhibited ZMP formylation. Importantly, ALDH1L1-expressing cells showed reduced ZMP sensitivity and higher mitochondrial activity. The suppression of mitochondrial serine catabolism by ALDH1L1 expression was speculated to be closely related to this phenotype. Gene set enrichment analysis utilizing The Cancer Genome Atlas data revealed that genes related to oxidative phosphorylation were enriched in HCC patients with high ALDH1L1 expression. Moreover, drug sensitivity data analysis demonstrated that HCC cell lines with low expression of ALDH1L1 were sensitive to ZMP and cordycepin, a structural analog of ZMP and AMP. Our study revealed that ZMP and AMP analogs might be effective in the pharmacotherapy of HCC patients with low expression of ALDH1L1.
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Affiliation(s)
- Masato Sasaki
- Division of Infection and Host Defense, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsusima, Aoba-ku, Sendai, Miyagi, 981-8558, Japan.
| | - Kazuo Yamamoto
- Biomedical Research Support Center, Nagasaki University School of Medicine, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Takeshi Ueda
- Department of Biochemistry, Faculty of Medicine, Kindai University, Osakasayama, Osaka, 589-8511, Japan
- Faculty of Medicine, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, 589-8511, Japan
| | - Hayato Irokawa
- Division of Microbiology, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsusima, Aoba-ku, Sendai, Miyagi, 981-8558, Japan
| | - Kouki Takeda
- Division of Microbiology, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsusima, Aoba-ku, Sendai, Miyagi, 981-8558, Japan
| | - Ryoya Sekine
- Division of Microbiology, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsusima, Aoba-ku, Sendai, Miyagi, 981-8558, Japan
| | - Fumie Itoh
- Division of Infection and Host Defense, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsusima, Aoba-ku, Sendai, Miyagi, 981-8558, Japan
| | - Yutaka Tanaka
- Division of Infection and Host Defense, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsusima, Aoba-ku, Sendai, Miyagi, 981-8558, Japan
| | - Shusuke Kuge
- Division of Microbiology, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsusima, Aoba-ku, Sendai, Miyagi, 981-8558, Japan
| | - Nobuyuki Shibata
- Division of Infection and Host Defense, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsusima, Aoba-ku, Sendai, Miyagi, 981-8558, Japan
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10
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Kumar S, Nadda N, Quadri A, Kumar R, Paul S, Tanwar P, Gamanagatti S, Dash NR, Saraya A, Shalimar, Nayak B. Assessments of TP53 and CTNNB1 gene hotspot mutations in circulating tumour DNA of hepatitis B virus-induced hepatocellular carcinoma. Front Genet 2023; 14:1235260. [PMID: 37593116 PMCID: PMC10429180 DOI: 10.3389/fgene.2023.1235260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Background: Hepatitis B virus (HBV) infection is one of the major causes of chronic liver disease, which progresses from chronic hepatitis B (CHB) to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Early detection and laboratory-based screening of hepatocellular carcinoma are still major challenges. This study was undertaken to determine whether the cancer hallmark gene signatures that are released into circulation as circulating tumour DNA (ctDNA) can be used as a liquid biopsy marker for screening, early detection, and prognosis of HCC. Methods: A total of 130 subjects, including HBV-HCC (n = 80), HBV-cirrhotic and non-cirrhotic (n = 35), and healthy (n = 15) controls, were evaluated for TP53 and beta-catenin (CTNNB1) gene hotspot mutations in ctDNA by Sanger-based cycle sequencing and droplet digital PCR (ddPCR) assays. Mutation detection frequency, percentage mutant fractions, and their association with tumour stage, mortality, and smoking habits were determined. Results: Sanger-based cycle sequencing was carried out for 32 HCC patients. Predict SNP Tools analysis indicated several pathogenic driver mutations in the ctDNA sequence, which include p.D228N, p.C229R, p.H233R, p.Y234D, p.S240T, p.G245S, and p.R249M for TP53 gene exon 7 and p.S33T for CTNNB1 gene exon 3. The TP53 c.746G>T (p.R249M) mutation was detected predominately (25% cases) by sequencing, but there was no dominant mutation at position c.747G>T (p.R249S) that was reported for HBV-HCC patients. A dual-probe ddPCR assay was developed to determine mutant and wild-type copy numbers of TP53 (p.R249M and p.R249S) and CTNNB1 (p.S45P) and their percentage mutant fraction in all 130 subjects. The TP53 R249M and CTNNB1 S45P mutations were detected in 31.25% and 26.25% of HCC patients, respectively, with a high mutant-to-wild-type fraction percentage (1.81% and 1.73%), which is significant as compared to cirrhotic and non-cirrhotic patients. Poor survival was observed in HCC patients with combined TP53 and CTNNB1 gene driver mutations. The TP53 R249M mutation was also significantly (p < 0.0001) associated with smoking habits (OR, 11.77; 95% CI, 3.219-36.20), but not the same for the TP53 R249S mutation. Conclusion: Screening of ctDNA TP53 and CTNNB1 gene mutations by ddPCR may be helpful for early detection and identifying the risk of HCC progression.
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Affiliation(s)
- Sonu Kumar
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Neeti Nadda
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Afnan Quadri
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Kumar
- Laboratory Oncology Unit (BRA-IRCH), All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Paul
- Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Pranay Tanwar
- Laboratory Oncology Unit (BRA-IRCH), All India Institute of Medical Sciences, New Delhi, India
| | | | - Nihar Ranjan Dash
- Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Anoop Saraya
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Shalimar
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Baibaswata Nayak
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
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11
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Silva MLS. Capitalizing glycomic changes for improved biomarker-based cancer diagnostics. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2023; 4:366-395. [PMID: 37455827 PMCID: PMC10344901 DOI: 10.37349/etat.2023.00140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/24/2023] [Indexed: 07/18/2023] Open
Abstract
Cancer serum biomarkers are valuable or even indispensable for cancer diagnostics and/or monitoring and, currently, many cancer serum markers are routinely used in the clinic. Most of those markers are glycoproteins, carrying cancer-specific glycan structures that can provide extra-information for cancer monitoring. Nonetheless, in the majority of cases, this differential feature is not exploited and the corresponding analytical assays detect only the protein amount, disregarding the analysis of the aberrant glycoform. Two exceptions to this trend are the biomarkers α-fetoprotein (AFP) and cancer antigen 19-9 (CA19-9), which are clinically monitored for their cancer-related glycan changes, and only the AFP assay includes quantification of both the protein amount and the altered glycoform. This narrative review demonstrates, through several examples, the advantages of the combined quantification of protein cancer biomarkers and the respective glycoform analysis, which enable to yield the maximum information and overcome the weaknesses of each individual analysis. This strategy allows to achieve higher sensitivity and specificity in the detection of cancer, enhancing the diagnostic power of biomarker-based cancer detection tests.
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Affiliation(s)
- Maria Luísa S. Silva
- Unidade de Aprendizagem ao Longo da Vida, Universidade Aberta, 1269-001 Lisboa, Portugal
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12
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Lin CL, Wu SY, Lai MW, Hsu CW, Chen WM, Jao AT, Chien CH, Hu CC, Chien RN, Yeh CT. Predicting Hepatocellular Carcinoma Risk in Chronic Hepatitis B Patients Receiving Finite Periods of Antiviral Therapy. Cancers (Basel) 2023; 15:3343. [PMID: 37444453 DOI: 10.3390/cancers15133343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
PURPOSE Hepatocellular carcinoma (HCC) is one of the most severe complications in chronic hepatitis B virus (HBV) infection. HCC can still develop in patients with chronic HBV (CHB) infection undergoing antiviral therapy. Several effective scoring systems for the prediction of HCC risk in CHB patients have been established. However, very few of them are designed for CHB patients receiving nucleos(t)ide analogues (NAs) therapy. Furthermore, none are available for HCC risk prediction in CHB patients receiving finite periods of antiviral therapy. METHODS This study enrolled 790 consecutive treatment-naïve patients with CHB infection who had visited our liver clinics from 2008 to 2012 for pretreatment assessment before receiving antiviral therapies. The treatments were provided at finite periods according to the National Health Insurance Policy in Taiwan. The last follow-up date was 31 December 2021. We analyzed the virological and clinical factors in these 790 CHB patients receiving finite periods of NA treatments and identified the most significant risk factors for HCC to establish a novel predictive scoring system. By using stepwise selection in a multivariate Cox proportional hazards model, we divided the patients into three risk groups. RESULTS Our predictive scoring system included five independent variables: genotype C (adjusted HR [aHR] = 2.23), NA-withdraw-related hepatitis relapse (aHR = 6.96), male (aHR = 4.19), liver cirrhosis (aHR = 11.14), and T1768A core promoter mutation (aHR = 3.21). This model revealed significant differences in HCC incidence among the three risk groups. The 5-year cumulative HCC risk significantly differed among the three risk groups (low risk: 1.33%, moderate risk: 4.99%, and high risk: 17.46%), with log-rank test p < 0.001. CONCLUSION Our predictive scoring system is a promising tool for the prediction of HCC in CHB patients receiving finite NA treatments. Genotype C, NA-withdraw-related hepatitis relapse, male gender, liver cirrhosis, and the T1768A HBV core promoter mutation were significant independent risk factors.
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Affiliation(s)
- Chih-Lang Lin
- Liver Research Center, Department of Gastroenterology and Hepatology, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
- College of Medicine, Chang Gung University, Taoyua 833, Taiwan
| | - Szu-Yuan Wu
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City 242, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City 242, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei City 242, Taiwan
| | - Ming-Wei Lai
- College of Medicine, Chang Gung University, Taoyua 833, Taiwan
- Liver Research Center, Chang Gung Memorial Hospital, Taoyuan 833, Taiwan
- Division of Pediatric Gastroenterology, Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Chao-Wei Hsu
- College of Medicine, Chang Gung University, Taoyua 833, Taiwan
- Liver Research Center, Chang Gung Memorial Hospital, Taoyuan 833, Taiwan
| | - Wan-Ming Chen
- Liver Research Center, Chang Gung Memorial Hospital, Taoyuan 833, Taiwan
- Division of Pediatric Gastroenterology, Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - An-Tzu Jao
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City 242, Taiwan
| | - Cheng-Hung Chien
- Liver Research Center, Department of Gastroenterology and Hepatology, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
- College of Medicine, Chang Gung University, Taoyua 833, Taiwan
| | - Ching-Chih Hu
- Liver Research Center, Department of Gastroenterology and Hepatology, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
- College of Medicine, Chang Gung University, Taoyua 833, Taiwan
| | - Rong-Nan Chien
- College of Medicine, Chang Gung University, Taoyua 833, Taiwan
- Liver Research Center, Chang Gung Memorial Hospital, Taoyuan 833, Taiwan
| | - Chau-Ting Yeh
- College of Medicine, Chang Gung University, Taoyua 833, Taiwan
- Liver Research Center, Chang Gung Memorial Hospital, Taoyuan 833, Taiwan
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13
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Goodwin B, Lou J, Butchy M, Wilson T, Atabek U, Spitz F, Hong Y. Hepatocellular-Cholangiocarcinoma Collision Tumors: An Update of Current Management Practices. Am Surg 2023; 89:2685-2692. [PMID: 36031932 DOI: 10.1177/00031348221124323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare form of primary hepatic collision tumor, with an incidence ranging from 0.4 to 14.2%. Given the diagnostic challenges and lack of randomized trials, standardized treatment has yet to be established. We aim to review the literature to summarize the diagnosis, molecular characteristics, current treatment modalities, and challenges for cHCC-CC. A literature review was performed using PubMed. We included studies investigating and describing cHCC-CC, focusing on surgical, medical, and radiologic treatments. Overall prognosis is poor, with a 5-year survival rate under 30%. Minor or major hepatectomy with R0 resection is the only curative treatment; however, recurrence is likely (as high as 50% within 5 years). The role of liver transplantation is also highly debated given the biliary nature of these tumors, with cHCC-CC as a relative contraindication for liver transplantation. Although gemcitabine-based treatments had higher progression-free survival over sorafenib, there is no standard chemotherapy regimen. Treatment with gemcitabine and platinum demonstrates improved disease control rates compared to gemcitabine in conjunction with 5-fluorouracil (78.4% verse 38.5% respectively). Additionally, platinum-containing chemotherapy regimens exhibit a higher overall response rate than non-platinum regimens (21.4% verse 7.0% respectively). These molecular-directed therapies have prolonged survival for HCC, but further investigation needs to be done to assess their utility in patients with cHCC-CC. cHCC-CC is a rare and complex subset of primary hepatic neoplasms with a dismal prognosis and unstandardized treatment options. Further trials need to be performed to investigate systemic chemotherapy and immunotherapy options for patients with unresectable disease.
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Affiliation(s)
- Brandon Goodwin
- Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | | | | | - Traeden Wilson
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | | | - Young Hong
- Cooper University Hospital, Camden, NJ, USA
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14
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Cuartas-Mesa MC, Romero Noboa ME, Choroomi Y, Aryal B, Venkataramanan A, Ferreira de Araujo Litvin R. A Chronic Cough and Something More: An Unusual Presentation of Hepatocellular Carcinoma. Cureus 2023; 15:e37300. [PMID: 37168167 PMCID: PMC10166591 DOI: 10.7759/cureus.37300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 05/13/2023] Open
Abstract
Liver cancer is one of the main contributors to cancer-related death and is the fifth most frequent cancer worldwide. Hepatocellular carcinoma (HCC), the most common of liver cancers, is most frequently diagnosed incidentally during routine imaging in high-risk patients with cirrhosis. However, patients with advanced disease may present with upper abdominal pain, early satiety, weight loss, and a palpable upper abdominal mass. We describe a case of HCC in a 69-year-old male presenting exclusively with an intractable cough, which improved after transarterial chemoembolization-raising awareness of the importance of having a systematic and physiopathology-based approach to chronic cough to have an adequate diagnosis and treatment.
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Affiliation(s)
| | | | - Yasmine Choroomi
- Internal Medicine, Rosalind Franklin University of Medicine and Science, Chicago, USA
| | - Badri Aryal
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
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15
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Ibrahim S, Baig B, Hisaindee S, Darwish H, Abdel-Ghany A, El-Maghraby H, Amin A, Greish Y. Development and Evaluation of Crocetin-Functionalized Pegylated Magnetite Nanoparticles for Hepatocellular Carcinoma. Molecules 2023; 28:molecules28072882. [PMID: 37049645 PMCID: PMC10095796 DOI: 10.3390/molecules28072882] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/14/2023] Open
Abstract
Liver cancer remains among the leading causes of cancer-related deaths worldwide. This is due to many reasons, including limitations of available drugs, late diagnosis due to the overlapping symptoms with many other liver diseases, and lack of effective screening modalities. Compared to conventional chemotherapy, targeted drug delivery systems are advantageous in many ways, as they minimize drug resistance and improve therapeutic value for cancer patients. Nanomaterials, in general, and nanoparticles, in particular, possess nm size, which provides a high surface area for a great extent of functionalization to be used for the targeted delivery of cancer drugs. Amongst the different formulations of nanoparticles, magnetic nanoparticles (MNPs) have unique chemical and physical characteristics and magnetic behavior, making them preferable candidates as a core for drug delivery systems. To maintain the nanosized structure of MNPs, a polymeric coating is usually applied to maintain the nanoparticles dispersed in the solution. Moreover, the polymeric coating provides a plate form for carrying drug molecules on its surface. In the present study, poly(ethylene glycol) (PEG)-coated MNPs were successfully synthesized, where the optimum concentration of PEG on the surface of the MNPs was investigated. The PEG-coated MNPs were further coated with crocetin at different concentrations. The crocetin-coated pegylated MNPs were evaluated in vitro using a hepatic cell line (HepG2) for up to 72 h. Results showed good release kinetics under acidic and neutral conditions. The optimally prepared drug delivery system showed a high potential for reducing the HepG2 cell proliferation in vitro using an MTT assay. The calculated IC50 for Cro-PEG-MNPs were 0.1019, 0.0903, and 0.0462 mg/mL of 5×, 10× and 20×, respectively.
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Affiliation(s)
- Sulafa Ibrahim
- Department of Chemistry, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Badriya Baig
- Department of Biology, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Soleiman Hisaindee
- Department of Chemistry, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Hussein Darwish
- Department of Glass Research, National Research Centre, Dokki, Cairo 12622, Egypt
| | - Ashraf Abdel-Ghany
- Department of Inorganic Chemistry, National Research Centre, Dokki, Cairo 12622, Egypt
| | - Hesham El-Maghraby
- Department of Chemistry, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Department of Ceramics, National Research Centre, Dokki, Cairo 12622, Egypt
| | - Amr Amin
- Department of Biology, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Yaser Greish
- Department of Chemistry, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Department of Ceramics, National Research Centre, Dokki, Cairo 12622, Egypt
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
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16
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Imaging Negative Hepatic Lesions: A Rare Case of Infiltrative Hepatocellular Carcinoma Diagnosed With Endoscopic Ultrasound. ACG Case Rep J 2023; 9:e00945. [PMID: 36628370 PMCID: PMC9820777 DOI: 10.14309/crj.0000000000000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 11/28/2022] [Indexed: 01/07/2023] Open
Abstract
Hepatocellular carcinoma is a common malignancy with male predominance. It is further classified into different subtypes, among which the infiltrative subtype is the most difficult to diagnose with imaging because of its inherently ill-defined micro nodules involving a segment or entire hepatic parenchyma without a distinguishable mass. Owing to the aggressive nature and decreased survival expectations in most patients with infiltrative hepatocellular carcinoma, liver transplants and surgical resections are not recommended. Our case describes a middle-aged woman presenting with alpha-fetoprotein >20,000 and imagings negative for hepatic mass, thereby necessitating the use of endoscopic ultrasound with fine-needle aspiration.
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17
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Amajala KC, Gudivada IP, Malla RR. Gamma Delta T Cells: Role in Immunotherapy of Hepatocellular Carcinoma. Crit Rev Oncog 2023; 28:41-50. [PMID: 38050980 DOI: 10.1615/critrevoncog.2023049893] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
The most typical type of liver cancer or hepatocellular carcinoma (HCC) develops from hepatocyte loss. Non-alcoholic fatty liver disease (NAFLD), viral hepatitis C and cirrhosis are the leading causes of HCC. With the Hepatitis B vaccine and medicines, there are several treatments for HCC, including liver resection, ablation, transplantation, immunotherapy, gene therapy, radiation embolization, and targeted therapy. Currently, a wide range of studies are carried out on gene therapy to identify biomarkers and pathways, which help us identify the exact stage of the disorder and reduce its effects. γδT cells have recently received much interest as a potential cancer treatment method in adaptive immunotherapy. γδT cells can quickly form connections between receptor and ligand activation. They can clonally expand and are a significant source of cytokines and chemokines. The present review provides a comprehensive understanding on the function of γδT cells in immunotherapies and how they are used to treat HCC.
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Affiliation(s)
- Krishna Chaitanya Amajala
- Department of Biochemistry and Bioinformatics, GITAM School of Science, GITAM Deemed to be University, Visakhapatnam 530045, Andhra Pradesh, India
| | - Indu Priya Gudivada
- Department of Biochemistry and Bioinformatics, GITAM School of Science, GITAM Deemed to be University, Visakhapatnam 530045, Andhra Pradesh, India
| | - Rama Rao Malla
- Cancer Biology Laboratory, Department of Biochemistry and Bioinformatics, School of Science, Gandhi Institute of Technology and Management (GITAM) (Deemed to be University), Visakhapatnam-530045, Andhra Pradesh, India; Department of Biochemistry and Bioinformatics, School of Science, GITAM (Deemed to be University), Visakhapatnam-530045, Andhra Pradesh, India
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18
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Elleithi YA, El-Gayar AM, Amin MN. Simvastatin Induces Apoptosis And Suppresses Hepatocellular Carcinoma Induced In Rats. Appl Biochem Biotechnol 2023; 195:1656-1674. [PMID: 36367620 PMCID: PMC9928804 DOI: 10.1007/s12010-022-04203-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2022] [Indexed: 11/13/2022]
Abstract
Hepatocellular carcinoma (HCC) is a frequent primary aggressive cancer, a crucial cause of cancer-related mortality globally. Simvastatin is a well-known safe cholesterol-lowering medication that has been recently shown to suppress cancer progression. Apoptosis is a well-organized and controlled cellular process that happens both physiologically and pathologically leading to executing cell death. Apoptosis is frequently downregulated in cancer cells. In the present study, we aimed to test the effect of simvastatin on HCC progression. HCC was induced in experimental rats by means of diethylnitrose amine (DEN) and thioacetamide (TAA) injections. Gross examination and liver index along with biochemical analysis of hepatic function were evaluated. Serum alpha-feto protein (AFP) concentration was measured by ELISA. Histopathological examination was used for assessing necroinflammatory scores and fibrosis degree. Apoptosis was assessed using immunohistochemistry (IHC) and quantitative PCR (qPCR). Simvastatin was found to induce apoptosis successfully in HCC and improve liver fibrosis, overall hepatic function, and necroinflammatory score. Simvastatin, therefore, may be a potential adjunctive therapeutic option in clinical settings of treating HCC.
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Affiliation(s)
- Yomna A. Elleithi
- Biochemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura, 3551 Egypt
| | - Amal M. El-Gayar
- Biochemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura, 3551 Egypt
| | - Mohamed N. Amin
- Biochemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura, 3551 Egypt ,Biochemistry Department, Faculty of Pharmacy, King Salman International University, Ras Sedr, South Sinai Egypt
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19
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Protein Glycosylation as Biomarkers in Gynecologic Cancers. Diagnostics (Basel) 2022; 12:diagnostics12123177. [PMID: 36553184 PMCID: PMC9777642 DOI: 10.3390/diagnostics12123177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/01/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Gynecologic cancers are the leading cause of death in women. Endometrial, ovarian, and cervical cancer are the three main types of gynecologic cancers. Poor prognoses and high mortality rates of advanced-stage cancer are still challenges of all three types. Diagnostic tools for early cancer detection could be the cornerstone for further cancer treatment and prevention. Glycosylation plays a vital role in cell proliferation, adhesion, motility, and angiogenesis, and is aberrantly expressed in cancer cells. Alterations of glycosylation may represent promising biomarkers with potential diagnostic and monitoring applications, as well as disease prognosis. Many glycosylated biomarkers, including glycoprotein, glycan, and enzyme, were discovered and well-studied for application in gynecologic cancers. Some of them have been developed as targets for cancer treatment. The use of certain biomarkers for diagnostics and monitoring of gynecologic cancers has clinical advantages, as it is quantitative, comparable, convenient, and inexpensive. However, one of the single markers have sufficient sensitivity for the screening of gynecologic cancers. In this review, we introduced the details of glycosylation and the current application of glycosylated biomarkers in these three cancers. Moreover, we also reviewed the different roles of each biomarker in other cancers and aimed to understand these glycosylated biomarkers comprehensively.
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Bawashkhah AS, Sindi GA, Almatrafi SB, Obaid EF, Bakhsh RI. Fibrolamellar Hepatocellular Carcinoma in the Absence of Risk Factors: A Case Report. Cureus 2022; 14:e32483. [DOI: 10.7759/cureus.32483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
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21
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Rhee Chai M, Sankaran P, Ming Yap L. Extrahepatic metastasis of hepatocellular carcinoma: A Malaysian case series. INTERNATIONAL JOURNAL OF HEPATOBILIARY AND PANCREATIC DISEASES 2022. [DOI: 10.5348/100099z04mc2022cs] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Introduction: Hepatocellular carcinoma (HCC) is a primary malignancy which arises from hepatocytes. It is the sixth most commonly diagnosed cancer and the third leading cause of cancer death worldwide in 2020. It predominantly metastasizes via the hematogenous route. However, there are possibility of distant metastasis via the lymphatic and bone dissemination in a few of HCC cases.
Case Series: We report two atypical cases of HCC with distant metastasis to cervical lymph node and bone in Malaysia. The first case reported is a HCC case of extrahepatic metastasis to cervical lymph node and the second case is a HCC case of extrahepatic metastasis to right femur.
Conclusion: The patients with atypical site of distant metastasis from HCC have poor prognosis. Overall physical examination should be done to prevent overlook for all the patients with HCC.
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Affiliation(s)
- Ming Rhee Chai
- Medical Officer, Surgery, Melaka General Hospital, Melaka, Malaysia
| | - Padmaan Sankaran
- Hepatobiliary Surgeon, Hepatobiliary Surgery, Melaka General Hospital, Melaka, Malaysia
| | - Lee Ming Yap
- Consultant Surgeon, General Surgery, Surgery, Melaka General Hospital, Melaka, Malaysia
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22
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Imanishi S, Nagata S, Fujita T, Fujii H. Circular RNAs hsa_circ_0001438 and hsa_circ_0000417 are downregulated and upregulated, respectively, in hepatocellular carcinoma. Int J Exp Pathol 2022; 103:245-251. [PMID: 36153641 PMCID: PMC9664408 DOI: 10.1111/iep.12457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/27/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most predominant type of liver cancer and is frequently fatal. Alpha-fetoprotein, alpha-fetoprotein-L3, and protein induced by vitamin K absence or antagonist-II are used as biomarkers to diagnose HCC. However, these biomarkers are not highly specific, especially for early-stage HCC diagnosis; therefore, more specific biomarkers are needed. Recently, circular RNA (circRNA) biomarkers have been used to diagnose several intractable diseases. In this study, we sought to identify circRNA biomarkers for the specific diagnosis of HCC. To this end, we compared the expression levels of circRNAs in primary HCC and normal tissues using publicly available RNA-seq data. Our analysis revealed that the expression levels of eight circRNAs were altered in primary HCC tissues compared with normal tissues. To confirm our findings, we examined the expression levels of selected circRNAs in HCC cell lines and normal hepatocytes. The expression level of hsa_circ_0001438, a circRNA that was downregulated in primary HCC, was lower in poorly and well-differentiated HCC cell lines than in normal hepatocytes. By contrast, the expression level of hsa_circ_0000417, which was increased in primary HCC, was strongly upregulated in a well-differentiated HCC cell line compared with normal hepatocytes. Thus, hsa_circ_0001438 and hsa_circ_0000417 might be potential biomarkers for the specific diagnosis of HCC. The experimental strategy described here, using publicly available RNA-seq data, is a useful and cost-effective method of identifying circRNA biomarkers.
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Affiliation(s)
- Sachiko Imanishi
- Department of Biochemistry and Genome BiologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Shoko Nagata
- Department of Biochemistry and Genome BiologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Toshitsugu Fujita
- Department of Biochemistry and Genome BiologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Hodaka Fujii
- Department of Biochemistry and Genome BiologyHirosaki University Graduate School of MedicineHirosakiJapan
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23
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Roa-Colomo A, López Garrido MÁ, Molina-Vallejo P, Rojas A, Sanchez MG, Aranda-García V, Salmeron J, Romero-Gomez M, Muntane J, Padillo J, Alamo JM, Lorente JA, Serrano MJ, Garrido-Navas MC. Hepatocellular carcinoma risk-stratification based on ASGR1 in circulating epithelial cells for cancer interception. Front Mol Biosci 2022; 9:1074277. [PMID: 36518850 PMCID: PMC9742249 DOI: 10.3389/fmolb.2022.1074277] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/16/2022] [Indexed: 09/24/2023] Open
Abstract
Purpose: Lack of diagnostic and prognostic biomarkers in hepatocellular carcinoma impedes stratifying patients based on their risk of developing cancer. The aim of this study was to evaluate phenotypic and genetic heterogeneity of circulating epithelial cells (CECs) based on asialoglycoprotein receptor 1 (ASGR1) and miR-122-5p expression as potential diagnostic and prognostic tools in patients with hepatocellular carcinoma (HCC) and liver cirrhosis (LC). Methods: Peripheral blood samples were extracted from LC and HCC patients at different disease stages. CECs were isolated using positive immunomagnetic selection. Genetic and phenotypic characterization was validated by double immunocytochemistry for cytokeratin (CK) and ASGR1 or by in situ hybridization with miR-122-5p and CECs were visualized by confocal microscopy. Results: The presence of CECs increased HCC risk by 2.58-fold, however, this was only significant for patients with previous LC (p = 0.028) and not for those without prior LC (p = 0.23). Furthermore, the number of CECs lacking ASGR1 expression correlated significantly with HCC incidence and absence of miR-122-5p expression (p = 0.014; r = 0.23). Finally, overall survival was significantly greater for patients at earlier cancer stages (p = 0.018), but this difference was only maintained in the group with the presence of CECs (p = 0.021) whereas progression-free survival was influenced by the absence of ASGR1 expression. Conclusion: Identification and characterization of CECs by ASGR1 and/or miR-122-5p expression may be used as a risk-stratification tool in LC patients, as it was shown to be an independent prognostic and risk-stratification marker in LC and early disease stage HCC patients.
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Affiliation(s)
- Amparo Roa-Colomo
- Clinical Medicine and Public Health Doctoral Program, University of Granada, Granada, Spain
- Gastroenterology and Hepatology Department, San Cecilio University Hospital, Granada, Spain
| | | | - Pilar Molina-Vallejo
- Genyo-Centro Pfizer-Universidad De Granada-Junta De Andalucía De Genómica e Investigación Oncológica, Granada, Spain
| | - Angela Rojas
- Seliver Group, Institute of Biomedicine of Seville (IBiS)/ Hospital Universitario Virgen Del Rocío/CSIC/Universidad De Sevilla, Seville, Spain
- Spanish Network for Biomedical Research in Hepatic and Digestive Diseases (CIBERehd), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Mercedes González Sanchez
- Gastroenterology and Hepatology Department, Virgen De Las Nieves University Hospital, Granada, Spain
| | - Violeta Aranda-García
- Statistician at Fundación para la Investigación Biosanitaria Andalucía Oriental Alejandro Otero (FIBAO), Hospital Virgen de las Nieves, Granada, Spain
| | - Javier Salmeron
- Gastroenterology and Hepatology Department, San Cecilio University Hospital, Granada, Spain
| | - Manuel Romero-Gomez
- Seliver Group, Institute of Biomedicine of Seville (IBiS)/ Hospital Universitario Virgen Del Rocío/CSIC/Universidad De Sevilla, Seville, Spain
- Spanish Network for Biomedical Research in Hepatic and Digestive Diseases (CIBERehd), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Jordi Muntane
- Spanish Network for Biomedical Research in Hepatic and Digestive Diseases (CIBERehd), Carlos III Health Institute (ISCIII), Madrid, Spain
- Institute of Biomedicine of Seville (IBiS), Hospital University Virgen del Rocío/CSIC/University of Seville, Seville, Spain
- Department of Medical Physiology and Biophysics, University of Seville, Seville, Spain
| | - Javier Padillo
- General and Gastrointestinal Surgery Division, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Jose María Alamo
- General and Gastrointestinal Surgery Division, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Jose A. Lorente
- Genyo-Centro Pfizer-Universidad De Granada-Junta De Andalucía De Genómica e Investigación Oncológica, Granada, Spain
- Legal Medicine Department, Medicine School, University of Granada, Granada, Spain
| | - María José Serrano
- Genyo-Centro Pfizer-Universidad De Granada-Junta De Andalucía De Genómica e Investigación Oncológica, Granada, Spain
- Comprehensive Oncology Division, Clinical University Hospital, Virgen de las Nieves-IBS, Granada, Spain
- Department of Pathological Anatomy, Faculty of Medicine, University of Granada, Granada, Spain
| | - M. Carmen Garrido-Navas
- Genyo-Centro Pfizer-Universidad De Granada-Junta De Andalucía De Genómica e Investigación Oncológica, Granada, Spain
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24
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Shukla A, Patkar S, Sundaram S, Shah SR, Ingle M, Gupta A, Gopan A, Kamat M, Mohanka R, Singh S, Walke S, Pandey V, Goel M. Clinical Profile, Patterns of Care & adherence to Guidelines in Patients with Hepatocellular Carcinoma: Prospective multi-center Study. J Clin Exp Hepatol 2022; 12:1463-1473. [PMID: 36340319 PMCID: PMC9630010 DOI: 10.1016/j.jceh.2022.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 05/27/2022] [Indexed: 12/12/2022] Open
Abstract
Background and aims Increasing incidence of hepatocellular carcinoma (HCC) in India is a matter of concern and need for adequate profiling and streamlining management strategies cannot be over-emphasized. Methods This is a prospective multi-centric observational cohort study comprising of an oncology center, one university tertiary hospital with specialized hepatology service, one public hospital with gastroenterology service, and a private liver transplant center located within a 3-km radius. The demographic and clinical parameters were recorded on a prospectively maintained database. The clinical profile, demographics, characteristics of HCC and the allocated treatment were noted and compared among the four centers. Results In total, 672 patients were enrolled from June 2016 till January 2020. Abdominal pain (64.3%) and weight loss (47.3%) were the most common symptoms. Most common identified etiology was hepatitis B (39%). The cancer center received lesser patients with hepatitis C and those with advanced stage of HCC. The private transplant center reported the highest proportion of NASH, which was also significantly higher in those belonging to higher socioeconomic strata, and lowest proportion of alcoholic cirrhosis. Metastasis was seen in almost one-fifth (19%) cases at diagnosis. Portal vein thrombosis was evident in 40%. Adherence to treatment guidelines was seen in three-fourth cases (76%). Conclusions Hepatitis B is the most common underlying cause for HCC, whereas other causes like NASH are on the rise. Etiologic profile may vary with selective specialization of centers catering to patients with HCC. Adherence to guideline while allocating treatment was high among all centers with highest non-adherence in BCLC A.
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Key Words
- AASLD, American Association of Study of Liver Disease
- AFP, Alpha fetoprotein
- ALP, Alkaline phosphatase
- ALT, Alanine transaminase
- AST, Aspartate transaminase
- BCLC, Barcelona Clinic Liver Cancer staging
- BCS, Budd Chiari syndrome
- CT, Computed tomography
- EASL, European Association for Study of Liver
- GGT, Gamma glutamyl transpeptidase
- HBV, Hepatitis B virus
- HCC, Hepatocellular carcinoma
- HCV, Hepatitis C virus
- HKLC, Hong-Kong Liver Cancer staging
- HVPG, Hepatic venous pressure gradient
- INR, International normalized ratio
- MDT, Multidisciplinary team
- MRI, Magnetic resonance imaging
- NAFLD, Non-alcoholic fatty liver disease
- PHT, Portal hypertension
- PVTT, Portal venous tumor thrombosis
- clinical profile
- hepatocellular carcinoma
- milan criteria
- multicenter
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Affiliation(s)
- Akash Shukla
- Department of Gastroenterology, Seth G.S Medical College and King Edward Memorial Hospital, Mumbai, India
| | - Shraddha Patkar
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Sridhar Sundaram
- Department of Gastroenterology, Seth G.S Medical College and King Edward Memorial Hospital, Mumbai, India
| | - Samir R. Shah
- Department of Hepatology, Institute of Liver Disease, Hepato-pancreatico-biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Meghraj Ingle
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Amit Gupta
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Amrit Gopan
- Department of Gastroenterology, Seth G.S Medical College and King Edward Memorial Hospital, Mumbai, India
| | - Mrunal Kamat
- Department of Hepatology, Institute of Liver Disease, Hepato-pancreatico-biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Ravi Mohanka
- Department of Hepatology, Institute of Liver Disease, Hepato-pancreatico-biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Sandeep Singh
- Department of Hepatology, Institute of Liver Disease, Hepato-pancreatico-biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Swapnil Walke
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Vikas Pandey
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Mahesh Goel
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
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25
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Devan AR, Pavithran K, Nair B, Murali M, Nath LR. Deciphering the role of transforming growth factor-beta 1 as a diagnostic-prognostic-therapeutic candidate against hepatocellular carcinoma. World J Gastroenterol 2022; 28:5250-5264. [PMID: 36185626 PMCID: PMC9521521 DOI: 10.3748/wjg.v28.i36.5250] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/30/2022] [Accepted: 08/16/2022] [Indexed: 02/06/2023] Open
Abstract
Transforming growth factor-beta (TGF-β) is a multifunctional cytokine that performs a dual role as a tumor suppressor and tumor promoter during cancer progression. Among different ligands of the TGF-β family, TGF-β1 modulates most of its biological outcomes. Despite the abundant expression of TGF-β1 in the liver, steatosis to hepatocellular carcinoma (HCC) progression triggers elevated TGF-β1 levels, contributing to poor prognosis and survival. Additionally, elevated TGF-β1 levels in the tumor microenvironment create an immunosuppressive stage via various mechanisms. TGF-β1 has a prime role as a diagnostic and prognostic biomarker in HCC. Moreover, TGF-β1 is widely studied as a therapeutic target either as monotherapy or combined with immune checkpoint inhibitors. This review provides clinical relevance and up-to-date information regarding the potential of TGF-β1 in diagnosis, prognosis, and therapy against HCC.
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Affiliation(s)
- Aswathy R Devan
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Kochi 682041, Kerala, India
| | - Keechilat Pavithran
- Department of Medical Oncology and Hematology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, Kerala, India
| | - Bhagyalakshmi Nair
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Kochi 682041, Kerala, India
| | - Maneesha Murali
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Kochi 682041, Kerala, India
| | - Lekshmi R Nath
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Kochi 682041, Kerala, India
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26
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Meléndez AV, Velasco Cárdenas RMH, Lagies S, Strietz J, Siukstaite L, Thomas OS, Tomisch J, Weber W, Kammerer B, Römer W, Minguet S. Novel lectin-based chimeric antigen receptors target Gb3-positive tumour cells. Cell Mol Life Sci 2022; 79:513. [PMID: 36097202 PMCID: PMC9468074 DOI: 10.1007/s00018-022-04524-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 07/19/2022] [Accepted: 07/31/2022] [Indexed: 11/05/2022]
Abstract
The link between cancer and aberrant glycosylation has recently become evident. Glycans and their altered forms, known as tumour-associated carbohydrate antigens (TACAs), are diverse, complex and difficult to target therapeutically. Lectins are naturally occurring glycan-binding proteins that offer a unique opportunity to recognise TACAs. T cells expressing chimeric antigen receptors (CARs) have proven to be a successful immunotherapy against leukaemias, but so far have shown limited success in solid tumours. We developed a panel of lectin-CARs that recognise the glycosphingolipid globotriaosylceramide (Gb3), which is overexpressed in various cancers, such as Burkitt's lymphoma, colorectal, breast and pancreatic. We have selected the following lectins: Shiga toxin's B-subunit from Shigella dysenteriae, LecA from Pseudomonas aeruginosa, and the engineered lectin Mitsuba from Mytilus galloprovincialis as antigen-binding domains and fused them to a well-known second-generation CAR. The Gb3-binding lectin-CARs have demonstrated target-specific cytotoxicity against Burkitt's lymphoma-derived cell lines as well as solid tumour cells from colorectal and triple-negative breast cancer. Our findings reveal the big potential of lectin-based CARs as therapeutical applications to target Gb3 and other TACAs expressed in haematological malignancies and solid tumours.
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Affiliation(s)
- Ana Valeria Meléndez
- Faculty of Biology, University of Freiburg, Schänzlestraße 1, 79104, Freiburg, Germany
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- CIBSS, Centre for Integrative Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Albertstraße 19a, 79104, Freiburg, Germany
| | - Rubí M-H Velasco Cárdenas
- Faculty of Biology, University of Freiburg, Schänzlestraße 1, 79104, Freiburg, Germany
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- CIBSS, Centre for Integrative Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
| | - Simon Lagies
- Institute of Organic Chemistry, Albert-Ludwigs-University Freiburg, Albertstraße 21, 79102, Freiburg, Germany
| | | | - Lina Siukstaite
- Faculty of Biology, University of Freiburg, Schänzlestraße 1, 79104, Freiburg, Germany
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- CIBSS, Centre for Integrative Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
| | - Oliver S Thomas
- Faculty of Biology, University of Freiburg, Schänzlestraße 1, 79104, Freiburg, Germany
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- CIBSS, Centre for Integrative Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Albertstraße 19a, 79104, Freiburg, Germany
| | - Jana Tomisch
- Faculty of Biology, University of Freiburg, Schänzlestraße 1, 79104, Freiburg, Germany
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- CIBSS, Centre for Integrative Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
| | - Wilfried Weber
- Faculty of Biology, University of Freiburg, Schänzlestraße 1, 79104, Freiburg, Germany
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- CIBSS, Centre for Integrative Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Albertstraße 19a, 79104, Freiburg, Germany
| | - Bernd Kammerer
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany
- Institute of Organic Chemistry, Albert-Ludwigs-University Freiburg, Albertstraße 21, 79102, Freiburg, Germany
- Centre for Integrative Signalling Analysis, University of Freiburg, Habsburgerstraße 49, 79104, Freiburg, Germany
| | - Winfried Römer
- Faculty of Biology, University of Freiburg, Schänzlestraße 1, 79104, Freiburg, Germany.
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany.
- CIBSS, Centre for Integrative Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany.
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Albertstraße 19a, 79104, Freiburg, Germany.
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany.
| | - Susana Minguet
- Faculty of Biology, University of Freiburg, Schänzlestraße 1, 79104, Freiburg, Germany.
- BIOSS, Centre for Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany.
- CIBSS, Centre for Integrative Biological Signalling Studies, University of Freiburg, Schänzlestraße 18, 79104, Freiburg, Germany.
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Albertstraße 19a, 79104, Freiburg, Germany.
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany.
- Center of Chronic Immunodeficiency (CCI), University Clinics and Medical Faculty, Freiburg, Germany.
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27
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Guerrero L, Paradela A, Corrales FJ. Targeted Proteomics for Monitoring One-Carbon Metabolism in Liver Diseases. Metabolites 2022; 12:metabo12090779. [PMID: 36144184 PMCID: PMC9501948 DOI: 10.3390/metabo12090779] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Liver diseases cause approximately 2 million deaths per year worldwide and had an increasing incidence during the last decade. Risk factors for liver diseases include alcohol consumption, obesity, diabetes, the intake of hepatotoxic substances like aflatoxin, viral infection, and genetic determinants. Liver cancer is the sixth most prevalent cancer and the third in mortality (second in males). The low survival rate (less than 20% in 5 years) is partially explained by the late diagnosis, which remarks the need for new early molecular biomarkers. One-carbon metabolism integrates folate and methionine cycles and participates in essential cell processes such as redox homeostasis maintenance and the regulation of methylation reactions through the production of intermediate metabolites such as cysteine and S-Adenosylmethionine. One-carbon metabolism has a tissue specific configuration, and in the liver, the participating enzymes are abundantly expressed—a requirement to maintain hepatocyte differentiation. Targeted proteomics studies have revealed significant differences in hepatocellular carcinoma and cirrhosis, suggesting that monitoring one-carbon metabolism enzymes can be useful for stratification of liver disease patients and to develop precision medicine strategies for their clinical management. Here, reprogramming of one-carbon metabolism in liver diseases is described and the role of mass spectrometry to follow-up these alterations is discussed.
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Affiliation(s)
- Laura Guerrero
- Centro Nacional de Biotecnología (CNB), CSIC. C/Darwin 3, 28049 Madrid, Spain
| | - Alberto Paradela
- Centro Nacional de Biotecnología (CNB), CSIC. C/Darwin 3, 28049 Madrid, Spain
| | - Fernando J. Corrales
- Centro Nacional de Biotecnología (CNB), CSIC. C/Darwin 3, 28049 Madrid, Spain
- National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Carlos III Health Institute), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-91-585-46-96
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28
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Rare Inherited Cholestatic Disorders and Molecular Links to Hepatocarcinogenesis. Cells 2022; 11:cells11162570. [PMID: 36010647 PMCID: PMC9406938 DOI: 10.3390/cells11162570] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer affecting adults and the second most common primary liver cancer affecting children. Recent years have seen a significant increase in our understanding of the molecular changes associated with HCC. However, HCC is a complex disease, and its molecular pathogenesis, which likely varies by aetiology, remains to be fully elucidated. Interestingly, some inherited cholestatic disorders that manifest in childhood are associated with early HCC development. This review will thus explore how three genes that are associated with liver disease in childhood (ABCB11, TJP2 and VPS33B) might play a role in the initiation and progression of HCC. Specifically, chronic bile-induced damage (caused by ABCB11 changes), disruption of intercellular junction formation (caused by TJP2 changes) and loss of normal apical–basal cell polarity (caused by VPS33B changes) will be discussed as possible mechanisms for HCC development.
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29
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Cheng C, Cai J, Teng W, Zheng Y, Huang Y, Wang Y, Peng C, Tang Y, Lee W, Yeh T, Xiao J, Lu L, Liao C, Harrison AP. A flexible three‐dimensional heterophase computed tomography hepatocellular carcinoma detection algorithm for generalizable and practical screening. Hepatol Commun 2022; 6:2901-2913. [PMID: 35852311 PMCID: PMC9512477 DOI: 10.1002/hep4.2029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/13/2022] [Accepted: 05/29/2022] [Indexed: 11/26/2022] Open
Abstract
Hepatocellular carcinoma (HCC) can be potentially discovered from abdominal computed tomography (CT) studies under varied clinical scenarios (e.g., fully dynamic contrast‐enhanced [DCE] studies, noncontrast [NC] plus venous phase [VP] abdominal studies, or NC‐only studies). Each scenario presents its own clinical challenges that could benefit from computer‐aided detection (CADe) tools. We investigate whether a single CADe model can be made flexible enough to handle different contrast protocols and whether this flexibility imparts performance gains. We developed a flexible three‐dimensional deep algorithm, called heterophase volumetric detection (HPVD), that can accept any combination of contrast‐phase inputs with adjustable sensitivity depending on the clinical purpose. We trained HPVD on 771 DCE CT scans to detect HCCs and evaluated it on 164 positives and 206 controls. We compared performance against six clinical readers, including two radiologists, two hepatopancreaticobiliary surgeons, and two hepatologists. The area under the curve of the localization receiver operating characteristic for NC‐only, NC plus VP, and full DCE CT yielded 0.71 (95% confidence interval [CI], 0.64–0.77), 0.81 (95% CI, 0.75–0.87), and 0.89 (95% CI, 0.84–0.93), respectively. At a high‐sensitivity operating point of 80% on DCE CT, HPVD achieved 97% specificity, which is comparable to measured physician performance. We also demonstrated performance improvements over more typical and less flexible nonheterophase detectors. Conclusion: A single deep‐learning algorithm can be effectively applied to diverse HCC detection clinical scenarios, indicating that HPVD could serve as a useful clinical aid for at‐risk and opportunistic HCC surveillance.
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Affiliation(s)
- Chi‐Tung Cheng
- Department of Trauma and Emergency Surgery Chang Gung Memorial Hospital at Linkou Chang Gung University Linkou Taiwan, Republic of China
| | | | - Wei Teng
- Department of Gastroenterology and Hepatology Chang Gung Memorial Hospital, Linkou Medical Center Linkou Taiwan, Republic of China
| | - Youjing Zheng
- Virginia Polytechnic Institute and State University Blacksburg Virginia USA
| | - Yu‐Ting Huang
- Department of Diagnostic Radiology Chang Gung Memorial Hospital at Keelung, Chang Gung University Keelung Taiwan, Republic of China
| | - Yu‐Chao Wang
- Department of General Surgery Chang Gung Memorial Hospital Linkou Taiwan, Republic of China
| | - Chien‐Wei Peng
- Department of Gastroenterology and Hepatology Chang Gung Memorial Hospital, Linkou Medical Center Linkou Taiwan, Republic of China
| | | | - Wei‐Chen Lee
- Department of General Surgery Chang Gung Memorial Hospital Linkou Taiwan, Republic of China
| | - Ta‐Sen Yeh
- Department of General Surgery Chang Gung Memorial Hospital Linkou Taiwan, Republic of China
| | | | - Le Lu
- PAII Inc. Bethesda Maryland USA
| | - Chien‐Hung Liao
- Department of Trauma and Emergency Surgery Chang Gung Memorial Hospital at Linkou Chang Gung University Linkou Taiwan, Republic of China
- Center for Artificial Intelligence in Medicine Chang Gung Memorial Hospital Linkou, Taiwan Taiwan, Republic of China
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30
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Gonçalves E, Gonçalves-Reis M, Pereira-Leal JB, Cardoso J. DNA methylation fingerprint of hepatocellular carcinoma from tissue and liquid biopsies. Sci Rep 2022; 12:11512. [PMID: 35798798 PMCID: PMC9262906 DOI: 10.1038/s41598-022-15058-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/17/2022] [Indexed: 11/09/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is amongst the cancers with highest mortality rates and is the most common malignancy of the liver. Early detection is vital to provide the best treatment possible and liquid biopsies combined with analysis of circulating tumour DNA methylation show great promise as a non-invasive approach for early cancer diagnosis and monitoring with low false negative rates. To identify reliable diagnostic biomarkers of early HCC, we performed a systematic analysis of multiple hepatocellular studies and datasets comprising > 1500 genome-wide DNA methylation arrays, to define a methylation signature predictive of HCC in both tissue and cell-free DNA liquid biopsy samples. Our machine learning pipeline identified differentially methylated regions in HCC, some associated with transcriptional repression of genes related with cancer progression, that benchmarked positively against independent methylation signatures. Combining our signature of 38 DNA methylation regions, we derived a HCC detection score which confirmed the utility of our approach by identifying in an independent dataset 96% of HCC tissue samples with a precision of 98%, and most importantly successfully separated cfDNA of tumour samples from healthy controls. Notably, our risk score could identify cell-free DNA samples from patients with other tumours, including colorectal cancer. Taken together, we propose a comprehensive HCC DNA methylation fingerprint and an associated risk score for detection of HCC from tissue and liquid biopsies.
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Affiliation(s)
- Emanuel Gonçalves
- Ophiomics, Pólo Tecnológico de 8, R. Cupertino de Miranda 9, 1600-513, Lisbon, Portugal.,INESC-ID, 1000-029, Lisbon, Portugal
| | - Maria Gonçalves-Reis
- Ophiomics, Pólo Tecnológico de 8, R. Cupertino de Miranda 9, 1600-513, Lisbon, Portugal
| | - José B Pereira-Leal
- Ophiomics, Pólo Tecnológico de 8, R. Cupertino de Miranda 9, 1600-513, Lisbon, Portugal
| | - Joana Cardoso
- Ophiomics, Pólo Tecnológico de 8, R. Cupertino de Miranda 9, 1600-513, Lisbon, Portugal.
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31
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Spontaneous Regression of Hepatocellular Carcinoma From Autoinfarction and Implications on Liver Transplantation. ACG Case Rep J 2022; 9:e00825. [PMID: 35919413 PMCID: PMC9278951 DOI: 10.14309/crj.0000000000000825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 06/06/2022] [Indexed: 11/17/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide. Spontaneous regression of HCC due to autoinfarction is rare. This case series describes 2 cases of HCC autoinfarction that affected transplant candidacy: 1 patient previously ineligible because of tumor size and not meeting the Milan criteria became eligible after autoinfarction and tumor shrinkage while the second one was delisted in the view of improved symptoms of chronic liver disease and significant HCC regression. These cases provide an opportunity to review the pathogenesis of HCC autoinfarction and to remind practitioners of how this entity might alter decision-making around transplant eligibility.
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32
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Fernandes-Ferreira R, Tenani GD, Pinhel MADS, Abrantes AMC, Botelho MFRR, Silva RDCMAD, Souza DRS, Silva RFD. GENES EXPRESSION AND SERUM BIOMARKERS FOR DIAGNOSIS OF HEPATOCELLULAR CARCINOMA, CIRRHOSIS AND HEPATITIS C. ARQUIVOS DE GASTROENTEROLOGIA 2022; 59:394-401. [PMID: 36102438 DOI: 10.1590/s0004-2803.202203000-71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the most common type of liver cancer. Risk factors for HCC include hepatitis C (HCV) and B (HBV) virus infection, alcoholic cirrhosis and genetic alterations that can affect several cellular pathways. OBJECTIVE This study purposed to analyze the gene and serum protein expression of vascular endothelial growth factor (VEGF), angiogenesis, alpha fetoprotein, cystatin B (CSTB), β-catenin and glypican-3 (GPC3) in groups with HCC, cirrhosis or HCV and controls, and their relation with clinical staging in the HCC and cirrhosis groups, as well its sensitivity and specificity values. METHODS A total of 230 individuals were distributed in Group 1 (G1) - 80 patients with HCC; Group 2 (G2) - 76 patients with cirrhosis due to any etiology; Group 3 (G3) - 33 patients with HCV; Group 4 (G4 - controls) - 41 individuals without clinical or biochemical signs of any liver disease. Gene expression was analyzed by qRT-PCR and serum proteins were performed using the ELISA method. RESULTS Increased VEGF and angiogenesis, alpha fetoprotein expression could be observed in BCLC stage-D patients compared to stage-B patients, and stage-C patients showed higher expression of β-catenin, compared to stage-B patients (P<0.05). For VEGF and GPC3, discriminatory power was observed between HCC patients and controls (AUC =0.71; 0.82, respectively). CSTB showed discriminatory power in the comparison between patients with HCV and controls (AUC =0.74). CONCLUSION The present study confirms the sensitivity of serum CSTB in the diagnosis of hepatitis C, and gene expression of VEGF and serum GPC3, confer both sensitivity and specificity for the diagnosis of HCC.
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Affiliation(s)
- Rafael Fernandes-Ferreira
- Faculdade de Medicina de São José do Rio Preto, Departamento de Biologia Molecular, São José do Rio Preto, SP, Brasil
- Universidade Paulista, Instituto de Ciências da Saúde, São José do Rio Preto, SP, Brasil
- Universidade de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | - Graciele Domitila Tenani
- Faculdade de Medicina de São José do Rio Preto, Departamento de Biologia Molecular, São José do Rio Preto, SP, Brasil
| | | | | | | | | | - Dorotéia Rossi Silva Souza
- Faculdade de Medicina de São José do Rio Preto, Departamento de Biologia Molecular, São José do Rio Preto, SP, Brasil
| | - Renato Ferreira da Silva
- Faculdade de Medicina de São José do Rio Preto, Departamento de Biologia Molecular, São José do Rio Preto, SP, Brasil
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33
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Gilles H, Garbutt T, Landrum J. Hepatocellular Carcinoma. Crit Care Nurs Clin North Am 2022; 34:289-301. [DOI: 10.1016/j.cnc.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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34
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Chauhan D, Kumar Y, Chandra R, Kumar S. 2D transparent few-layered hydrogen substituted graphdiyne nano-interface for unprecedented ultralow ANXA2 cancer biomarker detection. Biosens Bioelectron 2022; 213:114433. [PMID: 35696865 DOI: 10.1016/j.bios.2022.114433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/02/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022]
Abstract
Herein, we report synthesis of 2D few-layered transparent hydrogen substituted graphdiyne (HsGDY) nanosheets and explored its electrochemical characteristics for the first time to develop a nano-interface for cancer biomarker detection [liver cancer (LC) biomarker; ANXA2]. The semiconducting HsGDY (band gap; 1.98 eV) contains considerable number of sp and sp2 hybridised π-electrons with abundant hierarchical pores, thus reveals a negative peripheral charge and high surface area respectively, making it competent to immobilize mass anti-ANXA2 antibodies. The nano-interface platform is fabricated through electrophoretic deposition of HsGDY onto indium tin oxide (ITO) coated glass substrate (50V, 60s) with subsequent immobilization of anti-ANXA2 biomolecules and bovine serum albumin (BSA) to minimize non-specific binding. The pristine HsGDY and fabricated electrodes were characterized using spectroscopic, microscopic, zetasizer, surface area and pore size analyzer as well as electrochemical techniques. The electrochemical response of fabricated HsGDY nano-interface based biosensing platform (BSA/anti-ANXA2/HsGDY/ITO) is investigated via cyclic voltammetry (CV) and differential pulse voltammetry (DPV) techniques, which covers a wider linear detection range in between 0.01 fg mL-1 to 1000 ng mL-1 along with an exceptional sensitivity of 13.8 μA [log (ng mL-1)]-1 cm-2 and 2.8 μA [log (ng mL-1)]-1 cm-2 via CV and DPV techniques, respectively. This developed biosensor has the ability for unprecedented ultralow level i.e., upto 3 molecules of ANXA2 cancer biomarker detection. Moreover, the obtained electrochemical results show excellent correlation with the concentration of ANXA2 cancer biomarker present in LC patients obtained through enzyme linked immunosorbent assay (ELISA) technique.
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Affiliation(s)
- Dipti Chauhan
- Department of Chemistry, University of Delhi, Delhi-110007, India
| | - Yogesh Kumar
- Department of Chemistry, University of Delhi, Delhi-110007, India
| | - Ramesh Chandra
- Institute of Nano Medical Sciences, University of Delhi, Delhi-110007, India.
| | - Suveen Kumar
- Department of Chemistry, University of Delhi, Delhi-110007, India.
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35
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Chan HLY, Vogel A, Berg T, De Toni EN, Kudo M, Trojan J, Eiblmaier A, Klein H, Hegel JK, Sharma A, Madin K, Rolny V, Lisy M, Piratvisuth T. Performance evaluation of the Elecsys
PIVKA‐II
and Elecsys AFP assays for hepatocellular carcinoma diagnosis. JGH Open 2022; 6:292-300. [PMID: 35601131 PMCID: PMC9120909 DOI: 10.1002/jgh3.12720] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 12/12/2022]
Abstract
Background and Aims Prothrombin induced by vitamin K absence‐II (PIVKA‐II) is a serum biomarker linked to hepatocellular carcinoma (HCC), showing superiority to alpha‐fetoprotein (AFP) for early disease detection. We aimed to assess the clinical and analytical performance of the Elecsys® PIVKA‐II immunoassay in diagnosing HCC and evaluate PIVKA‐II's technical performance. Methods Serum samples from adult cases (i.e. patients with a first‐time HCC diagnosis; n = 168) and disease controls (i.e. patients without HCC with an at‐risk condition; n = 208) were assessed. An AFP cut‐off of 20 ng/mL was used to differentiate between HCC cases and disease controls. Clinical performance of the Elecsys PIVKA‐II assay was compared with that of comparator assays (Lumipulse G PIVKA‐II, μTASWako DCP, ARCHITECT PIVKA‐II) using receiver operating characteristic curve analysis to determine the area under the curve (AUC) values. Results The Elecsys PIVKA‐II assay compared favorably with comparator assays. Using a 28.4 ng/mL cut‐off, the Elecsys PIVKA‐II assay detected HCC with 86.9% sensitivity and 83.7% specificity. Clinical performance of the Elecsys PIVKA‐II assay (AUC: 90.8%) was equivalent to that of comparator assays (AUC: 88.3–89.6%). Relatively high PIVKA‐II concentrations were observed for cholangiocarcinoma and pancreatic cancer with the Elecsys assay in specificity panel analyses, indicating that high PIVKA‐II concentrations should not be used alone in the absence of other clinical data. Conclusions The Elecsys PIVKA‐II assay showed good analytical performance under routine laboratory conditions, comparing favorably with comparator assays. These findings support the suitability of the Elecsys PIVKA‐II assay as an aid in HCC diagnosis.
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Affiliation(s)
- Henry L Y Chan
- Faculty of Medicine The Chinese University of Hong Kong Hong Kong China
| | - Arndt Vogel
- Clinic for Gastroenterology, Hepatology and Endocrinology Medizinische Hochschule Hannover Hannover Germany
| | - Thomas Berg
- Division of Hepatology, Department of Medicine II Leipzig University Medical Center Leipzig Germany
| | - Enrico N De Toni
- Department of Medicine II University Hospital, Ludwig Maximilian University of Munich Munich Germany
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine Osaka Japan
| | - Jörg Trojan
- Department of Gastrointestinal Oncology Goethe Universitat Frankfurt Frankfurt Germany
| | - Anja Eiblmaier
- Laboratory Services Microcoat Biotechnologie GmbH Bernried Germany
| | | | - Johannes Kolja Hegel
- Studies, Collaborations, and Innovation Management Labor Berlin Charité Vivantes Services GmbH Berlin Germany
| | - Ashish Sharma
- Global Medical and Scientific Affairs Roche Diagnostics International Ltd Rotkreuz Switzerland
| | - Kairat Madin
- Global Study Management Roche Diagnostics GmbH Penzberg Germany
| | - Vinzent Rolny
- New Technology Statistics Roche Diagnostics GmbH Penzberg Germany
| | - Marcus‐Rene Lisy
- Research and Development Roche Diagnostics GmbH Penzberg Germany
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36
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Lee T, Rawding PA, Bu J, Hyun S, Rou W, Jeon H, Kim S, Lee B, Kubiatowicz LJ, Kim D, Hong S, Eun H. Machine-Learning-Based Clinical Biomarker Using Cell-Free DNA for Hepatocellular Carcinoma (HCC). Cancers (Basel) 2022; 14:cancers14092061. [PMID: 35565192 PMCID: PMC9103537 DOI: 10.3390/cancers14092061] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 02/08/2023] Open
Abstract
Simple Summary Circulating cell-free DNA (cfDNA) has attracted a great deal of scientific interest as a predictive biomarker for the diagnosis and prognosis of hepatocellular carcinoma (HCC). HCC result in high mortality due to the absence of blood biomarkers for early diagnosis and prognosis. We established cfDHCC as a new scoring system by applying a machine learning algorithm that integrates the expression profiles of cfDNA. Based on this, it was possible to accurately predict the clinico-pathological characteristics of patients with HCC as well as improve their survival. Abstract (1) Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide. Although various serum enzymes have been utilized for the diagnosis and prognosis of HCC, the currently available biomarkers lack the sensitivity needed to detect HCC at early stages and accurately predict treatment responses. (2) Methods: We utilized our highly sensitive cell-free DNA (cfDNA) detection system, in combination with a machine learning algorithm, to provide a platform for improved diagnosis and prognosis of HCC. (3) Results: cfDNA, specifically alpha-fetoprotein (AFP) expression in captured cfDNA, demonstrated the highest accuracy for diagnosing malignancies among the serum/plasma biomarkers used in this study, including AFP, aspartate aminotransferase, alanine aminotransferase, albumin, alkaline phosphatase, and bilirubin. The diagnostic/prognostic capability of cfDNA was further improved by establishing a cfDNA score (cfDHCC), which integrated the total plasma cfDNA levels and cfAFP-DNA expression into a single score using machine learning algorithms. (4) Conclusion: The cfDHCC score demonstrated significantly improved accuracy in determining the pathological features of HCC and predicting patients’ survival outcomes compared to the other biomarkers. The results presented herein reveal that our cfDNA capture/analysis platform is a promising approach to effectively utilize cfDNA as a biomarker for the diagnosis and prognosis of HCC.
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Affiliation(s)
- Taehee Lee
- Department of Biomedical Laboratory Science, Daegu Health College, Daegu 41453, Korea;
- Department of Senior Healthcare, Graduate School, Eulji University, Uijeongbu-si 11759, Korea;
| | - Piper A. Rawding
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin—Madison, Madison, WI 53705, USA; (P.A.R.); (J.B.); (L.J.K.); (D.K.)
- Wisconsin Center for NanoBioSystems (WisCNano), University of Wisconsin—Madison, Madison, WI 53705, USA
| | - Jiyoon Bu
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin—Madison, Madison, WI 53705, USA; (P.A.R.); (J.B.); (L.J.K.); (D.K.)
- Wisconsin Center for NanoBioSystems (WisCNano), University of Wisconsin—Madison, Madison, WI 53705, USA
- Department of Biological Sciences and Bioengineering, Inha University, Incheon 22212, Korea
- Industry-Academia Interactive R&E Center for Bioprocess Innovation, Inha University, Incheon 22212, Korea
| | - Sunghee Hyun
- Department of Senior Healthcare, Graduate School, Eulji University, Uijeongbu-si 11759, Korea;
| | - Woosun Rou
- Department of Internal Medicine, Chungnam National University Sejong Hospital (CNUSH), Sejong 30099, Korea; (W.R.); (H.J.)
| | - Hongjae Jeon
- Department of Internal Medicine, Chungnam National University Sejong Hospital (CNUSH), Sejong 30099, Korea; (W.R.); (H.J.)
| | - Seokhyun Kim
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Korea; (S.K.); (B.L.)
| | - Byungseok Lee
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Korea; (S.K.); (B.L.)
| | - Luke J. Kubiatowicz
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin—Madison, Madison, WI 53705, USA; (P.A.R.); (J.B.); (L.J.K.); (D.K.)
| | - Dawon Kim
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin—Madison, Madison, WI 53705, USA; (P.A.R.); (J.B.); (L.J.K.); (D.K.)
- Wisconsin Center for NanoBioSystems (WisCNano), University of Wisconsin—Madison, Madison, WI 53705, USA
| | - Seungpyo Hong
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin—Madison, Madison, WI 53705, USA; (P.A.R.); (J.B.); (L.J.K.); (D.K.)
- Wisconsin Center for NanoBioSystems (WisCNano), University of Wisconsin—Madison, Madison, WI 53705, USA
- Yonsei Frontier Lab, Department of Pharmacy, Yonsei University, Seoul 03722, Korea
- Correspondence: (S.H.); (H.E.); Tel.: +82-42-280-7418 (H.E.)
| | - Hyuksoo Eun
- Yonsei Frontier Lab, Department of Pharmacy, Yonsei University, Seoul 03722, Korea
- Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Korea
- Correspondence: (S.H.); (H.E.); Tel.: +82-42-280-7418 (H.E.)
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van Aalen EA, Wouters SFA, Verzijl D, Merkx M. Bioluminescent RAPPID Sensors for the Single-Step Detection of Soluble Axl and Multiplex Analysis of Cell Surface Cancer Biomarkers. Anal Chem 2022; 94:6548-6556. [PMID: 35438976 PMCID: PMC9069438 DOI: 10.1021/acs.analchem.2c00297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
![]()
Early diagnosis of
cancer is essential for the efficacy of treatment.
Our group recently developed RAPPID, a bioluminescent immunoassay
platform capable of measuring a wide panel of biomarkers directly
in solution. Here, we developed and systematically screened different
RAPPID sensors for sensitive detection of the soluble fraction of
Axl (sAxl), a cell surface receptor that is overexpressed in several
types of cancer. The best-performing RAPPID sensor, with a limit of
detection of 8 pM and a >9-fold maximal change in
emission
ratio, was applied to measure Axl in three different contexts: clinically
relevant sAxl levels (∼0.5 and ∼1 nM) in diluted blood
plasma, proteolytically cleaved Axl in the cell culture medium of
A431 and HeLa cancer cells, and Axl on the membrane of A431 cells.
We further extended the sensor toolbox by developing dual-color RAPPID
for simultaneous detection of Axl and EGFR on A431 and HeLa cells,
as well as an AND-gate RAPPID that measures the concurrent presence
of these two cell surface receptors on the same cell. These new RAPPID
sensors provide attractive alternatives for more laborious protein
detection and quantification methods such as FACS and immunostainings,
due to their simple practical implantation and low intrinsic background
signal.
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Affiliation(s)
- Eva A van Aalen
- Laboratory of Chemical Biology, Department of Biomedical Engineering, Eindhoven University of Technology, P.O Box 513, 5600 MB Eindhoven, The Netherlands.,Institute for Complex Molecular Systems, Eindhoven University of Technology, P.O Box 513, 5600 MB Eindhoven, The Netherlands
| | - Simone F A Wouters
- Laboratory of Chemical Biology, Department of Biomedical Engineering, Eindhoven University of Technology, P.O Box 513, 5600 MB Eindhoven, The Netherlands.,Institute for Complex Molecular Systems, Eindhoven University of Technology, P.O Box 513, 5600 MB Eindhoven, The Netherlands
| | | | - Maarten Merkx
- Laboratory of Chemical Biology, Department of Biomedical Engineering, Eindhoven University of Technology, P.O Box 513, 5600 MB Eindhoven, The Netherlands.,Institute for Complex Molecular Systems, Eindhoven University of Technology, P.O Box 513, 5600 MB Eindhoven, The Netherlands
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Thi Cam Huong N, Trung NQ, Luong BA, Tram DB, Vu HA, Bui HH, Pham Thi Le H. Mutations in the HBV PreS/S gene related to hepatocellular carcinoma in Vietnamese chronic HBV-infected patients. PLoS One 2022; 17:e0266134. [PMID: 35390033 PMCID: PMC8989215 DOI: 10.1371/journal.pone.0266134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/15/2022] [Indexed: 12/23/2022] Open
Abstract
Background Chronic hepatitis B virus (CHB) infection is a major health problem and leading cause of hepatocellular carcinoma (HCC) worldwide. Several point and deletion mutations on the PreS/S gene have been intensively considered associated with HCC. This study aimed to describe the characteristics of HBV PreS/S mutations in Vietnamese CHB-infected patients and their association with HCC. Methods This cross-sectional study was conducted from 02/2020 to 03/2021, recruited Vietnamese CHB-infected patients with HBV-DNA >3 log10-copies/mL and successful PreS/S gene sequencing. Mutations were detected by direct Sanger sequencing. Results 247 CHB-infected patients were recruited, characterized by 68.8% males, 54.7% HBV genotype B, 57.5% HBeAg positive, 23.1% fibrosis score ≥F3 and 19.8% HCC. 61.8% amino acid replacements were detected throughout the PreS1/PreS2/S genes. The most common point-mutations included N/H51Y/T/S/Q/P (30.4%), V68T/S/I (44.9%), T/N87S/T/P (46.2%) on PreS1 gene; T125S/N/P (30.8%), I150T (42.5%) on PreS2 gene; S53L (37.7%), A184V/G (39.3%), S210K/N/R/S (39.3%) on S gene. The rates of case(s) with any point-mutation on the Major Hydrophylic Region (MHR) and the "a" determinant region were 63.6% and 39.7%, respectively. Most of S point-mutations were presented with low rates such as T47A/E/V/K (9.3%), P120S/T (8.5%), G145R (2%). On multivariable analysis, males (OR = 4.51, 95%CI 1.78–11.4, p = 0.001), age≥40 (OR = 5.5, 95%CI 2.06–14.68, p = 0.001), W4P/R/Y on PreS1 (OR = 11.56, 95%CI 1.99–67.05, p = 0.006) and 4 S point-mutations as: T47A/E/V/K (OR = 3.67, 95%CI 1.19–11.29, p = 0.023), P120S/T (OR = 3.38, 95%CI 1.09–10.49, p = 0.035), S174N (OR = 29.73, 95%CI 2.12–417.07, p = 0.012), P203R (OR = 8.45, 95%CI 1.43–50.06, p = 0.019) were associated with HCC. Conclusions We detected 61% amino acid changes on PreS/S regions in Vietnamese CHB patients. One point-mutation at amino acid 4 on PreS1 gene and 4 point-mutations at amino acids 47, 120, 174, and 203 on S gene were associated with HCC. Further investigations are recommended to further clarify the relationship and interaction between mutations in HBV genome and HCC progression.
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Affiliation(s)
- Nguyen Thi Cam Huong
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam
- * E-mail:
| | - Nguyen Quang Trung
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam
| | - Bac An Luong
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Duong Bich Tram
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hoang Anh Vu
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hoang Huu Bui
- Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam
| | - Hoa Pham Thi Le
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam
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El-shaarawy F, Abo ElAzm MM, Mohamed RH, Radwan MI, Abo-Elmatty DM, Mehanna ET. Relation of the methylation state of RUNX3 and p16 gene promoters with hepatocellular carcinoma in Egyptian patients. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00256-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy of adults. RUNX3 and p16 are tumor suppressor genes that may be inactivated by hypermethylation which is a key epigenetic mechanism that contributes to the initiation and progression of various types of human carcinomas including HCC. The aim of this study was to assess the association of hypermethylation of RUNX3 and p16 gene promoters with the incidence of HCC in Egyptian patients. The study included 120 subjects: 30 HCC patients, 30 patients with hepatitis C virus (HCV) without cirrhosis, 30 cirrhotic patients, and 30 healthy volunteers. Methylation-specific polymerase chain reaction (PCR) was done for detection of hypermethylated p16 and RUNX3. Serum levels of liver enzymes and albumin were detected spectrophotometrically and alpha fetoprotein (AFP) was measured in serum by ELISA.
Results
Methylation of RUNX3 and p16 was detected in 25/30 (83.3%) and 26/30 (86.7%) of HCC patients, respectively. The methylation state of both RUNX3 and p16 genes was significantly higher in HCC patients compared to the control subjects (P = 0.016, OR = 4.38) and (P = 0.014, OR = 4.97), respectively. The methylation of both promoters was associated with higher AFP levels in the serum of all patients.
Conclusions
Hypermethylation of RUNX3 and p16 is significantly associated with the development of HCC and may be implicated in its pathogenesis.
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Diao S, Tian Y, Hu W, Hou J, Lambo R, Zhang Z, Xie Y, Nie X, Zhang F, Racoceanu D, Qin W. Weakly Supervised Framework for Cancer Region Detection of Hepatocellular Carcinoma in Whole-Slide Pathologic Images Based on Multiscale Attention Convolutional Neural Network. THE AMERICAN JOURNAL OF PATHOLOGY 2022; 192:553-563. [PMID: 34896390 DOI: 10.1016/j.ajpath.2021.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 06/14/2023]
Abstract
Visual inspection of hepatocellular carcinoma cancer regions by experienced pathologists in whole-slide images (WSIs) is a challenging, labor-intensive, and time-consuming task because of the large scale and high resolution of WSIs. Therefore, a weakly supervised framework based on a multiscale attention convolutional neural network (MSAN-CNN) was introduced into this process. Herein, patch-based images with image-level normal/tumor annotation (rather than images with pixel-level annotation) were fed into a classification neural network. To further improve the performances of cancer region detection, multiscale attention was introduced into the classification neural network. A total of 100 cases were obtained from The Cancer Genome Atlas and divided into 70 training and 30 testing data sets that were fed into the MSAN-CNN framework. The experimental results showed that this framework significantly outperforms the single-scale detection method according to the area under the curve and accuracy, sensitivity, and specificity metrics. When compared with the diagnoses made by three pathologists, MSAN-CNN performed better than a junior- and an intermediate-level pathologist, and slightly worse than a senior pathologist. Furthermore, MSAN-CNN provided a very fast detection time compared with the pathologists. Therefore, a weakly supervised framework based on MSAN-CNN has great potential to assist pathologists in the fast and accurate detection of cancer regions of hepatocellular carcinoma on WSIs.
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Affiliation(s)
- Songhui Diao
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Shenzhen College of Advanced Technology, University of Chinese Academy of Science, Shenzhen, China
| | - Yinli Tian
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; School of Microelectronics and Communication Engineering, Chongqing University, Chongqing, China
| | - Wanming Hu
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jiaxin Hou
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Shenzhen College of Advanced Technology, University of Chinese Academy of Science, Shenzhen, China
| | - Ricardo Lambo
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zhicheng Zhang
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Yaoqin Xie
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Shenzhen College of Advanced Technology, University of Chinese Academy of Science, Shenzhen, China
| | - Xiu Nie
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fa Zhang
- Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Daniel Racoceanu
- Sorbonne Université, Paris Brain Institute-Institut du Cerveau-ICM, Institut National de Santé et en Recherche Médicale, Centre National de Recherche Scientifique, Assistance Publique Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Wenjian Qin
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Shenzhen College of Advanced Technology, University of Chinese Academy of Science, Shenzhen, China.
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Turshudzhyan A, Wu GY. Persistently Rising Alpha-fetoprotein in the Diagnosis of Hepatocellular Carcinoma: A Review. J Clin Transl Hepatol 2022; 10:159-163. [PMID: 35233385 PMCID: PMC8845163 DOI: 10.14218/jcth.2021.00176] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/19/2021] [Accepted: 09/15/2021] [Indexed: 12/04/2022] Open
Abstract
Hepatocellular carcinoma (HCC), one of the most common malignant tumors worldwide, is known for its grim prognosis, with untreated life expectancy being only a matter of months after the diagnosis. The difficulty in making a diagnosis early is one of the main contributing factors to the poor prognosis. Alpha-fetoprotein (AFP) had long been used as a surveillance tool, but suboptimal specificity and sensitivity has prompted liver societies to abandon the recommendation for its universal use, even in combination with ultrasonography. Most studies have shown no obvious correlation between serum AFP level and HCC tumor size, stage, or survival post-diagnosis. However, some studies concluded that a gradual rise or persistent elevation in AFP were positive predictors for tumor development. Other studies reported a fall in AFP followed by a rise in patients with HCC as well as persistently rising AFP levels without development of HCC on follow up. Our calculation of the sensitivity and specificity of persistently rising AFP for HCC were both low, at 60% and 35.8%, respectively, indicating that the presence of persistently rising AFP per se did not offer diagnostic benefit. In addition, our calculated mean slopes of persistently rising AFP levels in HCC and non-HCC patients were numerically very different, but the difference was not statistically significant. We conclude that the published data do not support a role for rising AFP levels per se in the diagnosis of HCC.
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Affiliation(s)
- Alla Turshudzhyan
- Correspondence to: Alla Turshudzhyan, Department of Medicine, Division of Gastroenterology and Hepatology. University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06032, USA. ORCID: https://orcid.org/0000-0001-6867-7569. Tel: +1-860-679-6296, Fax: +1-860-679-6582, E-mail:
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Mbaga DS, Kenmoe S, Kengne-Ndé C, Ebogo-Belobo JT, Mahamat G, Foe-Essomba JR, Amougou-Atsama M, Tchatchouang S, Nyebe I, Feudjio AF, Kame-Ngasse GI, Magoudjou-Pekam JN, Fokou LKM, Meta-Djomsi D, Maïdadi-Foudi M, Touangnou-Chamda SA, Daha-Tchoffo AG, Selly-Ngaloumo AA, Nayang-Mundo RA, Yéngué JF, Taya-Fokou JB, Kenfack-Momo R, Atembeh Noura E, Demeni Emoh CP, Tazokong HR, Bowo-Ngandji A, Sake CS, Atenguena Okobalemba E, Njiki Bikoi J, Njouom R, Riwom Essama SH. Hepatitis B, C and D virus infections and risk of hepatocellular carcinoma in Africa: A meta-analysis including sensitivity analyses for studies comparable for confounders. PLoS One 2022; 17:e0262903. [PMID: 35061846 PMCID: PMC8782350 DOI: 10.1371/journal.pone.0262903] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 01/09/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction Africa denotes unique facies for hepatocellular carcinoma (HCC) characterized by a conjunction of low sensitization, restricted access to diagnosis and treatment and associated with the highest incidence and mortality in the world. We investigated whether hepatitis B (HBV), C (HCV) and D (VHD) viruses were etiological agents of HCC in Africa. Methods Relevant articles were searched in PubMed, Web of Science, African Index Medicus, and African Journal Online databases, as well as manual searches in relevant reviews and included articles. Analytical studies from Africa evaluating the association between HCC development and HBV, HCV, and HDV were included. Relevant studies were selected, data extracted, and the risk of bias assessed independently by at least 2 investigators. The association was estimated using odds ratios (OR) and their 95% confidence interval (95% CI) determined by a random-effects model. Sources of heterogeneity were determined by subgroup analyses. Results A total of 36 case-control studies were included. With controls having non-hepatic disease, the overall results suggested a significantly increased risk of HCC in patients with HBV (HBeAg (OR = 19.9; 95% CI = [3.7–105.2]), HBsAg (OR = 9.9; 95%) CI = [6.2–15.6]) and DNA (OR = 8.9; 95% CI = [5.9–13.4]); HCV (Anti-HCV (OR = 9.4; 95% CI = [6.3–14.0]) and RNA (OR = 16.5; 95% CI = [7.8–34.6]); HDV (Anti-VHD, (OR = 25.8; 95% CI = [5.9–112.2]); and HBV/HCV coinfections (HBV DNA/HCV RNA (OR = 22.5; 95% CI = [1.3–387.8]). With apparently healthy controls, the overall results suggested a significantly increased risk of HCC in patients with HBV (HBsAg, (OR = 8.9; 95% CI = [6.0–13.0]); HCV (Anti-HCV, (OR = 7.7; 95% CI = [5.6–10.6]); and HBV/HCV coinfections (HBsAg/Anti-HCV (OR = 7.8; 95% CI = [4.4–13.6]) Substantial heterogeneity and the absence of publication bias were recorded for these results. Conclusions In Africa, HBV/HCV coinfections and HBV, HCV, and HDV infections are associated with an increased risk of developing HCC. The implementation of large-scale longitudinal and prospective studies including healthy participants to search for early biomarkers of the risk of progression to HCC is urgently needed.
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Affiliation(s)
- Donatien Serge Mbaga
- Department of Microbiology, The University of Yaounde I, Yaoundé, Cameroon
- * E-mail: (DSM); (SK)
| | - Sebastien Kenmoe
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
- * E-mail: (DSM); (SK)
| | - Cyprien Kengne-Ndé
- Evaluation and Research Unit, National AIDS Control Committee, Yaoundé, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Gadji Mahamat
- Department of Microbiology, The University of Yaounde I, Yaoundé, Cameroon
| | | | - Marie Amougou-Atsama
- Centre de Recherche sur les Maladies Émergentes et Re-Emergentes, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | | | - Inès Nyebe
- Department of Microbiology, The University of Yaounde I, Yaoundé, Cameroon
| | | | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | | | | | - Dowbiss Meta-Djomsi
- Centre de Recherche sur les Maladies Émergentes et Re-Emergentes, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Martin Maïdadi-Foudi
- Centre de Recherche sur les Maladies Émergentes et Re-Emergentes, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | | | | | | | | | | | | | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaoundé, Cameroon
| | - Efietngab Atembeh Noura
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | | | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaoundé, Cameroon
| | | | | | - Jacky Njiki Bikoi
- Department of Microbiology, The University of Yaounde I, Yaoundé, Cameroon
| | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
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Mohamed AA, Zaghloul RA, Abdelghany AM, El Gayar AM. Selenium nanoparticles and quercetin suppress thioacetamide-induced hepatocellular carcinoma in rats: Attenuation of inflammation involvement. J Biochem Mol Toxicol 2022; 36:e22989. [PMID: 35179263 DOI: 10.1002/jbt.22989] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/10/2021] [Accepted: 01/05/2022] [Indexed: 12/14/2022]
Abstract
The current study investigates the anti-inflammatory and hepatoprotective effects of selenium (Se) formulated as nanoparticles (SeNPs) and in combination with quercetin (QCT) against thioacetamide (TAA)-induced hepatocellular carcinoma (HCC) in rats. Seventy-two male Sprague-Dawley rats were divided into six groups (n = 12). Three control groups; normal, SeNPs; group received SeNPs only and HCC; group received TAA. In addition, three preventive groups; SeNPs + TAA, QCT + TAA, and QCT + SeNPs + TAA. Induction of HCC was detected histopathologically and by the raise of the serum level of alpha-fetoprotein (AFP). Oxidative stress was evaluated by the hepatic levels of reduced glutathione (GSH), glutathione peroxidase (GPx), and malondialdehyde (MDA) spectrophotometrically. The oncogenic pathway of p53/β-catenin/cyclin D1 was assessed by immunohistochemistry. The inflammatory markers; interleukin-33 (IL-33), IL-6, and IL-1β were assessed by enzyme-linked immune sorbent assay. SeNPs prevented the elevation of serum AFP and hepatic IL-33, IL-1β, and IL-6 in comparison to HCC or QCT + TAA groups. SeNPs + TAA exhibited a lower positive hepatic staining of p53, β-catenin, and cyclin D1 in comparison to HCC or QCT + TAA groups. Moreover, SeNPs improved the overall oxidative balance indicated by low hepatic MDA and enhanced GSH and GPx when compared to HCC or QCT + TAA groups. SeNPs alone and in combination with QCT were found to suppress the progression of HCC in rats via the enhancement of the oxidative stress and then inflammatory status and the prevention of the deregulation of the oncogenic axis pathway of p53/β-catenin/cyclin D.
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Affiliation(s)
- Ahmed A Mohamed
- Department of Biochemistry, Faculty of Pharmacy, Sinai University, Cairo, Egypt.,Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Randa A Zaghloul
- Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Amr M Abdelghany
- Department of Spectroscopy, Physics Division, National Research Center, Giza, Egypt
| | - Amal M El Gayar
- Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
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Gibriel AA, Ismail MF, Sleem H, Zayed N, Yosry A, El-Nahaas SM, Shehata NI. Diagnosis and staging of HCV associated fibrosis, cirrhosis and hepatocellular carcinoma with target identification for miR-650, 552-3p, 676-3p, 512-5p and 147b. Cancer Biomark 2022; 34:413-430. [DOI: 10.3233/cbm-210456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND: Chronic HCV infection progresses to fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The latter represents the third most common cause for cancer mortality. Currently, there is no reliable non-invasive biomarker for diagnosis of HCV mediated disorders. OBJECTIVE: Profiling expression signature for circulatory miRNAs in the plasma of 167 Egyptian patients (40 healthy, 48 HCV fibrotic, 39 HCV cirrhotic and 40 HCV-HCC cases). METHODS: QRTPCR was used to quantify expression signature for circulatory miRNAs. RESULTS: MiR-676 and miR-650 were powerful in discriminating cirrhotic and late fibrosis from HCC. MiR-650 could distinguish mild (f0-f1) and advanced (f2-f3) fibrosis from HCC cases. MiR-650 and miR-147b could distinguish early fibrosis from healthy controls meanwhile miR-676 and miR-147b could effectively distinguish between mild chronic and (f1-f3) cases from healthy individuals. All studied miRNAs, except miR-512, can differentiate between (f0-f3) cases and healthy controls. Multivariate logistic regression revealed three potential miRNA panels for effective differentiation of HCC, cirrhotic and chronic liver cases. MiR-676-3p and miR-512-5p were significantly correlated in (f1-f3) fibrosis meanwhile miR-676 and miR-512 could differentiate between cirrhosis and (f0-f3) cases. Both miR-650 and miR-512-5p were positively correlated in the cirrhotic group and in (f0-f4) group. Putative targets for investigated miRNAs were also determined. CONCLUSIONS: Investigated miRNAs could assist in staging and diagnosis of HCV associated disorders.
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Affiliation(s)
- Abdullah Ahmed Gibriel
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, The British University in Egypt (BUE), Cairo, Egypt
| | - Manal Fouad Ismail
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Hameis Sleem
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, The British University in Egypt (BUE), Cairo, Egypt
| | - Naglaa Zayed
- Endemic Medicine Department and Hepatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Yosry
- Endemic Medicine Department and Hepatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Saeed M. El-Nahaas
- Endemic Medicine Department and Hepatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
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Choucair K, Kamran S, Saeed A. Clinical Evaluation of Ramucirumab for the Treatment of Hepatocellular Carcinoma (HCC): Place in Therapy. Onco Targets Ther 2022; 14:5521-5532. [PMID: 35002257 PMCID: PMC8721285 DOI: 10.2147/ott.s268309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
Hepatocellular carcinoma remains one of the leading causes of death from cancer worldwide as most cases are diagnosed at an advanced disease stage. Ramucirumab, a human anti-VEGFR-2 monoclonal antibody, is approved as a monotherapy for the treatment of patients with hepatocellular carcinoma and α-fetoprotein levels ≥400 ng/mL previously treated with sorafenib. As most patients present with an advanced disease, patients with α-fetoprotein levels ≥400 ng/mL have an aggressive disease and a poor prognosis, making ramucirumab an important treatment option for this subgroup of patients. This article provides a comprehensive review of the clinical efficacy of ramucirumab as highlighted in the two major trials that lead to its approval. We also briefly review the agent pharmacologic properties, as well as its safety and toxicity profile, before discussing certain limitations and challenges associated with ramucirumab use. Finally, we review completed and ongoing clinical trials and focus on those involving ramucirumab-based combinations, namely with immune therapy.
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Affiliation(s)
- Khalil Choucair
- Department of Medicine, Kansas University School of Medicine, Wichita, KS, USA
| | - Syed Kamran
- Department of Medicine, Kansas University School of Medicine, Wichita, KS, USA
| | - Anwaar Saeed
- Department of Medicine, Division of Medical Oncology, Kansas University Cancer Center, Kansas City, KS, USA
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Thida C, Pokhrel A, Sun L, Wu R, Jaswani V, Wang JC. Hemorrhagic Brain Metastasis as an Initial Presentation of Hepatocellular Carcinoma in a Patient With Alcohol-Related Liver Cirrhosis: A Case Report and Review of Literature. J Investig Med High Impact Case Rep 2022; 10:23247096221117788. [PMID: 35975720 PMCID: PMC9527531 DOI: 10.1177/23247096221117788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary hepatic cancer.
Although it usually presents as a liver mass, rarely HCC can have an initial
presentation at an extrahepatic site before the diagnosis of the primary lesion
in the liver. Even rarely was that brain metastasis as initial extrahepatic
presentations. Furthermore, the initial presentation of HCC as brain metastases
has been with most cases being secondary to hepatitis-related hepatoma. In this
case report, we are presenting a rare and unusual case of hemorrhagic cerebral
metastasis as an initial extrahepatic presentation of an alcohol-related
hepatoma. Our case is the second case in the English literature that has been
presented in such a way. Due to the uncommonness of presentation, there can be
diagnostic dilemmas and delay in treatment. Therefore, a high level of suspicion
is needed in the high-risk patients of HCC who present with unexplained or new
neurological signs and symptoms. More exploration is warranted for clinical
research and treatment guidelines for brain metastases of HCC to help improve
survival and quality of life.
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Affiliation(s)
- Chan Thida
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Akriti Pokhrel
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Lishi Sun
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Richard Wu
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Vijay Jaswani
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Jen C. Wang
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
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Elghoroury EA, Abdelghaffar EE, Awadallah E, Kamel SA, Kandil D, Hassan EM, Hassan M, Kamel MM, Gomaa MM, Fathalla LA. Detection of exosomal miR-18a and miR-222 levels in Egyptian patients with hepatic cirrhosis and hepatocellular carcinoma. Int J Immunopathol Pharmacol 2022; 36:3946320221097832. [PMID: 35467432 PMCID: PMC9047801 DOI: 10.1177/03946320221097832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is known to be the second leading cause of cancer-related mortality worldwide. For improving the prognosis as well as reducing the rate of mortality, early diagnosis of HCC is a must. AIMS This study was conducted to assess the ability of the serum expression of exosomal miR-18a and miR-222 to differentiate and diagnose patients with HCC, patients with liver cirrhosis, and healthy controls. METHODS This study included 51 patients with liver cirrhosis, 51 patients with HCC on top of hepatitis C virus (HCV) infection, and 50 healthy controls. RESULTS miR-18a and miR-222 were assessed using reverse transcription-polymerase chain reaction. MiR-18a and miR-222 levels were significantly higher in the liver cirrhosis and HCC groups than the control group (p ˂ 0.001). However, no statistically significant difference was found between patients with HCC and liver cirrhosis (p = 0.4 for miR-18a and p = 0.1 for miR-222). ROC curve analyses to evaluate the diagnostic performances of the two miRNAs as important noninvasive diagnostic markers revealed a best cutoff value of 2 for miR-18a to differentiate between liver cirrhosis, HCC, and healthy controls. And for mir-222, a cutoff value of 1.7 and 1.9 showed the highest specificity for discrimination between liver cirrhosis, HCC, and healthy controls, respectively. Moreover, logistic regression model revealed that miR-18a expression was independent predictive factor in HCC patients (p = 0.004), while miR-222 expression was independent predictive factor in liver cirrhosis patients (p < 0.001). CONCLUSION miR-18a and miR-222 were significantly discriminative markers between patients with liver cirrhosis and HCC and healthy individuals. Therefore, they have a prognostic rather than a diagnostic value. Moreover, miR-18a and miR-222 could be useful in identifying liver injuries, including fibrosis and cirrhosis.
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Affiliation(s)
- Eman A Elghoroury
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Esmat E Abdelghaffar
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Eman Awadallah
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Solaf A Kamel
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Dina Kandil
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Eman M Hassan
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Mirhane Hassan
- Clinical and Chemical Pathology Department, 68787National Research Centre, Dokki, Cairo, Egypt
| | - Mahmoud M Kamel
- Clinical and Chemical Pathology Department, 68804National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mohammed M Gomaa
- Department of Diagnostic and Interventional Radiology, 68804National Cancer Institute, Cairo University, Cairo, Egypt
| | - Lamiaa A Fathalla
- Clinical and Chemical Pathology Department, 68804National Cancer Institute, Cairo University, Cairo, Egypt
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Pavlova E, Maslakova A, Prusakov K, Bagrov D. Optical sensors based on electrospun membranes – principles, applications, and prospects for chemistry and biology. NEW J CHEM 2022. [DOI: 10.1039/d2nj01821g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Electrospun membranes are promising substrates for receptor layer immobilization in optical sensors. Either colorimetric, luminescence, or Raman scattering signal can be used to detect the analyte.
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Affiliation(s)
- Elizaveta Pavlova
- Lomonosov Moscow State University, Faculty of Biology, Leninskie Gory 1-12, 119234, Moscow, Russian Federation
- Federal Research Clinical Center of Physical–Chemical Medicine of the Federal Medical and Biological Agency of Russia, 1a Malaya Pirogovskaya Street, 119435, Moscow, Russian Federation
| | - Aitsana Maslakova
- Lomonosov Moscow State University, Faculty of Biology, Leninskie Gory 1-12, 119234, Moscow, Russian Federation
| | - Kirill Prusakov
- Lomonosov Moscow State University, Faculty of Biology, Leninskie Gory 1-12, 119234, Moscow, Russian Federation
- Federal Research Clinical Center of Physical–Chemical Medicine of the Federal Medical and Biological Agency of Russia, 1a Malaya Pirogovskaya Street, 119435, Moscow, Russian Federation
| | - Dmitry Bagrov
- Lomonosov Moscow State University, Faculty of Biology, Leninskie Gory 1-12, 119234, Moscow, Russian Federation
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49
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Zhao C, Dai H, Shao J, He Q, Su W, Wang P, Tang Q, Zeng J, Xu S, Zhao J, Xiang S. Accuracy of Various Forms of Contrast-Enhanced MRI for Diagnosing Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis. Front Oncol 2021; 11:680691. [PMID: 34950573 PMCID: PMC8690240 DOI: 10.3389/fonc.2021.680691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 11/08/2021] [Indexed: 12/11/2022] Open
Abstract
Background Contrast-enhanced MRI can be used to identify patients with hepatocellular carcinoma (HCC). However, studies around the world have found differing diagnostic accuracies for the technique. Hence, we designed this meta-analysis to assess the accuracy of contrast-enhanced MRI for HCC diagnosis. Methods We conducted a systematic search for all studies reporting the diagnostic accuracy of contrast-enhanced MRI for HCC in the databases of MEDLINE, EMBASE, Cochrane Library, Web of Science, SCOPUS, ScienceDirect, and Google Scholar from inception until January 2021. We used the "Midas" package from the STATA software to perform the meta-analysis. Results Our study was based on 21 publications with 5,361 patients. The pooled HCC diagnosis sensitivity and specificity were 75% (95% CI, 70%-80%) and 90% (95% CI, 88%-92%), respectively, for gadoxetic acid-enhanced MRI; and they were 70% (95% CI, 57%-81%) and 94% (95% CI, 85%-97%), respectively, for MRI with extracellular contrast agents (ECA-MRI). We found significant heterogeneity with a significant chi-square test and an I 2 statistic >75%. We also found significant publication bias as per Deeks' test results and funnel plot. Conclusion We found that both types of contrast-enhanced MRI are accurate diagnostic and surveillance tools for HCC and offer high sensitivity and specificity. Further studies on different ethnic populations are required to strengthen our findings.
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Affiliation(s)
- Chun Zhao
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Hongyan Dai
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Juwei Shao
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Qian He
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Wei Su
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Peng Wang
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Qiuyue Tang
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Junren Zeng
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Song Xu
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Juanjuan Zhao
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Shutian Xiang
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
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50
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de Castria TB, Tang L, Queiroz MM, Awni BM, Paroder V, Shamseddine A, Bariani GM, Mukherji D, Matar CF, Fernandes GDS, El-Olayan A, Sabatin F, Elias R, Gupta R, Janjigian YY, Abou-Alfa GK. Hepatoid esophagogastric adenocarcinoma and tumoral heterogeneity: a case report. J Gastrointest Oncol 2021; 12:3123-3132. [PMID: 35070435 PMCID: PMC8748022 DOI: 10.21037/jgo-21-287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/30/2021] [Indexed: 08/30/2023] Open
Abstract
Hepatoid adenocarcinoma of the stomach is an uncommon subtype of gastric cancer remarkably similar to hepatocellular carcinoma in histopathological analysis. It is also commonly associated with high serum alfa-fetoprotein and a poorer prognosis, despite the emergence of new therapeutic options. In recent years, next generation sequencing (NGS) technology has made it possible to identify and describe the genes and molecular alterations common to gastric cancer thereby contributing to the advancement of targeted therapies. A 62-year-old patient, with no prior risk factor for hepatocellular carcinoma (HCC), presented to the emergency room with dysphagia for solids, abdominal pain and weight loss of about 3 kilograms over 3 months. Histopathological analysis presented with disparities regarding HER2 and programmed death-ligand 1 (PD-L1) status in the primary and metastatic sites. We describe a case of a de novo metastatic, human epidermal growth factor receptor 2 (HER2) positive esophagogastric junction hepatoid adenocarcinoma. Although this is a rare subgroup of gastric cancer, treatment strategies were based in recent studies in immunotherapy and guided therapy, taking into consideration the molecular findings from the patient's tumor NGS analysis. Data about HER2 and PDL1 heterogeneity were also reviewed. Despite the aggressiveness and rarity of this histology, the patient had a good response to treatment.
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Affiliation(s)
- Tiago Biachi de Castria
- Centro de Oncologia, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Laura Tang
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Medical College at Cornell University, New York, NY, USA
| | | | | | - Viktoriya Paroder
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Medical College at Cornell University, New York, NY, USA
| | | | | | | | | | | | - Ashwaq El-Olayan
- National Guard Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Fouad Sabatin
- National Guard Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | | | | | - Yelena Y. Janjigian
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Medical College at Cornell University, New York, NY, USA
| | - Ghassan K. Abou-Alfa
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Medical College at Cornell University, New York, NY, USA
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