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Li J, Ma Y, Yang C, Qiu G, Chen J, Tan X, Zhao Y. Radiomics analysis of R2* maps to predict early recurrence of single hepatocellular carcinoma after hepatectomy. Front Oncol 2024; 14:1277698. [PMID: 38463221 PMCID: PMC10920317 DOI: 10.3389/fonc.2024.1277698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/09/2024] [Indexed: 03/12/2024] Open
Abstract
Objectives This study aimed to evaluate the effectiveness of radiomics analysis with R2* maps in predicting early recurrence (ER) in single hepatocellular carcinoma (HCC) following partial hepatectomy. Methods We conducted a retrospective analysis involving 202 patients with surgically confirmed single HCC having undergone preoperative magnetic resonance imaging between 2018 and 2021 at two different institutions. 126 patients from Institution 1 were assigned to the training set, and 76 patients from Institution 2 were assigned to the validation set. A least absolute shrinkage and selection operator (LASSO) regularization was conducted to operate a logistic regression, then features were identified to construct a radiomic score (Rad-score). Uni- and multi-variable tests were used to assess the correlations of clinicopathological features and Rad-score with ER. We then established a combined model encompassing the optimal Rad-score and clinical-pathological risk factors. Additionally, we formulated and validated a predictive nomogram for predicting ER in HCC. The nomogram's discrimination, calibration, and clinical utility were thoroughly evaluated. Results Multivariable logistic regression revealed the Rad-score, microvascular invasion (MVI), and α fetoprotein (AFP) level > 400 ng/mL as significant independent predictors of ER in HCC. We constructed a nomogram based on these significant factors. The areas under the receiver operator characteristic curve of the nomogram and precision-recall curve were 0.901 and 0.753, respectively, with an F1 score of 0.831 in the training set. These values in the validation set were 0.827, 0.659, and 0.808. Conclusion The nomogram that integrates the radiomic score, MVI, and AFP demonstrates high predictive efficacy for estimating the risk of ER in HCC. It facilitates personalized risk classification and therapeutic decision-making for HCC patients.
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Affiliation(s)
- Jia Li
- Department of Oncology, Central People’s Hospital of Zhanjiang, Zhanjiang, China
| | - Yunhui Ma
- Department of Oncology, Central People’s Hospital of Zhanjiang, Zhanjiang, China
| | - Chunyu Yang
- Department of Radiology, The First School of Clinical Medicine, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Ganbin Qiu
- Imaging Department of Zhaoqing Medical College, Zhaoqing, China
| | - Jingmu Chen
- Department of Radiology, Central People’s Hospital of Zhanjiang, Zhanjiang, China
| | - Xiaoliang Tan
- Department of Radiology, Central People’s Hospital of Zhanjiang, Zhanjiang, China
| | - Yue Zhao
- Department of Radiology, Central People’s Hospital of Zhanjiang, Zhanjiang, China
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Zhang J, Fang J, Xun Z, Xu Y, Lu X, Zhao H. Letter to the editor: Atezolizumab plus bevacizumab for hepatocellular carcinoma in the real world. Hepatology 2022; 76:E84-E85. [PMID: 35604038 DOI: 10.1002/hep.32588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 04/28/2022] [Indexed: 12/08/2022]
Affiliation(s)
- Junwei Zhang
- Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Jinyu Fang
- Department of Human Anatomy and Histology and Embryology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Ziyu Xun
- Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Yiyao Xu
- Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Xin Lu
- Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Haitao Zhao
- Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
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Wang W, Wang F, Chen Q, Ouyang S, Iwamoto Y, Han X, Lin L, Hu H, Tong R, Chen YW. Phase Attention Model for Prediction of Early Recurrence of Hepatocellular Carcinoma With Multi-Phase CT Images and Clinical Data. FRONTIERS IN RADIOLOGY 2022; 2:856460. [PMID: 37492657 PMCID: PMC10365106 DOI: 10.3389/fradi.2022.856460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/24/2022] [Indexed: 07/27/2023]
Abstract
Hepatocellular carcinoma (HCC) is a primary liver cancer that produces a high mortality rate. It is one of the most common malignancies worldwide, especially in Asia, Africa, and southern Europe. Although surgical resection is an effective treatment, patients with HCC are at risk of recurrence after surgery. Preoperative early recurrence prediction for patients with liver cancer can help physicians develop treatment plans and will enable physicians to guide patients in postoperative follow-up. However, the conventional clinical data based methods ignore the imaging information of patients. Certain studies have used radiomic models for early recurrence prediction in HCC patients with good results, and the medical images of patients have been shown to be effective in predicting the recurrence of HCC. In recent years, deep learning models have demonstrated the potential to outperform the radiomics-based models. In this paper, we propose a prediction model based on deep learning that contains intra-phase attention and inter-phase attention. Intra-phase attention focuses on important information of different channels and space in the same phase, whereas inter-phase attention focuses on important information between different phases. We also propose a fusion model to combine the image features with clinical data. Our experiment results prove that our fusion model has superior performance over the models that use clinical data only or the CT image only. Our model achieved a prediction accuracy of 81.2%, and the area under the curve was 0.869.
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Affiliation(s)
- Weibin Wang
- Graduate School of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Fang Wang
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Qingqing Chen
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Shuyi Ouyang
- College of Computer Science and Technology, Zhejiang University, Hangzhou, China
| | - Yutaro Iwamoto
- Graduate School of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Xianhua Han
- Graduate School of Information Science and Engineering, Yamaguchi University, Yamaguchi-shi, Japan
| | - Lanfen Lin
- College of Computer Science and Technology, Zhejiang University, Hangzhou, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Ruofeng Tong
- College of Computer Science and Technology, Zhejiang University, Hangzhou, China
- Zhejiang Lab, Research Center for Healthcare Data Science, Hangzhou, China
| | - Yen-Wei Chen
- Graduate School of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
- College of Computer Science and Technology, Zhejiang University, Hangzhou, China
- Zhejiang Lab, Research Center for Healthcare Data Science, Hangzhou, China
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4
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Wu JY, Huang LM, Bai YN, Wu JY, Wei YG, Zhang ZB, Yan ML. Imaging Features of Hepatocellular Carcinoma With Bile Duct Tumor Thrombus: A Multicenter Study. Front Oncol 2021; 11:723455. [PMID: 34804918 PMCID: PMC8602699 DOI: 10.3389/fonc.2021.723455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/18/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives There are still challenging problems in diagnosis of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) before operation. This study aimed to analyze the imaging features of HCC with B1–B3 BDTT. Materials and Methods The clinicopathological data and imaging findings of 30 HCC patients with B1–B3 BDTT from three high-volume institutions were retrospectively reviewed. A total of 631 patients without BDTT who were randomly collected from each of the enrolled centers were recorded as the control group to analyze the differences in clinicopathological characteristics and imaging features between the two groups. A total of 453 HCC patients who underwent surgical treatment in the three institutions from January 2020 to December 2020 were collected for a blinded reading test as the validation group. Results HCC patients with B1–B3 BDTT had more advanced tumor stages and adverse clinicopathological features. HCC lesions were detected in all patients, and intrahepatic bile duct dilation was observed in 28 (93.3%) patients with B1–B3 BDTT and 9 (1.43%) patients in HCC without BDTT. The intrahepatic bile duct dilation showed no enhancement at hepatic arterial phase (HAP) and no progressively delayed enhancement at portal venous phase (PVP), but it was more obvious at PVP on CT. In the reports of the 30 HCC patients with B1–B3 BDTT generated for the image when the scan was done, BDTT was observed in all 13 B3 patients and 3 of 12 B2 patients, but none of the 5 B1 patients. Fourteen patients were misdiagnosed before surgery. However, when using intrahepatic bile duct dilation in HCC patients as a potential biomarker for BDTT diagnosis, the sensitivity and specificity for BDTT diagnosis were 93.33% and 98.57%, respectively. The blinded reading test showed that intrahepatic bile duct dilation in CT and MRI scans could be for separating HCC patients with B1–B3 BDTT from HCC patients without BDTT. Conclusions The HCC lesions and intrahepatic bile duct dilation on CT or MRI scans are imaging features of HCC with BDTT, which might facilitate the early diagnosis of B1–B3 BDTT.
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Affiliation(s)
- Jun-Yi Wu
- Department of Hepatobiliary Surgery, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Li-Ming Huang
- Department of Hepatobiliary Surgery, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yan-Nan Bai
- Department of Hepatobiliary Surgery, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Jia-Yi Wu
- Department of Hepatobiliary Surgery, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Yong-Gang Wei
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Zhi-Bo Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Mao-Lin Yan
- Department of Hepatobiliary Surgery, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
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Wu JY, Sun JX, Bai YN, Huang XX, Wu JY, Wei YG, Zhang ZB, Zhou JY, Wang YD, Cheng SQ, Yan ML. Long-Term Outcomes of Anatomic Versus Nonanatomic Resection in Hepatocellular Carcinoma Patients with Bile Duct Tumor Thrombus: A Propensity Score Matching Analysis. Ann Surg Oncol 2021; 28:7686-7695. [PMID: 33929619 DOI: 10.1245/s10434-021-09874-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/28/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Anatomic resection (AR) of the liver is generally recommended in hepatocellular carcinoma (HCC) patients. However, the benefits of AR and nonanatomic resection (NAR) in HCC patients with bile duct tumor thrombus (BDTT) are unknown. This study aimed to compare long-term outcomes of AR and NAR in HCC patients with BDTT after curative resection. PATIENTS AND METHODS A total of 175 consecutive HCC patients with BDTT after curative resection between April 2009 and December 2017 were included. One-to-one propensity score matching (PSM) was performed to minimize the influence of potential confounders. Recurrence-free survival (RFS) and overall survival (OS) were compared between the cohorts. RESULTS After PSM, 120 patients were analyzed. The AR group had better RFS than the NAR group (P = 0.010). Even though there was no statistically significant difference in OS (P = 0.140, power = 0.33), the 3- and 5-year OS rates in the AR group (52.4% and 44.2%, respectively) were obviously higher than those in the NAR group (35.4% and 30.4%, respectively). When patients were further stratified according to tumor size, better RFS and OS were observed in patients with small (≤ 5 cm) tumors after AR (P < 0.001 and P = 0.004, respectively). Multivariate analysis identified AR (P = 0.024) as an independent favorable prognostic factor for RFS in HCC patients with BDTT. CONCLUSIONS AR is recommended for HCC patients with BDTT, especially in patients with small (≤ 5 cm) tumors.
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Affiliation(s)
- Jia-Yi Wu
- Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Ju-Xian Sun
- Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Yan-Nan Bai
- Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Xiao-Xiao Huang
- Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Jun-Yi Wu
- Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Yong-Gang Wei
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zhi-Bo Zhang
- Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jian-Yin Zhou
- Department of Hepatobiliary Surgery, Zhongshan Hospital of Xiamen University, Xiamen, China
| | - Yao-Dong Wang
- Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Shu-Qun Cheng
- Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
| | - Mao-Lin Yan
- Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China.
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Wu JY, Sun JX, Wu JY, Huang XX, Bai YN, Zeng YY, Zhang ZB, Cheng SQ, Yan ML. A nomogram based on combining systemic and hepatic inflammation markers for predicting microscopic bile duct tumour thrombus in hepatocellular carcinoma. BMC Cancer 2021; 21:272. [PMID: 33711965 PMCID: PMC7955625 DOI: 10.1186/s12885-021-07956-9] [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: 07/07/2020] [Accepted: 02/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background Bile duct invasion is a relatively rare event and is not well characterised in hepatocellular carcinoma (HCC). It remains very difficult to diagnose HCC with bile duct tumour thrombus (BDTT) before surgery. Increasing evidence has revealed that inflammation plays a critical role in tumorigenesis. This study aimed to develop nomograms based on systemic and hepatic inflammation markers to predict microscopic BDTT (micro-BDTT) before surgery in HCC. Methods A total of 723 HCC patients who underwent hepatectomy as initial therapy between January 2012 and June 2020 were included in the study. Logistic regression analysis was used to identify independent risk factors for micro-BDTT. The nomograms were constructed using significant predictors, including α-fetoprotein (AFP), alkaline phosphatase (ALP), direct bilirubin (DB), prognostic nutritional index (PNI), and γ-glutamyl transferase (γ-GT)/alanine aminotransferase (ALT). The prediction accuracies of the nomograms were evaluated using the area under the receiver operating characteristic (ROC) curve. Results AFP, ALP, DB, PNI, and γ-GT/ALT were independent risk factors for predicting micro-BDTT (P = 0.036, P = 0.004, P = 0.013, P = 0.012, and P = 0.006, respectively), which were assembled into the nomograms. The area under the ROC curve of the nomograms combining PNI and γ-GT/ALT for predicting micro-BDTT was 0.804 (95% confidence interval [CI]: 0.730–0.878). The sensitivity and specificity values when used in predicting micro-BDTT before surgery were 0.739 (95% CI: 0.612–0.866) and 0.781 (95% CI: 0.750–0.813), respectively. Conclusions The nomogram based on combining systemic and hepatic inflammation markers is suitable for predicting micro-BDTT before surgery in HCC patients, leading to a rational therapeutic choice for HCC.
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Affiliation(s)
- Jun-Yi Wu
- Department of Hepatobiliary Surgery, Fujian Provincial Hospital, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Ju-Xian Sun
- Department of Hepatic Surgery VI, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Road, Shanghai, 200433, China
| | - Jia-Yi Wu
- Department of Hepatobiliary Surgery, Fujian Provincial Hospital, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Xiao-Xiao Huang
- Department of Hepatobiliary Surgery, Fujian Provincial Hospital, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Yan-Nan Bai
- Department of Hepatobiliary Surgery, Fujian Provincial Hospital, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Yong-Yi Zeng
- Department of Hepatobiliary Surgery, Mengchao Hepotabiliary Hospital of Fujian Medical University, Fuzhou, China
| | - Zhi-Bo Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Shu-Qun Cheng
- Department of Hepatic Surgery VI, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Road, Shanghai, 200433, China.
| | - Mao-Lin Yan
- Department of Hepatobiliary Surgery, Fujian Provincial Hospital, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China.
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Zhao Y, Wu J, Zhang Q, Hua Z, Qi W, Wang N, Lin T, Sheng L, Cui D, Liu J, Song Q, Li X, Wu T, Guo Y, Cui J, Liu A. Radiomics Analysis Based on Multiparametric MRI for Predicting Early Recurrence in Hepatocellular Carcinoma After Partial Hepatectomy. J Magn Reson Imaging 2020; 53:1066-1079. [PMID: 33217114 DOI: 10.1002/jmri.27424] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Preoperative prediction of early recurrence (ER) of hepatocellular carcinoma (HCC) plays a critical role in individualized risk stratification and further treatment guidance. PURPOSE To investigate the role of radiomics analysis based on multiparametric MRI (mpMRI) for predicting ER in HCC after partial hepatectomy. STUDY TYPE Retrospective. POPULATION In all, 113 HCC patients (ER, n = 58 vs. non-ER, n = 55), divided into training (n = 78) and validation (n = 35) cohorts. FIELD STRENGTH/SEQUENCE 1.5T or 3.0T, gradient-recalled-echo in-phase T1 -weighted imaging (I-T1 WI) and opposed-phase T1 WI (O-T1 WI), fast spin-echo T2 -weighted imaging (T2 WI), spin-echo planar diffusion-weighted imaging (DWI), and gradient-recalled-echo contrast-enhanced MRI (CE-MRI). ASSESSMENT In all, 1146 radiomics features were extracted from each image sequence, and radiomics models based on each sequence and their combination were established via multivariate logistic regression analysis. The clinicopathologic-radiologic (CPR) model and the combined model integrating the radiomics score with the CPR risk factors were constructed. A nomogram based on the combined model was established. STATISTICAL TESTS Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative performance of each model. The potential clinical usefulness was evaluated by decision curve analysis (DCA). RESULTS The radiomics model based on I-T1 WI, O-T1 WI, T2 WI, and CE-MRI sequences presented the best performance among all radiomics models with an area under the ROC curve (AUC) of 0.771 (95% confidence interval (CI): 0.598-0.894) in the validation cohort. The combined nomogram (AUC: 0.873; 95% CI: 0.756-0.989) outperformed the radiomics model and the CPR model (AUC: 0.742; 95% CI: 0.577-0.907). DCA demonstrated that the combined nomogram was clinically useful. DATA CONCLUSION The mpMRI-based radiomics analysis has potential to predict ER of HCC patients after hepatectomy, which could enhance risk stratification and provide support for individualized treatment planning. EVIDENCE LEVEL 4. TECHNICAL EFFICACY Stage 4.
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Affiliation(s)
- Ying Zhao
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Jingjun Wu
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Qinhe Zhang
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Zhengyu Hua
- Department of Pathology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Wenjing Qi
- Department of Pathology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Nan Wang
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Tao Lin
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Liuji Sheng
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Dahua Cui
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Jinghong Liu
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Xin Li
- GE Healthcare (China), Shanghai, China
| | | | - Yan Guo
- GE Healthcare (China), Shanghai, China
| | | | - Ailian Liu
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
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Huang Q, Lin K, Wang L, Zeng J, Liu H, Ding Z, Zeng Y, Liu J. Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching Study. Cancer Manag Res 2020; 12:9183-9195. [PMID: 33061610 PMCID: PMC7535114 DOI: 10.2147/cmar.s270467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/29/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose To evaluate the effect of postoperative adjuvant transarterial chemoembolization (PA-TACE) on the prognosis of hepatocellular carcinoma (HCC) with macroscopic bile duct tumor thrombus (BDTT). Patients and Methods This study included 109 patients who underwent R0 resection for HCC with BDTT between January 2008 and December 2017: non-TACE (48) and PA-TACE (61). Propensity-score matching (PSM) was conducted in a 1:1 ratio. Recurrence and overall survival (OS) rates were analyzed using the Kaplan–Meier method. Independent risk factors were identified by univariate and multivariate Cox regression analyses. Subgroup analysis was performed by risk-factor stratification. Results The recurrence rates in the non-TACE and PA-TACE groups were different at 6 months (50.9% vs 26.9%, P=0.03) before PSM and at 6 months (59.3% vs 26.5%, P=0.02) and 12 months (81.4% vs 37.5%, P=0.022) after PSM. OS rates of the non-TACE and PA-TACE groups were different at 6 months (74.0% vs 91.6%, P<0.001) and 12 months (61.1% vs 77.6%, P=0.01) before PSM and at 6 months (73.0% vs 96.8%, P=0.01), 12 months (52.1% vs 89.6%, P=0.001), and 18 months (33.8% vs 64.4%, P=0.034) after PSM. PA-TACE was an independent prognostic factor for both recurrence and OS before and after PSM. Subgroup analysis showed that patients with no HBV infection, tumors >5 cm, macrovascular invasion, alpha-fetoprotein (AFP) >400 ng/mL, or gamma-glutamyl transferase (GGT) >150 U/L benefited significantly from PA-TACE in terms of recurrence rates (all P<0.05). Patients with no HBV infection, multiple tumors, tumors >5 cm, macrovascular invasion, or AFP >400 ng/mL benefited significantly from PA-TACE in terms of OS (all P<0.05). Conclusion PA-TACE could prolong the short-term prognosis of HCC with macroscopic BDTT and should be recommended for patients with no HBV infection, multiple tumors, tumors >5 cm, poor differentiation, macrovascular invasion, AFP >400 ng/mL, or GGT >150 U/L.
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Affiliation(s)
- Qizhen Huang
- Department of Radiation Oncology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Kongying Lin
- Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Lei Wang
- Department of Radiation Oncology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Jianxing Zeng
- Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Hongzhi Liu
- Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Zongren Ding
- Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Yongyi Zeng
- Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Jingfeng Liu
- Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China
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Wu H, Huang XP, Xiang R, Wu MY, Guo X, Li Q, Luo XL. CHEK2 SNPs predict better prognosis in HBV-related hepatocellular carcinoma patients. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2018; 11:3165-3175. [PMID: 31938446 PMCID: PMC6958064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/25/2017] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Checkpoint kinase 2 gene (CHEK2) is an important mediator of the DNA damage response pathway. Single nucleotide polymorphisms (SNPs) have been shown to influence the developing risk and clinical characteristics in various types of human malignancies. The values of CHEK2 SNPs in HBV-related hepatocellular carcinoma patients (HCC) were unknown and discussed here. METHODS The expression and prognostic prediction role of CHEK2 were searched and analyzed in HBV-related HCC patients by GEO database. SNPs in CHEK2 were genotyped by SNP selection tools, and further assessed their associations with clinical outcomes of 339 HBV-related HCC patients. RESULTS Patients with a higher CHEK2 gene expression predicted a worse relapse free survival (RFS). Moreover, those with a variant alleles CC/TT of SNPs rs1547014 and rs738722 had a significantly better prognosis when compared to the patients with CT genotype (P<0.015 for rs1547014, P=0.001 for rs738722), and CC/TT genotype combined with AFP≤400 ng/ml also predicted the best prognosis in HBV-related HCC patients. In stratified analysis, the protective effect of rs1547014 and rs738722 CC/TT genotype was more evident in patients with adverse strata, comparing the patients with favorable strata. CONCLUSION CHEK2 SNPs rs1547014 and rs738722 probably be potential prognostic bio-markers in HBV-related HCC patients.
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Affiliation(s)
- Hong Wu
- Department of Experimental Research, The Affiliated Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi, China
- Department of Chest Surgery, Sichuan Cancer HospitalChengdu, Sichuan, China
| | - Xin-Ping Huang
- Department of Experimental Research, The Affiliated Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi, China
- Shenzhen Hornetcorn Biotechnology Company, Ltd.Shenzhen, Guangdong, China
| | - Run Xiang
- Department of Experimental Research, The Affiliated Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi, China
- Department of Chest Surgery, Sichuan Cancer HospitalChengdu, Sichuan, China
| | - Man-Ya Wu
- Department of Experimental Research, The Affiliated Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi, China
| | - Xing Guo
- Department of Experimental Research, The Affiliated Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi, China
| | - Qiang Li
- Department of Experimental Research, The Affiliated Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi, China
- Department of Chest Surgery, Sichuan Cancer HospitalChengdu, Sichuan, China
| | - Xiao-Ling Luo
- Department of Experimental Research, The Affiliated Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi, China
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10
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Zhang N, Liu X, Liu L, Deng Z, Zeng Q, Pang W, Liu Y, Song D, Deng H. Glycogen synthase kinase-3β inhibition promotes lysosome-dependent degradation of c-FLIP L in hepatocellular carcinoma. Cell Death Dis 2018; 9:230. [PMID: 29445085 PMCID: PMC5833564 DOI: 10.1038/s41419-018-0309-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/02/2018] [Accepted: 01/11/2018] [Indexed: 12/16/2022]
Abstract
Glycogen synthase kinase-3β (GSK-3β) is a ubiquitously expressed serine/threonine kinase involved in a variety of functions ranging from the control of glycogen metabolism to transcriptional regulation. We recently demonstrated that GSK-3β inhibition triggered ASK1-JNK-dependent apoptosis in human hepatocellular carcinoma (HCC) cells. However, the comprehensive picture of downstream GSK-3β-regulated pathways/functions remains elusive. In this study, we showed that GSK-3β was aberrantly activated in HCC. Pharmacological inhibition and genetic depletion of GSK-3β suppressed the growth and induced caspase-dependent apoptosis in HCC cells. In addition, GSK-3β inhibition-induced apoptosis through downregulation of c-FLIPL in HCC, which was caused by biogenesis of functional lysosomes and subsequently c-FLIPL translocated to lysosome for degradation. This induction of the lysosome-dependent c-FLIPL degradation was associated with nuclear translocation of transcription factor EB (TFEB), a master regulator of lysosomal biogenesis. Moreover, GSK-3β inhibition-induced TFEB translocation acts through activation of AMPK and subsequently suppression of mTOR activity. Thus our findings reveal a novel mechanism by which inhibition of GSK-3β promotes lysosome-dependent degradation of c-FLIPL. Our study shows that GSK-3β may become a promising therapeutic target for HCC.
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Affiliation(s)
- Na Zhang
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China
| | - Xiaojia Liu
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China
| | - Lu Liu
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China
| | - Zhesong Deng
- Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Qingxuan Zeng
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China
| | - Weiqiang Pang
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China
| | - Yang Liu
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China
| | - Danqing Song
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China.
| | - Hongbin Deng
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100050, China.
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11
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Zhang R, Lin P, Yang H, He Y, Dang YW, Feng ZB, Chen G. Clinical role and biological function of CDK5 in hepatocellular carcinoma: A study based on immunohistochemistry, RNA-seq and in vitro investigation. Oncotarget 2017; 8:108333-108354. [PMID: 29312535 PMCID: PMC5752448 DOI: 10.18632/oncotarget.22659] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 10/27/2017] [Indexed: 12/20/2022] Open
Abstract
To investigate the clinical role and biological function of cyclin-dependent kinase 5 (CDK5) in hepatocellular carcinoma (HCC), 412 surgically resected tissue samples (HCC, n=171; non-HCC=241) were obtained and analyzed with immunohistochemistry. The diagnostic and prognostic values of CDK5 expression levels in HCC were clarified. Moreover, RNA-seq data or microarray datasets from The Cancer Genome Atlas (TCGA) (HCC, n=374; normal, n=50) or other public databases (HCC, n=1864; non-tumor=1995) regarding CDK5 in HCC were extracted and examined. Several bioinformatic methods were performed to identify CDK5-regulated pathways. In vitro experiments were adopted to measure proliferation and apoptosis in HCC cells after CDK5 mRNA was inhibited in the HCC cell lines HepG2 and HepB3. Based on immunohistochemistry, CDK5 expression levels were notably increased in HCC tissues (n=171) compared with normal (n=33, P<0.001), cirrhosis (n=37, P<0.001), and adjacent non-cancerous liver (n=171, P<0.001) tissues. The up-regulation of CDK5 was associated with higher differentiation (P<0.001), metastasis (P<0.001), advanced clinical TNM stages (P<0.001), portal vein tumor embolus (P=0.003) and vascular invasion (P=0.004). Additionally, TCGA data analysis also revealed significantly increased CDK5 expression in HCC compared with non-cancerous hepatic tissues (P<0.001). The pooled standard mean deviation (SMD) based on 36 included datasets (HCC, n=2238; non-cancerous, n=2045) indicated that CDK5 was up-regulated in HCC (SMD=1.23, 95% CI: 1.00-1.45, P<0.001). The area under the curve (AUC) of the summary receiver operating characteristic (SROC) curve was 0.88. Furthermore, CDK5 knock-down inhibited proliferation and promoted apoptosis. In conclusion, CDK5 plays an essential role in the initiation and progression of HCC, most likely via accelerating proliferation and suppressing apoptosis in HCC cells by regulating the cell cycle and DNA replication pathways.
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Affiliation(s)
- Rui Zhang
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Peng Lin
- Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Hong Yang
- Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yun He
- Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yi-Wu Dang
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Zhen-Bo Feng
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Gang Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
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12
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Shang L, Ye X, Zhu G, Su H, Su Z, Chen B, Xiao K, Li L, Peng M, Peng T. Prognostic value of integrin variants and expression in post-operative patients with HBV-related hepatocellular carcinoma. Oncotarget 2017; 8:76816-76831. [PMID: 29100351 PMCID: PMC5652745 DOI: 10.18632/oncotarget.20161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 06/20/2017] [Indexed: 01/21/2023] Open
Abstract
Integrins are a large family of cell surface receptors that bind extracellular matrix proteins and participate in cancer progression. However, the prognostic value of integrin family genes in post-operative patients with HBV-related hepatocellular carcinoma (HCC) remains unknown. In this study, we investigated 18 single nucleotide polymorphisms (SNPs) in integrin family genes and found that the AG/GG genotypes at rs988574 in ITGA1 predicted a better prognosis compared to carriers of the AA genotype (P = 0.025, HR = 0.69, 95%CI = 0.50–0.96). Moreover, rs988574 genotype combined with serum level of AFP had a better prognostic value in HBV-related HCC patients (P = 0.026, HR = 1.75, 95% CI = 1.07–2.85). Furthermore, we compared the expression of 24 integrin family genes in HBV-related HCC tissues and adjacent normal tissues. Survival analysis demonstrated that expression of three of the family members, ITGA5, ITGB5 and ITGA2B, were significantly associated with the overall survival (OS) or relapse-free survival (RFS) of HBV-related HCC patients. Additionally, patients with lower expression of both ITGA5 and ITGB5 had the best OS and RFS (P = 0.017 and P = 0.002, respectively). Our study demonstrated that rs988574 of ITGA1 and the expression of ITGA5, ITGB5 and ITGA2B are potential independent prognostic bio-markers and therapeutic targets for HBV-related HCC patients and may be useful for the diagnosis of HBV-related HCC.
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Affiliation(s)
- Liming Shang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinping Ye
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Guangzhi Zhu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Hao Su
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhixiong Su
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Bin Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Kaiyin Xiao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lequn Li
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Minhao Peng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Tao Peng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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13
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Chotirosniramit A, Liwattanakun A, Lapisatepun W, Ko-Iam W, Sandhu T, Junrungsee S. A single institution report of 19 hepatocellular carcinoma patients with bile duct tumor thrombus. J Hepatocell Carcinoma 2017; 4:41-47. [PMID: 28331844 PMCID: PMC5349699 DOI: 10.2147/jhc.s126308] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Obstructive jaundice caused due to bile duct tumor thrombus (BDTT) in a hepatocellular carcinoma (HCC) patient is an uncommon event. This study reports our clinical experiences and evaluates the outcomes of HCC patients with BDTT in a single institution. Methods A retrospective review of 19 HCC patients with secondary obstructive jaundice caused due to BDTT during a 15-year period was conducted. Results At the time of diagnosis, 14 (73.7%) patients had obstructive jaundice. Eighteen (94.7%) patients were preoperatively suspected of “obstruction of the bile duct”. Sixteen patients (84.2%) underwent a hepatectomy with curative intent, while two patients underwent removal of BDTT combined with biliary decompression and another patient received only palliative care as his liver reserve and general condition could not tolerate the primary tumor resection. The overall early recurrence (within 1 year) after hepatectomy occurred in more than half (9/16, 56.3%) of our patients. The 1-year survival rate of patients was 75% (12/16). The longest disease-free survival time was >11 years. Conclusion Identification of HCC patients with obstructive jaundice is clinically important because proper treatment can offer an opportunity for a cure and favorable long-term survival.
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Affiliation(s)
- Anon Chotirosniramit
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Akkaphod Liwattanakun
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Worakitti Lapisatepun
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wasana Ko-Iam
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Trichak Sandhu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sunhawit Junrungsee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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14
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Zhang T, Qiao X, Yang C. BRD4 inhibitor JQ1 inhibits viability of hepatocellular carcinoma cells. Shijie Huaren Xiaohua Zazhi 2016; 24:1501-1510. [DOI: 10.11569/wcjd.v24.i10.1501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore the effect of bromodomain-containing protein 4 (BRD4) inhibitor (JQ1) on the proliferation and apoptosis of two hepatocellular carcinoma cell lines.
METHODS: We used JQ1 to treat HepG2 and Bel-7402 cell lines. Cell viability was investigated by sulforhodamine B (SRB) staining. EdU incorporation assay and Hoechst 33342 staining were used to detect cell proliferation. Alteration of cell cycle and cell apoptosis were measured by flow cytometry. Early apoptosis was detected by Annexin V-FITC/propidium iodide double staining assay. Western blot was used to observe the level change of C-myc protein, because JQ1 mediates antiproliferative effect mainly by lowering its expression.
RESULTS: JQ1 significantly inhibited the viability of HCC cell lines HepG2 and Bel-7402. The inhibition was dose-dependent within a certain range. JQ1 inhibited cell proliferation as revealed by EdU incorporation assay. Annexin V-FITC/PI double staining analysis revealed that JQ1 can promote the cell apoptosis. JQ1 treatment significantly suppressed C-myc protein expression. Compared with JQ1 or sorafenib alone, sorafenib in combination with small dose of JQ1 more significantly inhibited HCC cell growth and increased apoptosis, suggesting that JQ1 and sorafenib have a synergistic effect.
CONCLUSION: BRD4 inhibitor JQ1 may be a potential new drug to treat hepatocellular carcinoma.
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