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Choi JY, Choi SH, Byun JH, Lee SJ, Kim SY, Won HJ, Shin YM. Liver Imaging Reporting and Data System version 2018 for diagnosing hepatocellular carcinoma in alcoholic liver cirrhosis and virus-related cirrhosis. Eur J Radiol 2023; 168:111139. [PMID: 37856941 DOI: 10.1016/j.ejrad.2023.111139] [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: 05/07/2023] [Revised: 09/01/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE We aimed to evaluate and compare the diagnostic performance of Liver Imaging Reporting and Data System (LI-RADS) v2018 for hepatocellular carcinoma (HCC) ≤ 3.0 cm on gadoxetic acid-enhanced MRI according to the etiology of cirrhosis. METHODS Thirty-eight patients with alcoholic liver cirrhosis (ALC) and 37 with hepatitis C virus-related cirrhosis (HCV) who underwent preoperative MRI and subsequent surgical resection or transplantation were included. For comparison groups, patients with hepatitis B virus-related cirrhosis (HBV) were included by 1:1 matching with HCV and ALC groups according to age, lesion size, and Child-Pugh classification. The imaging characteristics of background liver and focal lesions were analyzed. The diagnostic performance of LI-RADS was compared between HCV and HBV groups, and between ALC and HBV groups. RESULTS ALC group showed significantly higher frequency of hepatic steatosis (25.8 % vs. 6.1 %, p =.04) and lower frequency of nonperipheral washout on portal venous-phase in HCC (63.2 % vs. 97.1 %, p <.001) compared with HBV group. ALC group showed significantly lower sensitivity than HBV group (52.6 % vs. 88.6 %, p<.001). No significant differences in diagnostic performance were found between HCV and HBV groups. In ALC group, hepatobiliary-phase hypointensity provided significantly higher sensitivity (76.3 % vs. 52.6 %, p =.008). CONCLUSION The sensitivity of LI-RADS for diagnosing HCC ≤ 3.0 cm was significantly lower in the ALC group than in the HBV group.
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Affiliation(s)
- Ji Young Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Sang Hyun Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Ho Byun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - So Jung Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - So Yeon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyung Jin Won
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Moon Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Ren Z, Ducreux M, Abou-Alfa GK, Merle P, Fang W, Edeline J, Li Z, Wu L, Assenat E, Hu S, Rimassa L, Zhang T, Blanc JF, Pan H, Ross P, Yen CJ, Tran A, Shao G, Bouattour M, Chen Y, Meyer T, Hou J, Tougeron D, Bai Y, Hou MM, Meng Z, Wu J, Li V, Chica-Duque S, Cheng AL. Tislelizumab in Patients with Previously Treated Advanced Hepatocellular Carcinoma (RATIONALE-208): A Multicenter, Non-Randomized, Open-Label, Phase 2 Trial. Liver Cancer 2023; 12:72-84. [PMID: 36872927 PMCID: PMC9982342 DOI: 10.1159/000527175] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/11/2022] [Indexed: 02/19/2023] Open
Abstract
Introduction Tislelizumab (anti-programmed cell death protein 1 antibody) showed preliminary antitumor activity and tolerability in patients with advanced solid tumors, including hepatocellular carcinoma (HCC). This study aimed to assess the efficacy and safety of tislelizumab in patients with previously treated advanced HCC. Methods The multiregional phase 2 study RATIONALE-208 examined single-agent tislelizumab (200 mg intravenously every 3 weeks) in patients with advanced HCC with Child-Pugh A, Barcelona Clinic Liver Cancer stage B or C, and who had received one or more prior lines of systemic therapy. The primary endpoint was objective response rate (ORR), radiologically confirmed per Response Evaluation Criteria in Solid Tumors version 1.1 by the Independent Review Committee. Safety was assessed in patients who received ≥1 dose of tislelizumab. Results Between April 9, 2018, and February 27, 2019, 249 eligible patients were enrolled and treated. After a median study follow-up of 12.7 months, ORR was 13% (n = 32/249; 95% confidence interval [CI], 9-18), including five complete and 27 partial responses. The number of prior lines of therapy did not impact ORR (one prior line, 13% [95% CI, 8-20]; two or more prior lines, 13% [95% CI, 7-20]). Median duration of response was not reached. The disease control rate was 53%, and median overall survival was 13.2 months. Of the 249 total patients, grade ≥3 treatment-related adverse events were reported in 38 (15%) patients; the most common was liver transaminase elevations in 10 (4%) patients. Treatment-related adverse events led to treatment discontinuation in 13 (5%) patients or dose delay in 46 (19%) patients. No deaths were attributed to the treatment per investigator assessment. Conclusion Tislelizumab demonstrated durable objective responses, regardless of the number of prior lines of therapy, and acceptable tolerability in patients with previously treated advanced HCC.
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Affiliation(s)
- Zhenggang Ren
- Department of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Michel Ducreux
- Medical Oncology Department, Gustave Roussy, INSERM U1279, Paris-Saclay University, Villejuif, France
| | - Ghassan K Abou-Alfa
- Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Medical College at Cornell University, New York, New York, USA
| | - Philippe Merle
- Department of Hepatology, Hospital La Croix-Rousse, Lyon, France
| | - Weijia Fang
- Department of Medical Oncology, The First Affiliated Hospital Zhejiang University, Hangzhou, China
| | - Julien Edeline
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France, and ARPEGO (Accès à La Recherche Précoce Dans Le Grand-Ouest) Network, Rennes, France
| | - Zhiwei Li
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Lihua Wu
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Eric Assenat
- Department of Oncology, CHRU Saint Eloi, Montpellier, France
| | - Sheng Hu
- Department of Internal Medicine-Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Tao Zhang
- Abdominal Oncology Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jean-Frédéric Blanc
- Service Hépato-Gastroentérologie et Oncologie Digestive, Groupe Hospitalier Sud - Hôpital Haut Lévêque, Bordeaux, France
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Paul Ross
- Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust and Department of Oncology, King's College Hospital NHS Foundation Trust, London, UK
| | - Chia-Jui Yen
- Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Albert Tran
- Département Digestif, Université Côte d'Azur, Nice, France, and Centre Hospitalier Universitaire de Nice, Nice, France, and Centre Méditerranéen de Médecine Moléculaire, INSERUM U1065, Université Côte d'Azur, Nice, France
| | - Guoliang Shao
- Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Mohamed Bouattour
- Department of Digestive Oncology, APHP Hôpitaux Universitaires Paris Nord Val de Seine, Hôpital Beaujon, Clichy, France
| | - Yajin Chen
- Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Tim Meyer
- Academic Department of Oncology, Royal Free Hospital NHS Trust, Pond Street, London, UK
| | - Jinlin Hou
- State Key Laboratory of Organ Failure Research, Guangdong Key Laboratory of Viral Hepatitis Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - David Tougeron
- Gastroenterology and Hepatology Department, University of Poitiers and Department of Gastroenterology and Hepatology, Poitiers University Hospital, Poitiers, France
| | - Yuxian Bai
- Department of Gastrointestinal Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Ming-Mo Hou
- Department of Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Zhiqiang Meng
- Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - John Wu
- Biostatistics, BeiGene USA, Inc., Ridgefield Park, New Jersey, USA
| | - Vincent Li
- Clinical Development, BeiGene (Beijing) Co., Ltd., Beijing, China
| | | | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Cancer Center and National Taiwan University Hospital, Taipei, Taiwan
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3
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Wee IJY, Moe FNN, Sultana R, Ang RWT, Quek PPS, Goh BKP, Chan CY, Cheow PC, Chung AYF, Jeyaraj PR, Koh YX, Mack POP, Ooi LLPJ, Tan EK, Teo JY, Kam JH, Chua JSS, Ng AWY, Goh JSQ, Chow PKH. Extending Surgical Resection for Hepatocellular Carcinoma Beyond Barcelona Clinic for Liver Cancer (BCLC) Stage A: A Novel Application of the Modified BCLC Staging System. J Hepatocell Carcinoma 2022; 9:839-851. [PMID: 35999856 PMCID: PMC9393033 DOI: 10.2147/jhc.s370212] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/07/2022] [Indexed: 11/23/2022] Open
Abstract
Objective We aimed to prognosticate survival after surgical resection of HCC stratified by stage with amalgamation of the modified Barcelona Clinic Liver Cancer (BCLC) staging system and location of tumour. Methods This single-institutional retrospective cohort study included patients with HCC who underwent surgical resection between 1st January 2000 to 30th June 2016. Participants were divided into 6 different subgroups: A-u) Within MC with Unilobar lesions; A-b) Within MC + Bilobar lesions; B1-u) Out of MC + within Up-To-7 + Unilobar lesions; B1-b) Out of MC + within Up-to-7 + Bilobar lesions; B2-u) Out of MC + Out of Up-To-7 + Unilobar lesions; B2-b) Out of MC + Out of Up-To-7 + Bilobar lesions. A separate survival analysis was conducted for solitary HCC lesions according to three subgroups: A-S (Within MC); B1-S (Out of MC + within Up-To-7); B2-S (Out of MC + out of Up-To-7). Results A total of 794 of 1043 patients with surgical resection for HCC were analysed. Groups A-u (64.6%), A-b (58.4%) and B1-u (56.2%) had 5-year cumulative overall survival (OS) rates above 50% after surgical resection and median OS exceeding 60 months (P = 0.0001). The 5-year cumulative recurrence-free survival rates (RFS) were 40.4% (group A-u), 38.2% (group A-b), 36.3% (group B1-u), 24.6% (group B2-u), and 7.3% (group B2-b)(P=0.0001). For solitary lesions, the 5-year OS for the subgroups were A-S (65.1%), B1-S (56.0%) and B2-S (47.1%) (P = 0.0003). Compared to A-S, there was also a significant trend towards relatively poorer OS as the lesion sizes increased in B1-S (HR 1.46, 95% CI 1.03–2.08) and B2-S (HR 1.65, 95% CI 1.25–2.18). Conclusion We adopted a novel approach combining the modified BCLC B sub-classification and dispersion of tumour to show that surgical resection in intermediate stage HCC can be robustly prognosticated. We found that size prognosticates resection outcomes in solitary tumours.
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Affiliation(s)
- Ian J Y Wee
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Fiona N N Moe
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Rehena Sultana
- Center of Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Reiko W T Ang
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | | | - Brian Kim Poh Goh
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Chung Yip Chan
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Peng Chung Cheow
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Alexander Y F Chung
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Prema Raj Jeyaraj
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Ye Xin Koh
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Peter O P Mack
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - London Lucien P J Ooi
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Ek Khoon Tan
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Jin Yao Teo
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Juinn Huar Kam
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Jacelyn S S Chua
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Ashley W Y Ng
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Jade S Q Goh
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
| | - Pierce K H Chow
- Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.,Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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Deng X, Cheng J, Zhan N, Chen J, Zhan Y, Ni Y, Liao C. MicroRNA-135a expression is upregulated in hepatocellular carcinoma and targets long non-coding RNA TONSL-AS1 to suppress cell proliferation. Oncol Lett 2021; 22:808. [PMID: 34630715 PMCID: PMC8488329 DOI: 10.3892/ol.2021.13069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/11/2021] [Indexed: 12/24/2022] Open
Abstract
Dysregulation of long non-coding RNAs (lncRNAs) results in development of human diseases, including hepatocellular carcinoma (HCC). lncRNA TONSL-AS1 has been reported to act as a tumor suppressor in gastric cancer. The present study aimed to investigate the role of TONSL-AS1 in hepatocellular carcinoma (HCC). Reverse transcription-quantitative PCR analysis was performed to detect the expression levels of TONSL-AS1 and microRNA (miRNA/miR)-135a in HCC tissues and paired adjacent normal tissues. A 5-year follow-up study was performed to determine the prognostic value of TONSL-AS1 in HCC. The association between miR-135a and TONSL-AS1 was assessed via overexpression experiments. The Cell Counting Kit-8 assay was performed to assess cell proliferation. The results demonstrated that TONSL-AS1 expression was downregulated in HCC tissues, which was associated with a lower survival rate in patients with HCC. TONSL-AS1 and miR-135a were predicted to interact with each other, whereby overexpression of miR-135a downregulated TONSL-AS1 expression. The results demonstrated that TONSL-AS1 and miR-135a were inversely correlated with each other. Notably, overexpression of TONSL-AS1 inhibited HCC cell proliferation, while overexpression of miR-135a promoted HCC cell proliferation and decreased the effect of overexpression of TONSL-AS1 on cell proliferation. Taken together, the results of the present study suggest that miR-135a expression is upregulated in HCC and targets lncRNA TONSL-AS1 to suppress cell proliferation.
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Affiliation(s)
- Xuesong Deng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Shenzhen University, Health Science Center/Shenzhen Second People's Hospital, Shenzhen, Guangdong 518035, PR. China
| | - Jun Cheng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Shenzhen University, Health Science Center/Shenzhen Second People's Hospital, Shenzhen, Guangdong 518035, PR. China
| | - Naiyang Zhan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Shenzhen University, Health Science Center/Shenzhen Second People's Hospital, Shenzhen, Guangdong 518035, PR. China
| | - Jianwei Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Shenzhen University, Health Science Center/Shenzhen Second People's Hospital, Shenzhen, Guangdong 518035, PR. China
| | - Yongqiang Zhan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Shenzhen University, Health Science Center/Shenzhen Second People's Hospital, Shenzhen, Guangdong 518035, PR. China
| | - Yong Ni
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Shenzhen University, Health Science Center/Shenzhen Second People's Hospital, Shenzhen, Guangdong 518035, PR. China
| | - Caixian Liao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Shenzhen University, Health Science Center/Shenzhen Second People's Hospital, Shenzhen, Guangdong 518035, PR. China
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Alghamdi M, Alghamdi AS, Aljedai A, Khathlan AA, Masri NA, Qutub A, Quaiz MA, Sanai F, Subahi G, Sulimani S. Revealing Hepatitis B Virus as a Silent Killer: A Call-to-Action for Saudi Arabia. Cureus 2021; 13:e14811. [PMID: 34094765 PMCID: PMC8170052 DOI: 10.7759/cureus.14811] [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] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The Kingdom of Saudi Arabia (KSA) was the first country in the Middle East to adopt the hepatitis B virus (HBV) vaccine. Despite an expanded HBV immunization program and significant progress in HBV prevention in the country, HBV infection is a significant public health burden. This review lists coordinated solutions for healthcare stakeholders, patients, and health authorities to curb HBV and its impact in KSA. It further aims to draw policymakers' attention to key priorities to bridge HBV care gaps in the country. METHODS As part of the pre-engagement activity, medical experts across KSA were interviewed to gain a preliminary understanding of the current unmet needs in HBV management in the country. Top-recommended action points derived from the pre-engagement activity were discussed. Key priority action points to curb the impact of HBV in KSA were identified. RESULTS The priority action points together with the challenges and unmet needs in the management and care of HBV in KSA were: (a) establish a national-level registry, (b) implement screening campaigns, (c) improve linkage of care between primary care physicians (PCPs) and specialists, and (d) increase PCP education and awareness. CONCLUSION This work is an endeavor to set the stage for a strategic policy framework aimed at eliminating HBV in KSA. The action points/steps for the identified priorities must run parallelly across various regions in KSA, to successfully manage and further eliminate the threat of HBV.
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Affiliation(s)
- Mohammed Alghamdi
- Department of Gastroenterology, King Fahad Military Medical Complex, Dahran, SAU
| | - Abdullah S Alghamdi
- Medical Department/Gastroenterology Unit, King Fahad General Hospital, Jeddah, SAU
| | - Ahmed Aljedai
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Abdullah A Khathlan
- Gastroenterology and Hepatology Department, King Fahad Medical City, Riyadh, SAU
| | - Nasser A Masri
- Department of Gastroenterology, Prince Sultan Military Medical City, Riyadh, SAU
| | - Adel Qutub
- Gastroenterology and Hepatology Department, King Fahad Medical City, Riyadh, SAU
| | - Mohammed A Quaiz
- Department of Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Faisal Sanai
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, SAU
| | - Ghadi Subahi
- Preventive Medicine, Ministry of Health, Riyadh, SAU
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Nazer S, Andleeb S, Ali S, Gulzar N, Raza A, Khan H, Akhtar K, Ahmed MN. Cytotoxicity, Anti-diabetic, and hepato-protective potential of Ajuga bracteosa-conjugated silver nanoparticles in Balb/c mice. Curr Pharm Biotechnol 2021; 23:318-336. [PMID: 33882804 DOI: 10.2174/1389201022666210421101837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Ajuga bracteosa is a traditional herb used against various diseases. OBJECTIVE Current research aimed to investigate the anti-diabetic and hepato-protective effect of green synthesized silver nanoparticles (ABAgNPs) using Ajuga bracteosa aqueous extract (ABaqu). METHODS In vitro anti-diabetic and cytotoxic effects were carried out via α- glucosidase inhibition, brine shrimp lethality, and protein kinase inhibition assays. For in vivo screening of 200 mg/kg and 400 mg/kg of both ABAgNPs and ABaqu in alloxan-induced and CCl4-induced Swiss albino mice were used. Liver and kidney functional markers, hematology, and histopathological studies were carried out after 14 days of administration. RESULTS In vivo antidiabetic and anti-cancerous effects showed valuable anti-hyperglycemic and hepato-protective potential when mice were treated with ABaqu and ABAgNPs. A significant reduction in the blood glucose level was recorded when ABaqu and ABAgNPs were administrated orally compared to Glibenclamide treated group. Significant reduction in ALT, AST, ALP, urea, uric acid, and creatinine was recorded in ABaqu and ABAgNPs treated diabetic mice. The hepato-protective findings indicated that ALT, ALP, AST were elevated in CCl4-induced mice while declined in both ABAgNPs and ABaqu treated CCl4-induced mice. Histopathological examination revealed that ABAgNPs have hepato-protective activity. CONCLUSION It was concluded that ABAgNPs and ABaqu possessed strong anti-diabetic and hepato-protective phytoconstituents which could be used in the prevention of diseases.
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Affiliation(s)
- Sadia Nazer
- Microbial Biotechnology laboratory, Department of Zoology, University of Azad Jammu and Kashmir, Muzaffarabad, 13100, Pakistan
| | - Saiqa Andleeb
- Microbial Biotechnology laboratory, Department of Zoology, University of Azad Jammu and Kashmir, Muzaffarabad, 13100, Pakistan
| | - Shaukat Ali
- Department of Zoology, Government College University, Lahore, Pakistan
| | - Nazia Gulzar
- Microbial Biotechnology laboratory, Department of Zoology, University of Azad Jammu and Kashmir, Muzaffarabad, 13100, Pakistan
| | - Abida Raza
- National Institute for Lasers and Optronics (NILOP), Pakistan Atomic Energy Commission, Islamabad, Pakistan
| | - Habib Khan
- Microbial Biotechnology laboratory, Department of Zoology, University of Azad Jammu and Kashmir, Muzaffarabad, 13100, Pakistan
| | - Kalsoom Akhtar
- Department of Chemistry, University of Azad Jammu and Kashmir, Muzaffarabad, 13100, Pakistan
| | - Muhammad Naeem Ahmed
- Department of Chemistry, University of Azad Jammu and Kashmir, Muzaffarabad, 13100, Pakistan
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7
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Chen K, Abbassi M, Ko NY. A Shock-Like Pain and Inability to Ambulate: Thoracic Spinal Cord Compression from Hepatocellular Carcinoma. Case Rep Oncol 2021; 14:56-61. [PMID: 33776682 PMCID: PMC7983535 DOI: 10.1159/000509511] [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: 06/12/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022] Open
Abstract
Hepatocellular carcinoma commonly metastasizes to organs, but there are few reports of vertebral metastases causing cord compression. Here, we present a case of thoracic cord compression in a patient with advanced hepatocellular carcinoma. Providers' and patient's awareness of this risk is important, as this is an oncological emergency.
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Affiliation(s)
- Kay Chen
- Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Mashya Abbassi
- Department of Radiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Naomi Y. Ko
- Department of Medicine, Section of Hematology Oncology, Boston University and Boston Medical Center, Boston, Massachusetts, USA
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8
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Lin MT, Chang KC, Yen YH, Tsai MC, Chen CH, Wang JH, Hsiao CC, Chiu YH, Hu TH. Chronic hepatitis B exhibited higher rate of hepatocellular carcinoma occurrence than hepatitis C in cirrhotic patients after effective antiviral treatment. J Formos Med Assoc 2020; 120:621-628. [PMID: 32718890 DOI: 10.1016/j.jfma.2020.07.019] [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: 10/12/2019] [Revised: 06/07/2020] [Accepted: 07/15/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND/PURPOSE Effective antiviral-therapy can reduce the risk of liver cirrhosis related hepatocellular carcinoma in patients with chronic hepatitis B and hepatitis C. Yet, the difference of hepatocellular carcinoma development in chronic hepatitis B and hepatitis C patients with cirrhosis after effective antiviral therapy treatment is unknown. In this study, We comprehensive explored the difference among them. METHODS 1363 patients with cirrhosis and hepatitis B virus treated with nucleos(t)ide analogues (NUCs) with completely suppressed virus, and patients with cirrhosis and hepatitis C virus treated with pegylated interferon (peg-IFN)/ribavirin (RBV) combination therapy who achieved sustained virologic response were enrolled. RESULTS Total 261 developed hepatocellular carcinoma within a median follow-up of 4.25 years. Univariate analysis, patients developed hepatocellular carcinoma tended to be of older age, and had lower platelet counts, were chronic hepatitis B carriers, and had higher serum alfa-fetoprotein (AFP) (≥20 ng/mL), FIB-4 index and APRI scores. Subsequent multivariate analysis revealed older age, lower platelet counts, high AFP levels and chronic hepatitis B carriers were independent risk factors of hepatocellular carcinoma. CONCLUSION Our findings identify that chronic hepatitis B patients were with a higher risk of hepatocellular carcinoma compared to chronic hepatitis C patients after achieving virological response. Special attention should be paid to those patients.
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Affiliation(s)
- Ming-Tsung Lin
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan
| | - Kuo-Chin Chang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Yi-Hao Yen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Ming-Chao Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Chien-Hung Chen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Jing-Houng Wang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Chang-Chun Hsiao
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan; Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Yueh-Hsia Chiu
- Department of Health Care Management, College of Management, Chang Gung University, Taiwan
| | - Tsung-Hui Hu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
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9
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Liu J, Ma Z, Liu Y, Wu L, Hou Z, Li W. Screening of potential biomarkers in hepatitis C virus-induced hepatocellular carcinoma using bioinformatic analysis. Oncol Lett 2019; 18:2500-2508. [PMID: 31452738 PMCID: PMC6676667 DOI: 10.3892/ol.2019.10578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 06/06/2019] [Indexed: 01/10/2023] Open
Abstract
Evidence suggests that hepatitis C virus (HCV) infection is among the main causes of hepatocellular carcinoma (HCC). In addition, HCV-induced HCC (HCV-HCC) exhibits adverse clinical outcomes and limited therapeutic treatments are available for this condition. To investigate key biomarkers in the occurrence and development of HCV-HCC, microarray datasets GSE62232, GSE69715 and GSE107170 were downloaded from the Gene Expression Omnibus database for analysis. The differentially expressed genes between HCV-HCC and normal tissue were identified using the GEO2R online tool. The function enrichment analyses including Gene Ontology and Kyoto Encyclopedia of Genes and Genomes were performed using the Database for Annotation, Visualization and Integrated Discovery online tool. A protein-protein interaction network was constructed using the Search Tool for the Retrieval of Interacting Genes database and visualized using Cytoscape. A total of 368 DEGs were identified, and the top 10 hub genes with a high degree of connectivity were selected for further analysis. Subsequently, overall survival and disease-free survival analysis revealed that there was a significant association between altered expression of HMMR, CCNB1 and KIF20A, and poor clinical outcome. In summary, these results indicate that HMMR, CCNB1 and KIF20A are potential targets for diagnosis and therapy of HCV-HCC.
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Affiliation(s)
- Jun Liu
- Department of Laboratory Medicine, Yue Bei People's Hospital, Shaoguan, Guangdong 512026, P.R. China
| | - Zhanzhong Ma
- Department of Laboratory Medicine, Yue Bei People's Hospital, Shaoguan, Guangdong 512026, P.R. China
| | - Yanming Liu
- Department of Laboratory Medicine, Yue Bei People's Hospital, Shaoguan, Guangdong 512026, P.R. China
| | - Liangyin Wu
- Department of Laboratory Medicine, Yue Bei People's Hospital, Shaoguan, Guangdong 512026, P.R. China
| | - Zhiwei Hou
- Reproductive Medicine Center, Yue Bei People's Hospital, Shaoguan, Guangdong 512026, P.R. China
| | - Wenli Li
- Reproductive Medicine Center, Yue Bei People's Hospital, Shaoguan, Guangdong 512026, P.R. China
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10
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Liu H, Zhao P, Jin X, Zhao Y, Chen Y, Yan T, Wang J, Wu L, Sun Y. A 9‑lncRNA risk score system for predicting the prognosis of patients with hepatitis B virus‑positive hepatocellular carcinoma. Mol Med Rep 2019; 20:573-583. [PMID: 31115573 PMCID: PMC6579967 DOI: 10.3892/mmr.2019.10262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 12/28/2018] [Indexed: 12/18/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and can be induced by hepatitis B virus (HBV) infection. The aim of the present study was to screen prognosis‑associated long noncoding RNAs (lncRNAs) and construct a risk score system for the disease. The RNA‑sequencing data of patients with HCC (including 100 HCC samples and 26 normal samples) were extracted from The Cancer Genome Atlas (TCGA) database. In addition, GSE55092, GSE19665 and GSE10186 datasets were downloaded from the Gene Expression Omnibus database. Combined with weighted gene co‑expression network analysis, the identification and functional annotation of stable modules was performed. Using the MetaDE package, the consensus differentially expressed RNAs (DE‑RNAs) were analyzed. To construct a risk score system, prognosis‑associated lncRNAs and the optimal lncRNA combination were separately analyzed by survival and penalized packages. Finally, pathway enrichment analysis for the nodes in an lncRNA‑mRNA network was conducted via Gene Set Enrichment Analysis. A total of four stable modules and 3,051 consensus DE‑RNAs were identified. The stable modules were significantly associated with the histological grades of HCC, tumor, node and metastasis stage, pathological stage, recurrence and exposure to radiation therapy. A 9‑lncRNA optimal combination [DiGeorge syndrome critical region gene 9, glucosidase, β, acid 3 (GBA3), HLA complex group 4, N‑acetyltransferase 8B, neighbor of breast cancer 1 gene 2, prostate androgen‑regulated transcript 1, ret finger protein like 1 antisense RNA 1, solute carrier family 22 member 18 antisense and T‑cell leukemia/lymphoma 6] was selected from the 14 prognosis‑associated lncRNAs, and was further supported by the validation dataset, GSE10186. The lncRNA‑mRNA co‑expression network revealed lncRNA GBA3 as a positive regulator of phosphoenolpyruvate carboxykinase 2, an important enzyme in the metabolic pathway of gluconeogenesis. A risk score system was established based on the optimal 9 lncRNAs, which may be valuable for predicting the prognosis of patients with HBV‑positive HCC and improving understanding of mechanisms associated with the pathogenesis of this disease. On the contrary, a larger, independent cohort of patients is required to further validate the risk‑score system.
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Affiliation(s)
- Honghong Liu
- International Center for Liver Disease Treatment, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
| | - Ping Zhao
- International Center for Liver Disease Treatment, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
| | - Xueyuan Jin
- International Center for Liver Disease Treatment, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
| | - Yanling Zhao
- Department of Pharmacy, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
| | - Yongqian Chen
- International Center for Liver Disease Treatment, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
| | - Tao Yan
- International Center for Liver Disease Treatment, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
| | - Jianjun Wang
- International Center for Liver Disease Treatment, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
| | - Liang Wu
- International Center for Liver Disease Treatment, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
| | - Yongqiang Sun
- Integrative Medical Center, 302 Hospital of The People's Liberation Army, Beijing 100039, P.R. China
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11
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Kim YR, Byun MR, Choi JW. Integrin α6 as an invasiveness marker for hepatitis B viral X-driven hepatocellular carcinoma. Cancer Biomark 2018; 23:135-144. [PMID: 30010110 DOI: 10.3233/cbm-181498] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) accounts for more than 60% of hepatocellular carcinoma (HCC) cases. However, there is limited information about the features of HBV-driven HCC that differentiate it from other types of HCC. OBJECTIVE The aim of this study is to find a gene specific to HBV-driven HCC and understand its role during tumorigenesis. METHODS The differences in gene expression patterns were analyzed among patients with hepatitis virus-unrelated liver cirrhosis, and hepatitis C virus- and HBV-driven HCC. Genes expressed only in HBV patients were compared to genes of transgenic mice expressing hepatitis B viral X gene. RESULTS Integrin α6 was commonly overexpressed in both HBV-driven HCC patients and transgenic mice expressing viral X. This gene's activation induced overexpression of integrin α6, as well as formation of integrins α6β1 and α6β4, without changing the expression of non-integrin laminin receptors. Suppression of integrin α6 caused significant inhibition of tumor migration in vitro. CONCLUSIONS This study found a significant association between HBV and integrin α6, which may be responsible for early migration and invasion of HCC. Thus, integrin α6 is a predictive marker for tumor recurrence and invasiveness of HBV-driven HCC.
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Affiliation(s)
- Yi Rang Kim
- Department of Hemato-Oncology, Yuseong Sun Hospital, Daejeon, Korea
| | - Mi Ran Byun
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, Korea.,Department of Life and Nanopharmaceutical Science, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin Woo Choi
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, Korea.,Department of Life and Nanopharmaceutical Science, Graduate School, Kyung Hee University, Seoul, Korea
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12
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Lee YS, Seo YS, Kim JH, Lee J, Kim HR, Yoo YJ, Kim TS, Kang SH, Suh SJ, Joo MK, Jung YK, Lee BJ, Yim HJ, Yeon JE, Kim JS, Park JJ, Um SH, Bak YT, Byun KS. Can More Aggressive Treatment Improve Prognosis in Patients with Hepatocellular Carcinoma? A Direct Comparison of the Hong Kong Liver Cancer and Barcelona Clinic Liver Cancer Algorithms. Gut Liver 2018; 12:94-101. [PMID: 28873509 PMCID: PMC5753690 DOI: 10.5009/gnl17040] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/23/2017] [Accepted: 04/24/2017] [Indexed: 12/19/2022] Open
Abstract
Background/Aims In addition to the globally endorsed Barcelona Clinic Liver Cancer (BCLC) staging system, other algorithms or staging systems have been developed, including the Hong Kong Liver Cancer (HKLC) staging system. This study aimed to validate the HKLC staging system relative to the BCLC staging system for predicting survival for hepatocellular carcinoma (HCC) patients in Korea. Methods From 2004 to 2013, 2,571 patients newly diagnosed with HCC were consecutively enrolled at three Korea University medical centers. Results Both staging systems differentiated survival well (p<0.001). However, 1-year and 3-year survival were predicted better using the HKLC system than the BCLC system (area under the receiver operating characteristic curve: 0.869 vs 0.856 for 1 year, p=0.002; 0.841 vs 0.827 for 3 years, p=0.010). In hypothetical survival curves, the HKLC system exhibited better median overall survival than the BCLC system (33.1 months vs 19.2 months). In evaluations of prognosis according to either BCLC or HKLC treatment guidelines, risk of death was reduced in the group following only HKLC guidelines compared with the group following only BCLC guidelines (hazard ratio, 0.601; 95% confidence interval, 0.443 to 0.816; p=0.001). Conclusions Although both staging systems predicted and discriminated HCC prognoses well, the HKLC system showed more encouraging survival benefits than the BCLC system.
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Affiliation(s)
- Young-Sun Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yeon Seok Seo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Hoon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Hae Rim Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yang Jae Yoo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Tae Suk Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seong Hee Kang
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Jun Suh
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Moon Kyung Joo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kul Jung
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Beom Jae Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Eun Yeon
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jae Seon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong-Jae Park
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Soon Ho Um
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young-Tae Bak
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kwan Soo Byun
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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13
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Golabi P, Jeffers T, Younoszai Z, Otgonsuren M, Sayiner M, Mishra A, Venkatesan C, Younossi Z. Independent Predictors of Mortality and Resource Utilization in Viral Hepatitis Related Hepatocellular Carcinoma. Ann Hepatol 2018; 16:555-564. [PMID: 28611258 DOI: 10.5604/01.3001.0010.0290] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Hepatitis B (HBV) and C viruses (HCV) are important causes of hepatocellular carcinoma (HCC). Our aim was to assess mortality and resource utilization of patients with HCC-related to HBV and HCV. MATERIAL AND METHODS National Cancer Institute's Surveillance, Epidemiology and End Results (SEER)-Medicare linked database (2001-2009) was used. Medicare claims included patient demographic information, diagnoses, treatment, procedures, ICD-9 codes, service dates, payments, coverage status, survival data, carrier claims, and Medicare Provider Analysis and Review (MEDPAR) data. HCC related to HBV/HCV and non-cancer controls with HBV/HCV were included. Pair-wise comparisons were made by t-tests and chi-square tests. Logistic regression models to estimate odds ratios (ORs) with 95% confidence intervals (CIs) were used. RESULTS We included 2,711 cases of HCC (518 HBV, 2,193 HCV-related) and 5,130 non-cancer controls (1,321 HBV, 3,809 HCV). Between 2001-2009, HCC cases related to HBV and HCV increased. Compared to controls, HBV and HCV patients with HCC were older, more likely to be male (73.2% vs 48.9% and 57.1% vs. 50.5%), die within one-year (49.3% vs. 20.3% and 52.2% vs. 19.2%), have decompensated cirrhosis (44.8% vs. 6.9% and 53.9% vs. 10.4%) and have higher inpatient ($60.471 vs. $47.223 and $56.033 vs. $41.005) and outpatient charges ($3,840 vs. $3,328 and $3,251 vs. $2,096) (all P < 0.05). In two separate multivariate analyses, independent predictors of one-year mortality were older age, being male and the presence of decompensated cirrhosis. CONCLUSIONS The rate of viral hepatitis-related HCC is increasing. Mortality and resource utilization related to HBV and HCV-related HCC is substantial.
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Affiliation(s)
- Pegah Golabi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States
| | - Thomas Jeffers
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States
| | - Zahra Younoszai
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States
| | - Munkhzul Otgonsuren
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States
| | - Mehmet Sayiner
- Center for Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United States
| | - Alita Mishra
- Center for Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United States
| | - Chapy Venkatesan
- Center for Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United States
| | - Zobair Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States
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14
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Chon YE, Jung KS, Kim MJ, Choi JY, An C, Park JY, Ahn SH, Kim BK, Kim SU, Park H, Hwang SK, Rim KS, Han KH, Kim DY. Predictors of failure to detect early hepatocellular carcinoma in patients with chronic hepatitis B who received regular surveillance. Aliment Pharmacol Ther 2018; 47:1201-1212. [PMID: 29492988 DOI: 10.1111/apt.14578] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 09/28/2017] [Accepted: 01/30/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND A proportion of chronic hepatitis B (CHB) patients are diagnosed with advanced hepatocellular carcinoma (HCC) despite regular surveillance. AIMS To determine predictors for HCC detection failure in CHB patients who underwent regular surveillance. METHODS CHB patients with well-preserved liver function, who underwent ultrasonography and alpha-foetoprotein (AFP) analysis every 6 months, were enrolled. Cox regression analysis was used to identify predictors for detection failure, defined as HCC initially diagnosed at Barcelona Clinic Liver Cancer (BCLC) stage B or C. RESULTS Of the 4590 CHB patients (mean age, 52.1 years; men, 61.6%), 169 patients were diagnosed with HCC (3.68%) and 35 (20.7%) HCC patients were initially diagnosed with HCC BCLC stage B or C. The cumulative incidence of HCC detection failure was 0.2% at year 1 and 1.3% at year 5. Multivariate analyses indicated that cirrhosis (hazard ratio [HR], 3.078; 95% CI, 1.389-6.821; P = 0.006), AFP levels ≥9 ng/mL (HR, 5.235; 95% CI, 2.307-11.957; P = 0.010), and diabetes mellitus (HR, 3.336; 95% CI, 1.341-8.296; P = 0.010) were independent predictors of HCC detection failure. Another model that incorporated liver stiffness (LS) values identified LS values ≥11.7 kPa (HR, 11.045; 95% CI, 2.066-59.037; P = 0.005) and AFP levels ≥9 ng/mL (HR, 4.802; 95% CI, 1.613-14.297; P = 0.005) as predictors of detection failure. CONCLUSIONS In CHB patients undergoing regular surveillance with ultrasonography and alpha-foetoprotein (AFP) analysis every 6 months, the HCC detection failure rate was not high (0.8% per person; 0.1% per test). However, careful attention should be paid in patients with advanced liver fibrosis (clinical cirrhosis or LS value >11.7 kPa), high AFP levels, or diabetes mellitus, who are prone to surveillance failure.
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Affiliation(s)
- Y E Chon
- Department of Internal Medicine, CHA Bundang Medical Center, Institute of Gastroenterology, CHA University, Seongnam, Korea.,CHA Bundang Liver Center, CHA Bundang Medical Center, Seongnam, Korea
| | - K S Jung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - M-J Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - J-Y Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - C An
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - S H Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - B K Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - S U Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - H Park
- Department of Internal Medicine, CHA Bundang Medical Center, Institute of Gastroenterology, CHA University, Seongnam, Korea.,CHA Bundang Liver Center, CHA Bundang Medical Center, Seongnam, Korea
| | - S K Hwang
- Department of Internal Medicine, CHA Bundang Medical Center, Institute of Gastroenterology, CHA University, Seongnam, Korea.,CHA Bundang Liver Center, CHA Bundang Medical Center, Seongnam, Korea
| | - K S Rim
- Department of Internal Medicine, CHA Bundang Medical Center, Institute of Gastroenterology, CHA University, Seongnam, Korea.,CHA Bundang Liver Center, CHA Bundang Medical Center, Seongnam, Korea
| | - K-H Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - D Y Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
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15
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Abdel-Mohsen MA, El-Braky AAA, Ghazal AAER, Shamseya MM. Autophagy, apoptosis, vitamin D, and vitamin D receptor in hepatocellular carcinoma associated with hepatitis C virus. Medicine (Baltimore) 2018; 97:e0172. [PMID: 29561429 PMCID: PMC5895342 DOI: 10.1097/md.0000000000010172] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The aims of this study were to investigate the interplay between autophagy and apoptosis and to investigate the association between both of autophagy and apoptosis and vitamin D and its receptor in hepatitis C virus (HCV) viral infection and its implication in the progression into hepatocellular carcinoma (HCC).A cross-sectional study where serum levels of microtubule-associated protein 1A/1B-light chain 3 (LC3); marker of autophagy, caspase-3; marker of apoptosis, vitamin D3 and vitamin D receptor (VDR) were measured in healthy subjects as well as HCV and HCV-HCC patients using enzyme-linked immunosorbent assay technique.Collectively, the liver profile revealed hepatic dysfunctions in HCV patients with or without HCC. A significant reduction in the serum concentration levels LC3 and caspase-3 were observed referring to the down regulation of autophagy and host-mediated apoptosis in HCV patients with or without HCC. Deficiency of vitamin D and decreased levels of its receptor were observed in HCV and HCV-HCC patients.The perturbation in vitamin D/VDR axis, which modulates both of autophagy and apoptosis in HCV infection, may point out to its involvement and implication in the pathogenesis of HCV infection and the development of HCV-related HCC. Therefore, supplementation with vitamin D may not be the only solution to restore the vital biological functions of vitamin D but VDR-targeted therapy may be of great importance in this respect.
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Affiliation(s)
| | | | | | - Mohammed Mohammed Shamseya
- Department of Clinical and Experimental Internal Medicine, Medical Research Institute, Alexandria University, Alexandria, Egypt
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16
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Shimada S, Kamiyama T, Yokoo H, Orimo T, Wakayama K, Einama T, Kakisaka T, Kamachi H, Taketomi A. Clinicopathological Characteristics of Hepatocellular Carcinoma with Microscopic Portal Venous Invasion and the Role of Anatomical Liver Resection in These Cases. World J Surg 2018; 41:2087-2094. [PMID: 28271260 DOI: 10.1007/s00268-017-3964-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aims of this study were to investigate predictive factors for microscopic portal venous invasion (mPVI) in hepatocellular carcinoma (HCC) and whether anatomical liver resection (ALR) was useful in such cases. METHODS We analyzed 852 patients with HCC without macroscopic portal venous invasion who were treated at our hospital between January 1990 and May 2014. These patients were stratified into a microscopic portal venous invasion group (mPVI group; n = 153) and non-microscopic portal venous invasion group (NmPVI group; n = 699). RESULTS PIVKA-II ≥100 mAU/ml, a tumor size ≥5 cm, a confluent lesion, and poor differentiation were found to be independent risk factors for mPVI. Among the mPVI group who had single HCC under 5 cm, serum albumin level <4.0 g/dl, PIVKA-II ≥100 mAU/ml, a positive surgical margin, and non-ALR (NALR) were independent unfavorable prognostic factors for overall survival (OS). PIVKA-II ≥100 mAU/ml, a positive surgical margin and NALR were independent unfavorable prognostic factors for relapse-free survival (RFS). ALR was significantly favorable factor for both OS and RFS of the mPVI group who had single HCC under 5 cm. CONCLUSIONS Even if no portal venous invasion is detectable in HCC patients preoperatively, a PIVKA-II ≥100 mAU/ml, tumor size ≥5 cm, and a confluent lesion indicate a high risk of mPVI. ALR should be considered for the patients with these characteristics because it is a favorable prognostic factor in these cases with mPVI.
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Affiliation(s)
- Shingo Shimada
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North15-West7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Toshiya Kamiyama
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North15-West7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hideki Yokoo
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North15-West7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Tatsuya Orimo
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North15-West7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Kenji Wakayama
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North15-West7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Takahiro Einama
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North15-West7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | | | - Hirofumi Kamachi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North15-West7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North15-West7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
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17
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Differences in somatic mutation landscape of hepatocellular carcinoma in Asian American and European American populations. Oncotarget 2018; 7:40491-40499. [PMID: 27246981 PMCID: PMC5130022 DOI: 10.18632/oncotarget.9636] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 05/09/2016] [Indexed: 02/06/2023] Open
Abstract
The incidence rate of hepatocellular carcinoma (HCC) is higher in populations of Asian ancestry than European ancestry (EA). We sought to investigate HCC mutational differences between the two populations, which may reflect differences in the prevalence of etiological factors. We compared HCC somatic mutations in patients of self-reported Asian American and EA from The Cancer Genome Atlas (TCGA), and assessed associations of tumor mutations with established HCC risk factors. Although the average mutation burden was similar, TP53 and RB1 were mutated at a much higher frequency in Asian Americans than in EAs (TP53: 43% vs. 21%; RB1: 19% vs. 2%). Three putative oncogenic genes, including TRPM3, SAGE1, and ADAMTS7, were mutated exclusively in Asians. In addition, VEGF binding pathway, a druggable target by tyrosine kinase inhibitors such as sorafenib, was mutated at a higher frequency among Asians (13% vs. 2%); while the negative regulation of IL17 production, involved in inflammation and autoimmunity, was mutated only in EAs (12% vs. 0). Accounting for HCC risk factors had little impact on any of the mutational differences. In conclusion, we demonstrated here mutational differences in important cancer genes and pathways between Asian and European ancestries. These differences may have implications for the prevention and treatment of HCC.
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18
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Makol A, Kanthaje S, Dhiman RK, Kalra N, Chawla YK, Chakraborti A. Association of liver cirrhosis severity with type 2 diabetes mellitus in hepatocellular carcinoma. Exp Biol Med (Maywood) 2017; 243:323-326. [PMID: 29186978 DOI: 10.1177/1535370217744511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a major risk factor associated with hepatocellular carcinoma (HCC). However, the association of T2DM with liver cirrhosis and therapy response in HCC patients is not clear. Hence, in this study, we have evaluated the influence of T2DM on liver cirrhosis severity of HCC and sorafenib response. HCC patients were divided in two groups: T2DM (n = 20) and non-T2DM (nT2DM; n = 50). We found significantly higher number of patients in T2DM group had decompensated liver disease with Child-Turcotte-Pugh score ≥ 7. Additionally, 71.4% patients were observed to be sorafenib sensitive in T2DM group which was significantly higher as compared to 30% in nT2DM group. This study has highlighted the predisposition of HCC patients with T2DM toward more severe liver disease who were found to be better respondents of sorafenib. Impact statement We have explored the association of type 2 diabetes mellitus (T2DM) on liver cirrhosis severity along with response toward sorafenib in hepatocellular carcinoma (HCC). Most HCC patients exhibit prior history of liver cirrhosis that results following long span of chronic liver disease. T2DM constitutes as an important risk factor for HCC development which is known to elevate its incidence. Further, sorafenib is the FDA approved therapy for HCC whose therapeutic outcome is not investigated in HCC patients with T2DM till date. This observation-based study has unveiled a positive association between T2DM and severity of liver cirrhosis as well as sorafenib response in HCC as examined in a clinical setting.
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Affiliation(s)
- Ankita Makol
- 1 Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Shruthi Kanthaje
- 1 Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Radha K Dhiman
- 2 Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Naveen Kalra
- 3 Department of Radio Diagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Yogesh K Chawla
- 2 Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Anuradha Chakraborti
- 1 Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Mgaieth S, Kemp W, Gow P, Fink M, Lubel J, Nicoll A, Gazzola A, Hong T, Ryan M, Knight V, Dev AT, Sood S, Bell S, Paul E, Roberts SK. Impact of viral hepatitis aetiology on survival outcomes in hepatocellular carcinoma: A large multicentre cohort study. J Viral Hepat 2017; 24:982-989. [PMID: 28414893 DOI: 10.1111/jvh.12717] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 02/27/2017] [Indexed: 12/15/2022]
Abstract
While HBV and HCV are risk factors for HCC, uncertainty exists as to whether these viral infections have prognostic significance in HCC. Thus, we compared the overall survival of patients with HBV, HCV and nonviral HCC, and evaluated whether the presence of HBV and HCV predicts patient outcomes. We conducted a multicentre study of HCC cases diagnosed at six Melbourne tertiary hospitals between Jan 2000-Dec 2014. Patient demographics, liver disease and tumour characteristics and patient outcomes were obtained from hospital databases, computer records and the Victorian Death Registry. Survival outcomes were compared between HBV, HCV and nonviral hepatitis cases and predictors of survival determined using Cox proportional hazards regression. There were 1436 new HCC cases identified including 776 due to viral hepatitis (HBV 235, HCV 511, HBV-HCV 30) and 660 from nonviral causes. The median survival of HBV, HCV and nonviral HCC patients was 59.1, 28.4 and 20.9 months, respectively (P<.0001). On multivariate analysis, independent risk factors for survival included HCC aetiology, gender, BCLC stage, serum AFP, total number and size of lesions, and serum creatinine and albumin. After adjusting for these and method of detection, HBV remained an independent predictor of improved overall survival when compared to both nonviral (HR 0.60%, 95% CI 0.35-0.98; P=.03) and HCV-related HCC (HR 0.51%, 95% CI 0.30-0.85; P=.01). In this large multicentre study, HBV is independently associated with improved overall survival compared with HCV and nonviral-related HCC. Further studies are needed to determine the underlying factor(s) responsible.
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Affiliation(s)
- S Mgaieth
- Department of Gastroenterology, Alfred Hospital, Melbourne, Vic., Australia
| | - W Kemp
- Department of Gastroenterology, Alfred Hospital, Melbourne, Vic., Australia
| | - P Gow
- Department of Gastroenterology, Austin Hospital, Heidelberg, Vic., Australia
| | - M Fink
- Department of Surgery, Austin Hospital, Heidelberg, Vic., Australia
| | - J Lubel
- Department of Gastroenterology, Box Hill Hospital, Box Hill, Vic., Australia
| | - A Nicoll
- Department of Gastroenterology, Box Hill Hospital, Box Hill, Vic., Australia.,Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Vic., Australia
| | - A Gazzola
- Department of Gastroenterology, Alfred Hospital, Melbourne, Vic., Australia
| | - T Hong
- Department of Gastroenterology, St Vincent's Hospital, Fitzroy, Vic., Australia
| | - M Ryan
- Department of Gastroenterology, St Vincent's Hospital, Fitzroy, Vic., Australia
| | - V Knight
- Department of Gastroenterology, Monash Medical Centre, Clayton, Vic., Australia
| | - A T Dev
- Department of Gastroenterology, Monash Medical Centre, Clayton, Vic., Australia
| | - S Sood
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Vic., Australia
| | - S Bell
- Department of Gastroenterology, St Vincent's Hospital, Fitzroy, Vic., Australia
| | - E Paul
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - S K Roberts
- Department of Gastroenterology, Alfred Hospital, Melbourne, Vic., Australia
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20
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Loho IM, Hasan I, Lesmana CRA, Dewiasty E, Gani RA. Hepatocellular Carcinoma in a Tertiary Referral Hospital in Indonesia: Lack of Improvement of One-Year Survival Rates between 1998-1999 and 2013-2014. Asian Pac J Cancer Prev 2017; 17:2165-70. [PMID: 27221913 DOI: 10.7314/apjcp.2016.17.4.2165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The survival of hepatocellular carcinoma (HCC) patients is usually low due to late diagnosis. Cipto Mangunkusumo Hospital as the largest tertiary referral hospital in Indonesia, has recently improved its modalities for advanced HCC management, but there has not been any evaluation on any improvement in HCC patient survival. MATERIALS AND METHODS A retrospective analysis on 114 HCC patients in 2013-2014 were conducted and compared with the database for 77 HCC patients in 1998-1999. Clinical characteristics and treatment received were recorded and the survival of both groups was analyzed using the Kaplan-Meier method and compared using the log-rank test. RESULTS The percentage of HBV positive patients had increased after fifteen years from 32.5% to 67.5%. Only two patients (1.8%) in 2013-2014 were diagnosed with HCC during surveillance program. Proportions of Barcelona Clinic Liver Cancer A, B, C, and D in 2013-2014 were 1.8%, 42%, 28.1%, and 28.1%, respectively. There was an increase in the use of potentially curative treatment, such as surgical resection or combination of loco-regional therapies. The one-year survival rate increased from 24.1% in 1998-1999 to 29.4% in 2013-2014, while the median survival decreased from 146 days to 138 days, but the difference was not statistically significant (p=0.913). CONCLUSIONS There was no improvement in the median survival of HCC patients after fifteen years because most continued to present at late stages. There is an urgent need for a nationwide implementation of a hepatitis screening program and HCC surveillance education.
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Affiliation(s)
- Imelda M Loho
- Internal Medicine Department, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia E-mail :
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21
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Comparison of the outcomes of hepatocellular carcinoma after hepatectomy between two regional medical centers in China and Japan. Asian J Surg 2016; 40:380-388. [PMID: 27236717 DOI: 10.1016/j.asjsur.2016.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/24/2016] [Accepted: 03/01/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is a common malignant disease of the liver in China and Japan. The purpose of this study was to compare the outcomes of HCC patients after hepatectomy between two regional medical centers in China and Japan. METHODS Data on HCC after hepatectomy were collected from January 2005 to December 2014 from Nagasaki University Hospital in Nagasaki, Japan and the Second Affiliated Hospital of Nanchang University in Nanchang, China. The patient and tumor characteristics, HCC etiology, and overall survival rates after hepatectomy were investigated. RESULTS Two hundred patients in the Nagasaki group and 238 patients in the Nanchang group were diagnosed with HCC and underwent hepatectomy. The major underlying liver diseases were hepatitis C infection (32%, 64/200) and nonalcoholic steatohepatitis (NASH) (34.5%, 69/200) in the Nagasaki group, while in the Nanchang group, hepatitis B infection (79.4%, 189/238) was the dominant etiology. Large tumors (> 5 cm), the presence of a tumor capsule and a high alpha-fetoprotein value (≥ 400 U/L) were more frequently observed in the Nanchang group as compared with the Nagasaki group (p < 0.05). According to an outcome analysis, the Nanchang patients showed worse survival rates as compared with Nagasaki patients, particularly those with American Joint Committee on Cancer stages I and III due to the aggressive character of HCC in the Nanchang group. CONCLUSION There are significant differences in the clinicopathologic features and outcomes of HCC patients from Japan and China. These differences may impact the eligibility for potentially curative therapy and the prognosis of patients with HCC.
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22
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Zekri ARN, Youssef ASED, Bakr YM, Gabr RM, Ahmed OS, Elberry MH, Mayla AM, Abouelhoda M, Bahnassy AA. Early detection of hepatocellular carcinoma co-occurring with hepatitis C virus infection: A mathematical model. World J Gastroenterol 2016; 22:4168-4182. [PMID: 27122667 PMCID: PMC4837434 DOI: 10.3748/wjg.v22.i16.4168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/16/2016] [Accepted: 03/02/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To develop a mathematical model for the early detection of hepatocellular carcinoma (HCC) with a panel of serum proteins in combination with α-fetoprotein (AFP).
METHODS: Serum levels of interleukin (IL)-8, soluble intercellular adhesion molecule-1 (sICAM-1), soluble tumor necrosis factor receptor II (sTNF-RII), proteasome, and β-catenin were measured in 479 subjects categorized into four groups: (1) HCC concurrent with hepatitis C virus (HCV) infection (n = 192); (2) HCV related liver cirrhosis (LC) (n = 96); (3) Chronic hepatitis C (CHC) (n = 96); and (4) Healthy controls (n = 95). The R package and different modules for binary and multi-class classifiers based on generalized linear models were used to model the data. Predictive power was used to evaluate the performance of the model. Receiver operating characteristic curve analysis over pairs of groups was used to identify the best cutoffs differentiating the different groups.
RESULTS: We revealed mathematical models, based on a binary classifier, made up of a unique panel of serum proteins that improved the individual performance of AFP in discriminating HCC patients from patients with chronic liver disease either with or without cirrhosis. We discriminated the HCC group from the cirrhotic liver group using a mathematical model (-11.3 + 7.38 × Prot + 0.00108 × sICAM + 0.2574 ×β-catenin + 0.01597 × AFP) with a cutoff of 0.6552, which achieved 98.8% specificity and 89.1% sensitivity. For the discrimination of the HCC group from the CHC group, we used a mathematical model [-10.40 + 1.416 × proteasome + 0.002024 × IL + 0.004096 × sICAM-1 + (4.251 × 10-4) × sTNF + 0.02567 ×β-catenin + 0.02442 × AFP] with a cutoff 0.744 and achieved 96.8% specificity and 89.7% sensitivity. Additionally, we derived an algorithm, based on a binary classifier, for resolving the multi-class classification problem by using three successive mathematical model predictions of liver disease status.
CONCLUSION: Our proposed mathematical model may be a useful method for the early detection of different statuses of liver disease co-occurring with HCV infection.
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23
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Narin P, Hamajima N, Kouy S, Hirosawa T, Eav S. Characteristics of liver cancer at Khmer-soviet Friendship Hospital in Phnom Penh, Cambodia. Asian Pac J Cancer Prev 2015; 16:35-9. [PMID: 25640378 DOI: 10.7314/apjcp.2015.16.1.35] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is one of the most frequent cancers in South East Asian countries including Cambodia, where prevalence of chronic carriers of hepatitis B and C virus (HBV and HCV) is reported to be very high. We reviewed HCC cases admitted to a cancer hospital in Phnom Penh, which is the only one hospital for cancer treatment and care in Cambodia during the study period. MATERIALS AND METHODS Information was collected from medical records of 281 cases (210 males and 71 females) diagnosed as primary HCC from 2006 to 2011. RESULTS The subjects were 7-81 years old with a median age of 53 years. Hypochondriac pain was the most common complained symptom (74%). One third of the cases presented with jaundice. Nearly half had ascites at their first visit. One third had liver cirrhosis. Nearly three fourths of the cases presented with tumor sized more than 50 mm in diameter, and in almost all cases (97.4%) the size was more than 20 mm. Among 209 subjects tested, hepatitis virus carriers were 75.6%; 46.4% for HBV only, 21.5% for HCV only, and 7.7% for both viral infections. Median age of patients with HBV was about ten years younger than those with HCV. CONCLUSIONS This study revealed the characteristics of HCC cases in Cambodia, although there were several limitations. Most HCC cases were infected with HBV and/or HCV, and diagnosed at late stages with complications. This implicated that public health intervention to prevent HBV and HCV infection is of high priority.
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Affiliation(s)
- Piseth Narin
- Department of International Cooperation, Ministry of Health, Phnom Penh, Cambodia E-mail :
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24
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Kulik L, Salem R. Yttrium-90 radioembolization for hepatocellular carcinoma in hepatitis B: commentary on a 103-patient Asian cohort. Hepatol Int 2015. [PMID: 26202633 DOI: 10.1007/s12072-014-9560-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Laura Kulik
- Division of Hepatology, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - Riad Salem
- Section of Interventional Radiology, Department of Radiology, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA.
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25
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Ha NH, Woo BH, Kim DJ, Ha ES, Choi JI, Kim SJ, Park BS, Lee JH, Park HR. Prolonged and repetitive exposure to Porphyromonas gingivalis increases aggressiveness of oral cancer cells by promoting acquisition of cancer stem cell properties. Tumour Biol 2015; 36:9947-60. [PMID: 26178482 DOI: 10.1007/s13277-015-3764-9] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 07/03/2015] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is the most common chronic inflammatory condition occurring in the human oral cavity, but our knowledge on its contribution to oral cancer is rather limited. To define crosstalk between chronic periodontitis and oral cancer, we investigated whether Porphyromonas gingivalis, a major pathogen of chronic periodontitis, plays a role in oral cancer progression. To mimic chronic irritation by P. gingivalis in the oral cavity, oral squamous cell carcinoma (OSCC) cells were infected with P. gingivalis twice a week for 5 weeks. Repeated infection of oral cancer cells by P. gingivalis resulted in morphological changes of host cancer cells into an elongated shape, along with the decreased expression of epithelial cell markers, suggesting acquisition of an epithelial-to-mesenchymal transition (EMT) phenotype. The prolonged exposure to P. gingivalis also promoted migratory and invasive properties of OSCC cells and provided resistance against a chemotherapeutic agent, all of which are described as cellular characteristics undergoing EMT. Importantly, long-term infection by P. gingivalis induced an increase in the expression level of CD44 and CD133, well-known cancer stem cell markers, and promoted the tumorigenic properties of infected cancer cells compared to non-infected controls. Furthermore, increased invasiveness of P. gingivalis-infected OSCC cells was correlated with enhanced production of matrix metalloproteinase (MMP)-1 and MMP-10 that was stimulated by interleukin-8 (IL-8) release. This is the first report demonstrating that P. gingivalis can increase the aggressiveness of oral cancer cells via epithelial-mesenchymal transition-like changes and the acquisition of stemness, implicating P. gingivalis as a potential bacterial risk modifier.
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Affiliation(s)
- Na Hee Ha
- Department of Oral Pathology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan-Si, Kyeongsangnam-Do, 626-870, South Korea
| | - Bok Hee Woo
- Department of Oral Pathology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan-Si, Kyeongsangnam-Do, 626-870, South Korea
| | - Da Jeong Kim
- Department of Oral Pathology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan-Si, Kyeongsangnam-Do, 626-870, South Korea
| | - Eun Sin Ha
- Department of Oral Pathology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan-Si, Kyeongsangnam-Do, 626-870, South Korea
| | - Jeom Il Choi
- Department of Periodontology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan, 626-870, South Korea
| | - Sung Jo Kim
- Department of Periodontology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan, 626-870, South Korea
| | - Bong Soo Park
- Department of Oral Anatomy, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan, 626-870, South Korea
| | - Ji Hye Lee
- Department of Oral Pathology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan-Si, Kyeongsangnam-Do, 626-870, South Korea.,Institute of Translational Dental Sciences, Pusan National University, 49 Busandaehak-Ro, Yangsan, 626-870, South Korea
| | - Hae Ryoun Park
- Department of Oral Pathology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Yangsan-Si, Kyeongsangnam-Do, 626-870, South Korea. .,Institute of Translational Dental Sciences, Pusan National University, 49 Busandaehak-Ro, Yangsan, 626-870, South Korea.
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26
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Chen CC, Kim KH, Lau LF. The matricellular protein CCN1 suppresses hepatocarcinogenesis by inhibiting compensatory proliferation. Oncogene 2015; 35:1314-23. [PMID: 26028023 PMCID: PMC4666840 DOI: 10.1038/onc.2015.190] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 04/23/2015] [Accepted: 05/01/2015] [Indexed: 12/11/2022]
Abstract
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide, and is on the rise in the United States. Previous studies showed that the matricellular protein CCN1 (CYR61) is induced during hepatic injuries and functions to restrict and resolve liver fibrosis. Here we show that CCN1 suppresses hepatocarcinogenesis by inhibiting carcinogen-induced compensatory hepatocyte proliferation, thus limiting the expansion of damaged and potentially oncogenic hepatocytes. Consistent with tumor suppression, CCN1 expression is down-regulated in human HCC. Ccn1ΔHep mice with hepatocyte-specific deletion of Ccn1 suffer increased HCC tumor multiplicity induced by the hepatocarcinogen diethylnitrosoamine (DEN). Knockin mice (Ccn1dm/dm) that express an integrin α6β1-binding defective CCN1 phenocopied Ccn1ΔHep mice, indicating that CCN1 acts through its α6β1 binding sites in this context. CCN1 effectively inhibits EGFR-dependent hepatocyte proliferation through integrin α6-mediated accumulation of reaction oxygen species (ROS), thereby triggering p53 activation and cell cycle block. Consequently, Ccn1dm/dm mice exhibit diminished p53 activation and elevated compensatory hepatocyte proliferation, resulting in increased HCC. Furthermore, we show that a single dose of the EGFR inhibitor erlotinib delivered prior to DEN-induced injury was sufficient to block compensatory proliferation and annihilate development of HCC nodules observed 8 months later, suggesting potential chemoprevention by targeting CCN1-inhibitable EGFR-dependent hepatocyte proliferation. Together, these results show that CCN1 is an injury response protein that functions not only to restrict fibrosis in the liver, but also to suppress hepatocarcinogenesis by inhibiting EGFR-dependent hepatocyte compensatory proliferation.
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Affiliation(s)
- C-C Chen
- Department of Biochemistry and Molecular Genetics, University of Illinois at Chicago, Chicago, IL, USA
| | - K-H Kim
- Department of Biochemistry and Molecular Genetics, University of Illinois at Chicago, Chicago, IL, USA
| | - L F Lau
- Department of Biochemistry and Molecular Genetics, University of Illinois at Chicago, Chicago, IL, USA
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Pančoška P, Skála L, Nešetřil J, Carr BI. Evaluation of total hepatocellular cancer lifespan, including both clinically evident and preclinical development, using combined network phenotyping strategy and fisher information analysis. Semin Oncol 2015; 42:339-46. [PMID: 25843738 PMCID: PMC4388062 DOI: 10.1053/j.seminoncol.2014.12.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We previously showed that for hepatocellular cancer (HCC) prognostication, disease parameters need to be considered within a total personal clinical context. This requires preserving the coherence of data values, observed simultaneously for each patient during baseline diagnostic evaluation. Application of the Network Phenotyping Strategy (NPS) provided quantitative descriptors of these patient coherences. Combination of these descriptors with Fisher information about the patient tumor mass and the histogram of the tumor masses in the whole cohort permitted estimation of the time from disease onset until clinical diagnosis (t(baseline)). We found faster growth of smaller tumors having total masses<70 (80% of cohort) which involved about three times more interacting cellular processes than were observed for slower growing larger tumors (20% of cohort) with total masses>70. Combining the clinical survival and t(baseline) normalized all HCC patients to a common 1,045 days of mean total disease duration (t(baseline) plus post diagnosis survival). We also found a simple relationship between the baseline clinical status, t(baseline), and survival. Every difference between individual patient baseline clinical profiles and special coherent clinical status (HL1) reduced the above common overall survival (OVS) by 65 days. In summary, we showed that HCC patients with any given tumor can best have their tumor biology understood, when account is taken of the total clinical and liver contexts, and with knowing the point in the tumor history when an HCC diagnosis is made. This ability to compute the t(baseline) from standard clinical data brings us closer to calculating survival from diagnosis of individual HCC patients.
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Affiliation(s)
- Petr Pančoška
- Department of Medicine and Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, PA; Computer Science Institute (IUUK) of Charles University Prague, Czech Republic
| | - Lubomír Skála
- Department of Chemical Physics and Optics, Faculty of Mathematics and Physics, Charles University Prague, Czech Republic
| | - Jaroslav Nešetřil
- Computer Science Institute (IUUK) of Charles University Prague, Czech Republic
| | - Brian I Carr
- Department of Gastroenterology and Liver Diseases Tel-Aviv Sourasky Medical Center Tel Aviv, Israel.
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Carr BI, Guerra V, Steel JL, Lu SN. A comparison of patients with hepatitis B- or hepatitis C-based advanced-stage hepatocellular carcinoma. Semin Oncol 2015; 42:309-15. [PMID: 25843735 DOI: 10.1053/j.seminoncol.2014.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer death and has characteristic causes, epidemiology and clinical features. The leading causes include hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholism, and aflatoxin B1 dietary exposure, as well as combinations of these factors. Few cancers offer the opportunity to study the clinical and cancer phenotype that results from different causes, quite like HCC. Advantage was taken of a large cohort of advanced, unresectable and untransplantable HCCs to compare the phenotypes resulting from HBV-based compared with HCV-based HCC. The main findings were that HBV-based HCC patients were statistically significantly younger, had a higher percent of males, had larger maximum tumor sizes, and had higher blood alpha-fetoprotein (AFP) and albumin levels and platelet counts than HCV-based HCC patients. These differences partly reflect an earlier age of HBV infection and a lesser degree of cirrhosis-associated liver damage, as a result of the different biological consequences of chronic HBV compared with chronic HCV infection.
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Affiliation(s)
- Brian I Carr
- Department of Gastroenterology and Liver Diseases Tel-Aviv Sourasky Medical Center Tel Aviv, Israel.
| | - Vito Guerra
- Department of Epidemiology, IRCCS de Bellis, National Institute for Digestive Diseases, Castellana Grotte, Italy
| | - Jennifer L Steel
- Departments of Surgery, Psychiatry, and Psychology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Sheng-Nan Lu
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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29
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Blank S, Wang Q, Fiel MI, Luan W, Kim KW, Kadri H, Mandeli J, Hiotis SP. Assessing prognostic significance of preoperative alpha-fetoprotein in hepatitis B-associated hepatocellular carcinoma: normal is not the new normal. Ann Surg Oncol 2014; 21:986-94. [PMID: 24232510 DOI: 10.1245/s10434-013-3357-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hepatitis B (HBV)-associated hepatocellular carcinoma (HCC) is often associated with alpha-fetoprotein (AFP) production. Although serum AFP has been demonstrated to be a prognostic factor for patient survival, optimal cutoff levels remain unclear. METHODS Patients with HBV-associated HCC treated by primary liver resection were prospectively followed at a single institution between 1995 and 2008. AFP level was categorized into quintiles for Kaplan–Meier analysis and multivariable Cox proportional hazards regression models. RESULTS Best 5-year survival after surgery was observed for patients with AFP in the first quintile (1.4-4.1 ng/mL), with progressively worse outcomes for patients in each increasing quintile. AFP was associated with overall survival (HR = 1.61; 95 % CI 1.30-1.98), disease-free survival (HR = 1.26; 95 % CI 1.10-1.44), and 2-year recurrence (HR = 1.30; 95 % CI 1.07-1.57) in multivariate analysis. Noncirrhotic patients (Ishak 1-5) with AFP in quintile 1 had 94 % 5-year survival, compared with 0 % survival for patients with AFP in quintile 5 (2,332.7-327,560.0 ng/mL) and Ishak stage 6 cirrhosis. CONCLUSIONS Preoperative serum AFP is an independent predictor of prognosis among HBV-HCC patients following surgical resection. Categorizing AFP into quintiles creates the opportunity to observe differences in outcomes even at low serum levels within the normal range. Additionally, combining AFP quintiles and fibrosis staging provides a predictive model of prognosis for HCC. Thus, even small differences in AFP within the normal range may impact prognosis and disease progression for HBV-HCC.
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30
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Sinn DH, Gwak GY, Cho J, Paik SW, Yoo BC. Comparison of clinical manifestations and outcomes between hepatitis B virus- and hepatitis C virus-related hepatocellular carcinoma: analysis of a nationwide cohort. PLoS One 2014; 9:e112184. [PMID: 25372403 PMCID: PMC4221592 DOI: 10.1371/journal.pone.0112184] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/13/2014] [Indexed: 12/24/2022] Open
Abstract
Background We analyzed whether difference exist in the clinical manifestations and outcomes of hepatocellular carcinoma (HCC) according to the two major etiologies of HCC from a nationwide, population-based, random HCC registry. Methods Of the 31,521 new HCC cases registered at the Korea Central Cancer Registry between 2003 and 2005, 4,630 (14.7%) were randomly abstracted, and followed up until December 2011. Of those, 2,785 hepatitis B virus (HBV)-related and 447 hepatitis C virus (HCV)-related HCC patients were compared. Results The mean annual incidence rates of HBV- and HCV-related HCC incidence per 100,000 persons were 20.8 and 4.9, respectively. The annual incidence rate of HBV-related HCC peaked at 50–59 age group (46.5 per 100,000 persons), while the annual incidence rate of HCV-related HCC increased gradually to the ≥70 year age group (13.2 per 100,000 persons). Large tumors (≥5 cm) and portal vein invasion at initial diagnosis were more frequent in HBV-related HCC, while multiple tumors were more frequent in HCV-related HCC. In outcome analysis, HBV-related HCC showed poorer survival than HCV-related HCC [median survival: 1.34 vs. 2.17 years, adjusted hazard ratio (95% confidence interval): 0.88 (0.78–0.98), P = 0.03, adjusted for age, gender, Child-Pugh class, AJCC/mUICC stage, and initial treatment modality]. However, when divided according to the AJCC/mUICC stage, survival difference was observed only for those with AJCC/mUICC stage IV tumor, but not for AJCC/mUICC stage I, II or III tumors. The treatment outcome of each modality (resection, ablation, and transartherial chemoeombolization) was comparable between the two etiologies. Conclusion HBV-related and HCV-related HCC have clear differences in clinical manifestation, requiring different screening strategy according to etiology to optimize HCC surveillance in HBV-endemic area. However, etiology did not affect treatment outcomes and long-term survival within the same stage except for far advanced tumors.
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Affiliation(s)
- Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Geum-Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- * E-mail:
| | - Juhee Cho
- Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
- Department of Health, Behavior and Society and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Chul Yoo
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Chan SL. Drug development for hepatocellular carcinoma: knowing the past helps to understand the future. Oncologist 2014; 19:1115-7. [PMID: 25223461 PMCID: PMC4221377 DOI: 10.1634/theoncologist.2014-0304] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 08/21/2014] [Indexed: 12/22/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a highly complicated disease characterized by comorbid cirrhosis and disease heterogeneity. Given multiple failures in the past, we need to learn from previous experiences and generate novel ideas to increase the chance of success. More effort and patience should be exercised in the selection of a homogeneous patient population and identification of predictive markers during drug development for HCC.
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Affiliation(s)
- Stephen L Chan
- State Key Laboratory in Oncology in South China, Sir Y.K. Pao Center for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, People's Republic of China
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Fatima S, Luk JM, Poon RTP, Lee NP. Dysregulated expression of dickkopfs for potential detection of hepatocellular carcinoma. Expert Rev Mol Diagn 2014; 14:535-48. [PMID: 24809435 DOI: 10.1586/14737159.2014.915747] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The prognosis for hepatocellular carcinoma (HCC) remains dismal due to the lack of diagnostic markers for early detection. This review will discuss the clinical potential of the dickkopf (DKK) family members as diagnostic and/or prognostic markers for HCC. In comparison to serum α-fetoprotein (AFP) level, which remains the gold standard for HCC diagnosis, high serum DKK1 levels have higher diagnostic value for HCC, especially for AFP-negative HCC, and can distinguish HCC from non-malignant chronic liver diseases. Additionally, the combination of serum DKK1 and AFP levels enhances diagnostic accuracy for HCC compared to serum DKK1 or AFP levels alone. Although DKK1 offers potential for its use in HCC diagnosis this review will discuss the challenges facing DKK1 and also shed some light on recent developments on the remaining DKK family members: DKK2, DKK3 and DKK4.
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Affiliation(s)
- Sarwat Fatima
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
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Nomoto S, Hishida M, Inokawa Y, Sugimoto H, Kodera Y. Management of hepatocellular carcinoma should consider both tumor factors and background liver factors. Hepatobiliary Surg Nutr 2014; 3:82-5. [PMID: 24812599 DOI: 10.3978/j.issn.2304-3881.2014.02.13] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 02/26/2014] [Indexed: 12/19/2022]
Abstract
As progression and outcome of relapsed hepatocellular carcinoma (HCC) are distinct from those of a second primary tumor, clonal analyses of initial and recurrent HCCs are thus clinically useful. Although several studies in Japan and Taiwan had shown that the multicentric origin (MO) recurrences were more common than intrahepatic metastases (IM), a recent report from China indicated that IM cases outnumber MO recurrences. In managing HCC cases, both tumor malignancy and background liver function are important considerations (and which we characterize as tumor factors and background liver factors, respectively); they indicate both appropriate treatment, and likely post-surgical outcome. In this editorial, we explain why the report had shown such a different conclusion. We also discuss current management of HCC.
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Affiliation(s)
- Shuji Nomoto
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Mitsuhiro Hishida
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Yoshikuni Inokawa
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Hiroyuki Sugimoto
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
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Munaf A, Memon MS, Kumar P, Ahmed S, Kumar MB. Comparison of viral hepatitis-associated hepatocellular carcinoma due to HBV and HCV - cohort from liver clinics in Pakistan. Asian Pac J Cancer Prev 2014; 15:7563-7. [PMID: 25292029 DOI: 10.7314/apjcp.2014.15.18.7563] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the first cause of death in cirrhotic patients, mostly due to viral hepatitis with HCV or HBV infection. This study was performed to estimate the true prevalence of viral hepatitis-related HCC and the demographic and clinical-pathological associations with the two virus types. MATERIALS AND METHODS This cross sectional observational study enrolled clinical data base of 188 HCC patients and variables included from baseline were age, sex, area of residence, clinical-pathological features such as underlying co-morbidity, presence or absence of liver cirrhosis, macrovascular involvement, tumor extension and metastasis, liver lobes involved, serum alpha-fetoprotein level, and hepatitis serologies. RESULTS Overall prevalence of HCV- and HBV-related HCC was 66.0% and 34.0%, respectively. Patients with HCV were more likely to develop HCC at advanced age (52.4±11.9 vs. 40.7±12.09 years), with highly raised serum AFP levels (≥400ng/ml) 78.2% (HBV 67.1%), large tumor size (HCV-66% >5 cm, HBV-59.3%), and presence of portal vein thrombosis (8.06%, HBV 1.56%). A binominal multivariate analysis showed that HCV-HCC group were more likely to be cirrhotic (OR=0.245, 95%CI: 0.117, 0.516) and had more than two times higher rate of solitary macrovascular involvement (OR=2.533, 95%CI: 1.162, 5.521) as compared with HBV associated HCC. CONCLUSIONS Statistically significant variations were observed from baseline to clinical-pathological characteristics in HCV vs HBV associated HCC. Our study suggests prompt and early screening for high risk patients so that the rate of progression of these chronic viral diseases to cirrhosis and cancer can be decreased.
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Affiliation(s)
- Alvina Munaf
- Asian Institute of Medical Sciences, Hyderabad, Pakistan E-mail :
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Bertani S, Pineau P, Loli S, Moura J, Zimic M, Deharo E, Ruiz E. An atypical age-specific pattern of hepatocellular carcinoma in Peru: a threat for Andean populations. PLoS One 2013; 8:e67756. [PMID: 23840771 PMCID: PMC3695993 DOI: 10.1371/journal.pone.0067756] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 05/22/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In South America, the highest incidence of primary liver cancer is observed in Peru. However, national estimations on hepatocellular carcinoma incidence and mortality are approximated using aggregated data from surrounding countries. Thus, there is a lack of tangible information from Peru that impairs an accurate description of the local incidence, presentation, and outcomes of hepatocellular carcinoma. The present study attempts to fill this gap and assesses the clinical epidemiology of hepatocellular carcinoma in this country. METHODS A retrospective cohort study was conducted by analysing the medical charts of 1,541 patients with hepatocellular carcinoma admitted between 1997 and 2010 at the Peruvian national institute for cancer. The medical records including liver function, serologic status, and tumor pathology and stage were monitored. Statistical analyses were performed in order to characterize tumor presentation according to demographic features, risk factors, and regional origin. RESULTS Surprisingly, the age distribution of the patient population displayed bimodality corresponding to two distinct age-based subpopulations. While an older group was in keeping with the age range observed for hepatocellular carcinoma around the world, a younger population displayed an abnormally juvenile mean age of 25.5 years old. In addition, each subpopulation displayed age-specific pathophysiological and clinical characteristics. CONCLUSIONS The analysis suggests two different age-specific natural histories of hepatocellular carcinoma in the Peruvian patient population. This otherwise unusual tumor process that is ongoing in younger patients leads to the hypothesis that there may be a Peru-endemic risk factor driving hepatocarcinogenesis in the local population.
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Affiliation(s)
- Stéphane Bertani
- Université de Toulouse 3, Unité de Pharmacochimie et Pharmacologie pour le Développement, UMR152, Toulouse, France.
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Yuan W, Huang T, Yu J, Zeng L, Lian B, He Q, Li Y, Zhang X, Zhou F, Xie L. Comparative analysis of viral protein interaction networks in Hepatitis B virus and Hepatitis C virus infected HCC. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2013; 1844:271-9. [PMID: 23774196 DOI: 10.1016/j.bbapap.2013.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 05/09/2013] [Accepted: 06/04/2013] [Indexed: 02/07/2023]
Abstract
Previously, the different mechanisms of HBV infection and HCV infection were studied experimentally. Multiple studies also compared the differential network between HBV induced HCC and HCV induced HCC based on gene expression data. However network level comparison combining viral-human interaction network and dysfunctional protein interaction network for HBV and HCV-HCC has rarely been done before. In this work we did some pioneer job in construction of HBV/HCV viral dysfunctional network in HCC, in hope of investigating viral infection impact on the change of genome expression and eventually, the development of HCC. We found that HBx, the main HBV viral protein, directly acted on the gene groups of cell cycle, which could perfectly explain the dominant cell proliferation effect shown in the dysfunctional network of HBV-HCC. On the other hand, multiple important HCV viral proteins including CORE, NS3 and NS5A were found to target very important cancer related proteins such as TP53 and SMAD3, but no direct targeting to major immune response or inflammation related proteins. Therefore the dominant activation of immune response and inflammation related pathways shown in dysfunctional network of HCV-HCC might not be a direct effect of HCV infection. They might have been an indirect demonstration of activated cancer promoting pathways. Similar approaches may as well be applied to other important virus infection caused human diseases to help elucidate the mechanisms of virus-host interaction, and even help with investigations on anti-virus based therapies. This article is part of a Special Issue entitled: Computational Proteomics, Systems Biology & Clinical Implications.
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Affiliation(s)
- Weilan Yuan
- School of Life Sciences and Technology, Tongji University, Shanghai 200092, PR China; Shanghai Center for Bioinformation Technology, Shanghai 201203, PR China.
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Zhu J, Jiang F, Ni HB, Xiao MB, Chen BY, Ni WK, Lu CH, Ni RZ. Combined analysis of serum γ-glutamyl transferase isoenzyme II, α-L-fucosidase and α-fetoprotein detected using a commercial kit in the diagnosis of hepatocellular carcinoma. Exp Ther Med 2012; 5:89-94. [PMID: 23251247 PMCID: PMC3524245 DOI: 10.3892/etm.2012.783] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 10/29/2012] [Indexed: 12/25/2022] Open
Abstract
γ-glutamyl transferase isoenzyme II (GGT-II) is a sensitive biomarker of hepatocellular carcinoma (HCC). However, numerous disadvantages of the traditional manual method affected its application. The commercial kit provided a convenient and fast method for the determination of GGT-II levels. The purposes of the present study were to compare the reproducibility and sensitivity between the manual and commercial kit methods and to evaluate the diagnostic efficiency for HCC with the combined analysis of GGT-II, α-L-fucosidase (AFU) and α-fetoprotein (AFP). In patients with various liver diseases (HCC, liver cirrhosis and chronic hepatitis) and normal subjects, GGT-II was detected by manual and commercial polyacrylamide gel electrophoresis (PAGE). The levels of AFU and AFP were assayed by colorimetry and a chemiluminescence immunoassay, respectively. The commercial PAGE had equal diagnostic efficiency with traditional manual PAGE and no significant differences were observed in intra- and average-gel reproducibility and GGT-II sensitivities between the manual and commercial PAGE (P>0.05). The incidence of GGT-II detected by commercial PAGE in HCC patients was 84.1% and <8% in benign liver disease. The levels of AFU and AFP in the benign liver diseases and normal subjects were lower than those in HCC. According to the cut-off value obtained by receiver operating characteristic curves, a total of 56.6 and 59.3% of HCC patients (64 out of 113 and 67 out of 113) had AFU >636.5 μmol/l h and AFP >44.0 μg/l, respectively. There were no significant correlations between GGT-II and AFU or AFP. Combined detection of GGT-II with AFU or AFP increased the diagnostic sensitivity to 92.9 and 93.8%, respectively. These results suggest that commercial PAGE provides a simple and reproducible method for GGT-II detection. Combined determination of GGT-II with AFU or AFP exhibited superior sensitivity and specificity for the diagnosis of HCC.
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