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Macdonald JK, Clift CL, Saunders J, Zambrzycki SC, Mehta AS, Drake RR, Angel PM. Differential Protease Specificity by Collagenase as a Novel Approach to Serum Proteomics That Includes Identification of Extracellular Matrix Proteins without Enrichment. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2024; 35:487-497. [PMID: 38329320 PMCID: PMC10921462 DOI: 10.1021/jasms.3c00366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024]
Abstract
Circulating extracellular matrix (ECM) proteins are serological biomarkers of interest due to their association with pathologies involving disease processes such as fibrosis and cancers. In this study, we investigate the potential for serum biomarker research using differential protease specificity (DPS), leveraging alternate protease specificity as a targeting mechanism to selectively digest circulating ECM protein serum proteins. A proof-of-concept study is presented using serum from patients with cirrhotic liver or hepatocellular carcinoma. The approach uses collagenase DPS for digestion of deglycosylated serum and liquid-chromatography-trapped ion mobility-tandem mass spectrometry (LC-TIMS-MS/MS) to enhance the detection of ECM proteins in serum. It requires no sample enrichment and minimizes the albumin average precursor intensity readout to less than 1.2%. We further demonstrate the capabilities for using the method as a high-throughput matrix-assisted laser/desorption ionization mass spectrometry (MALDI-MS) assay coupled with reference library searching. A goal is to improve the depth and breadth of biofluid proteomics for noninvasive assays.
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Affiliation(s)
- Jade K. Macdonald
- Department of Cell and Molecular
Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, South Carolina 29425, United States
| | | | | | - Stephen C. Zambrzycki
- Department of Cell and Molecular
Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, South Carolina 29425, United States
| | - Anand S. Mehta
- Department of Cell and Molecular
Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, South Carolina 29425, United States
| | - Richard R. Drake
- Department of Cell and Molecular
Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, South Carolina 29425, United States
| | - Peggi M. Angel
- Department of Cell and Molecular
Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, South Carolina 29425, United States
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Liu R, Wu S, Yu HY, Zeng K, Liang Z, Li S, Hu Y, Yang Y, Ye L. Prediction model for hepatocellular carcinoma recurrence after hepatectomy: Machine learning-based development and interpretation study. Heliyon 2023; 9:e22458. [PMID: 38034691 PMCID: PMC10687050 DOI: 10.1016/j.heliyon.2023.e22458] [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: 05/24/2023] [Revised: 09/10/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023] Open
Abstract
Background Identifying patients with hepatocellular carcinoma (HCC) at high risk of recurrence after hepatectomy can help to implement timely interventional treatment. This study aimed to develop a machine learning (ML) model to predict the recurrence risk of HCC patients after hepatectomy. Methods We retrospectively collected 315 HCC patients who underwent radical hepatectomy at the Third Affiliated Hospital of Sun Yat-sen University from April 2013 to October 2017, and randomly divided them into the training and validation sets at a ratio of 7:3. According to the postoperative recurrence of HCC patients, the patients were divided into recurrence group and non-recurrence group, and univariate and multivariate logistic regression were performed for the two groups. We applied six machine learning algorithms to construct the prediction models and performed internal validation by 10-fold cross-validation. Shapley additive explanations (SHAP) method was applied to interpret the machine learning model. We also built a web calculator based on the best machine learning model to personalize the assessment of the recurrence risk of HCC patients after hepatectomy. Results A total of 13 variables were included in the machine learning models. The multilayer perceptron (MLP) machine learning model was proved to achieve optimal predictive value in test set (AUC = 0.680). The SHAP method displayed that γ-glutamyl transpeptidase (GGT), fibrinogen, neutrophil, aspartate aminotransferase (AST) and total bilirubin (TB) were the top 5 important factors for recurrence risk of HCC patients after hepatectomy. In addition, we further demonstrated the reliability of the model by analyzing two patients. Finally, we successfully constructed an online web prediction calculator based on the MLP machine learning model. Conclusion MLP was an optimal machine learning model for predicting the recurrence risk of HCC patients after hepatectomy. This predictive model can help identify HCC patients at high recurrence risk after hepatectomy to provide early and personalized treatment.
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Affiliation(s)
- Rongqiang Liu
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Shinan Wu
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Hao yuan Yu
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kaining Zeng
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhixing Liang
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Siqi Li
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yongwei Hu
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang Yang
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Linsen Ye
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Xu J, An S, Lu Y, Li L, Wu ZQ, Xu HG. Preoperative alpha fetoprotein, total bilirubin, fibrinogen, albumin, and lymphocytes predict postoperative survival in hepatocellular carcinoma. Cancer Med 2023. [PMID: 37156623 DOI: 10.1002/cam4.6030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/13/2023] [Accepted: 04/21/2023] [Indexed: 05/10/2023] Open
Abstract
AIMS Our study focused on exploring the feasible prognostic laboratory parameters of HCC and establishing a score model to estimate individualized overall survival (OS) in HCC after resection. METHODS Four hundred and sixty-one patients with HCC who underwent hepatectomy between January 2010 and December 2017 was enrolled in this investigation. Cox proportional hazards model was conducted to analyze the prognostic value of laboratory parameters. The score model construction was based on the forest plot results. Overall survival was evaluated by Kaplan-Meier method and the log-rank test. The novel score model was validated in an external validation cohort from a different medical institution. RESULTS We identified that alpha fetoprotein (AFP), total bilirubin (TB), fibrinogen (FIB), albumin (ALB), and lymphocyte (LY) were independent prognostic factors. High AFP, TB, FIB (HR > 1, p < 0.05), and low ALB, LY (HR < 1, p < 0.05) were associated with the survival of HCC. The novel score model of OS based on these five independent prognostic factors achieved high C-index of 0.773 (95% confidence interval [CI]: 0.738-0.808), which was significantly higher than those of the single five independent factors (0.572-0.738). The score model was validated in the external cohort whose C-index was 0.7268 (95% CI: 0.6744-0.7792). CONCLUSION The novel score model we established was an easy-to-use tool which could enable individualized estimation of OS in patients with HCC who underwent curative hepatectomy.
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Affiliation(s)
- Jia Xu
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, Jiangsu, China
| | - Shu An
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ying Lu
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, Jiangsu, China
| | - Laisheng Li
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Qi Wu
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, Jiangsu, China
| | - Hua-Guo Xu
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, Jiangsu, China
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Luo PQ, Ye ZH, Zhang LX, Song ED, Wei ZJ, Xu AM, Lu Z. Prognostic factors for disease-free survival in postoperative patients with hepatocellular carcinoma and construction of a nomogram model. World J Clin Cases 2022; 10:13250-13263. [PMID: 36683638 PMCID: PMC9850999 DOI: 10.12998/wjcc.v10.i36.13250] [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] [Received: 08/12/2022] [Revised: 09/15/2022] [Accepted: 11/25/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the most common type of liver cancer and has a high risk of invasion and metastasis along with a poor prognosis.
AIM To investigate the independent predictive markers for disease-free survival (DFS) in patients with HCC and establish a trustworthy nomogram.
METHODS In this study, 445 patients who were hospitalized in The First Affiliated Hospital of Anhui Medical College between December 2009 and December 2014 were retrospectively examined. The survival curve was plotted using the Kaplan–Meier method and survival was determined using the log-rank test. To identify the prognostic variables, multivariate Cox regression analyses were carried out. To predict the DFS in patients with HCC, a nomogram was created. C-indices and receiver operator characteristic curves were used to evaluate the nomogram's performance. Decision curve analysis (DCA) was used to evaluate the clinical application value of the nomogram.
RESULTS Longer DFS was observed in patients with the following characteristics: elderly, I–II stage, and no history of hepatitis B. The calibration curve showed that this nomogram was reliable and had a higher area under the curve value than the tumor node metastasis (TNM) stage. Moreover, the DCA curve revealed that the nomogram had good clinical applicability in predicting 3- and 5-year DFS in HCC patients after surgery.
CONCLUSION Age, TNM stage, and history of hepatitis B infection were independent factors for DFS in HCC patients, and a novel nomogram for DFS of HCC patients was created and validated.
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Affiliation(s)
- Pan-Quan Luo
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
| | - Zheng-Hui Ye
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
| | - Li-Xiang Zhang
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
| | - En-Dong Song
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
| | - Zhi-Jian Wei
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
| | - A-Man Xu
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
| | - Zhen Lu
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230011, Anhui Province, China
- Anhui Public Health Clinical Center, Hefei 230011, Anhui Province, China
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Inoue A, Matsumoto T, Ito Y, Saegusa M, Takahashi H. TP53 positivity combined with high fibrinogen expression defines a subtype of oral squamous cell carcinoma with an unfavorable prognosis. Hum Pathol 2022; 130:25-35. [PMID: 36441045 DOI: 10.1016/j.humpath.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/04/2022] [Accepted: 10/20/2022] [Indexed: 11/04/2022]
Abstract
The number of deaths due to oral squamous cell carcinoma (OSCC), a malignant tumor of the oral cavity, is on the increase. We examined fibrinogen (FIB) expression in patients with OSCC and developed novel immunoprofile classification methods that include FIB. The plasma FIB level in patients with OSCC was elevated compared with that in patients with non-tumor oral disease (non-T); using a cut-off point of 342 mg/dL, we found the area under the curve-receiver operating characteristic level for OSCC was 0.745. Similarly, FIB expression in OSCC tissues was significantly higher compared with that in non-T tissues. Hierarchical clustering based on the immunoprofile of several markers including FIB, p53, and p16 revealed four groups that could be used to categorize OSCC cases (referred to as immunoprofile subtypes [IPS], I-IV). Tumors in IPS-II, which were FIB+/p53+, were associated with a significantly worse overall survival (OS) when compared with the other subtypes. We conclude that our IPS classification system can facilitate prognostic evaluation in OSCC, and that quantification of FIB is an important component of the classification strategy for this disease.
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Affiliation(s)
- Akemi Inoue
- Department of Pathology, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa 252-0373, Japan
| | - Toshihide Matsumoto
- Department of Pathology, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa 252-0373, Japan.
| | - Yuka Ito
- Department of Pathology, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa 252-0373, Japan
| | - Makoto Saegusa
- Department of Pathology, School of Medicine, Kitasato University Sagamihara, Kanagawa 252-0374, Japan
| | - Hiroyuki Takahashi
- Department of Pathology, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa 252-0373, Japan
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Sebastian-Valles F, Sánchez de la Blanca Carrero N, Rodríguez-Laval V, Martinez-Hernández R, Serrano-Somavilla A, Knott-Torcal C, Muñoz de Nova JL, Martín-Pérez E, Marazuela M, Sampedro-Nuñez MA. Impact of Change in Body Composition during Follow-Up on the Survival of GEP-NET. Cancers (Basel) 2022; 14:cancers14215189. [PMID: 36358607 PMCID: PMC9654293 DOI: 10.3390/cancers14215189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are heterogeneous rare diseases causing malnutrition and cachexia in which the study of body composition may have an impact in prognosis. Aim: Evaluation of muscle and fat tissues by computed tomography (CT) at the level of the third lumbar (L3 level) at diagnosis and at the end of follow-up in GET-NET patients and their relationships with clinical and biochemical variables as predictors of survival. Methodology: Ninety-eight GEP-NET patients were included. Clinical and biochemical parameters were evaluated. Total body, subcutaneous, visceral and total fat areas and very low-density, low-density, normal density, high-density, very high-density and total muscle areas were obtained from CT images. Results: Body composition measures and overall mortality correlated with age, ECOG (Eastern Cooperative Oncology Group performance status) metastases, lactate dehydrogenase (LDH), albumin and urea levels. Although there was no relationship between body composition variables at diagnosis and overall and specific mortality, an increase in low-density muscle and a decrease in normal-density muscle during follow-up were independently correlated to overall (p <0.05) and tumor-cause mortality (p < 0.05). Conclusion: Although body composition measures obtained by CT at diagnosis did not impact survival of GEP-NET patients, a loss of good quality muscle during follow-up was associated with an increased overall and tumor-related mortality. Nutritional status should therefore be supervised by nutrition specialists and an increase in good quality muscle could improve prognosis.
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Affiliation(s)
- Fernando Sebastian-Valles
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, 28006 Madrid, Spain
| | | | | | | | - Ana Serrano-Somavilla
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Carolina Knott-Torcal
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, 28006 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - José Luis Muñoz de Nova
- Department of General and Digestive Surgery, Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Elena Martín-Pérez
- Department of General and Digestive Surgery, Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Mónica Marazuela
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, 28006 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, 28006 Madrid, Spain
- Correspondence: ; Tel.: +34-915-202494
| | - Miguel Antonio Sampedro-Nuñez
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, 28006 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, 28006 Madrid, Spain
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Liu G, Xu X, Geng H, Li J, Zou S, Li X. FGA inhibits metastases and induces autophagic cell death in gastric cancer via inhibiting ITGA5 to regulate the FAK/ERK pathway. Tissue Cell 2022; 76:101767. [DOI: 10.1016/j.tice.2022.101767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/23/2022] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
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Wang C, Liu Z, Chen J, Rao W, Dong S, Yang M, Zheng S, Zang Y, Xu X. A model integrated fibrinogen and D-dimer for prediction of hepatocellular carcinoma recurrence following liver transplantation: a multicentre study. Am J Transl Res 2022; 14:572-581. [PMID: 35173875 PMCID: PMC8829632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND We aimed to investigate whether D-dimer and fibrinogen levels could predict prognosis of patients with hepatocellular carcinoma (HCC) following liver transplantation. METHODS From January 2015 to January 2020, we conducted a study on patients with hepatitis B-related liver cancer. Two hundred seventy (270) liver transplant recipients were recruited. Considering D-dimer and plasma fibrinogen levels, a model was established to predict liver cancer recurrence following liver transplantation. Subsequent verification was performed on a validation cohort of 295 recipients from two other hospitals. RESULTS Elevated D-dimer and plasma fibrinogen levels demonstrated independent correlation between overall survival and tumour-free survival among patients with HCC who underwent liver transplantation. Those who had preoperative fibrinogen ≥2.27 g/L had significantly reduced overall survival and tumour-free survival than those who had preoperative fibrinogen <2.27 g/L, in the discovery cohort. Recipients with increased risk had preoperative plasma D-dimer ≥2400 µg/L. The model was: Y= logit (P) =0.91* fibrinogen concentration +0.967* D-dimer +0.585* alpha-fetoprotein +1.623* Milan criteria +0.68* microvascular invasion -3.159. At a cut-off score of -1.524, the validation cohort had area under curve values of 0.764 and 0.828 respectively; analysis of this data optimised predictive performance for overall and tumour-free survival. CONCLUSIONS For patients who have undergone liver transplantation for HCC, preoperative D-dimer and fibrinogen levels independently predicted key outcomes such as overall survival and tumour-free survival.
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Affiliation(s)
- Chao Wang
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineHangzhou, China
- Zhejiang University Cancer CenterHangzhou, China
- Institute of Organ Transplantation, Zhejiang UniversityHangzhou, China
| | - Zhikun Liu
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineHangzhou, China
- Zhejiang University Cancer CenterHangzhou, China
- Institute of Organ Transplantation, Zhejiang UniversityHangzhou, China
| | - Jun Chen
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineHangzhou, China
- Zhejiang University Cancer CenterHangzhou, China
- Institute of Organ Transplantation, Zhejiang UniversityHangzhou, China
| | - Wei Rao
- Division of Hepatology, Liver Disease Center, The Affiliated Hospital of Qingdao UniversityQingdao, China
- Institute of Transplantation Science, Qingdao UniversityQingdao, China
| | - Siyi Dong
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of MedicineHangzhou, China
| | - Modan Yang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of MedicineHangzhou, China
| | - Shusen Zheng
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of MedicineHangzhou, China
- Institute of Organ Transplantation, Zhejiang UniversityHangzhou, China
- Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) HospitalHangzhou, China
| | - Yunjin Zang
- Division of Liver Transplantation Organ Transplantation Center, The Affiliated Hospital of Qingdao UniversityQingdao, China
- Institute of Transplantation Science, Qingdao UniversityQingdao, China
| | - Xiao Xu
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineHangzhou, China
- Zhejiang University Cancer CenterHangzhou, China
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of MedicineHangzhou, China
- Institute of Organ Transplantation, Zhejiang UniversityHangzhou, China
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Deng Y, Zhu S, Yan W, Qi L, Chen Z, Ma L. Influence of clear cell carcinoma on the post-hepatectomy prognosis of patients with hepatocellular carcinoma. Future Oncol 2021; 18:543-552. [PMID: 34878322 DOI: 10.2217/fon-2021-0381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The authors aimed to identify factors that independently influence the survival of patients with primary clear cell carcinoma of the liver (PCCCL). Methods: A total of 470 patients with hepatocellular carcinoma were retrospectively analyzed. Multivariate Cox analysis was used to identify potential factors associated with prognosis of PCCCL. Results: Patients with PCCCL showed significantly higher disease-free survival (DFS) and overall survival (OS) compared with patients with non-clear cell hepatocellular carcinoma. Multivariate analysis revealed that AFP level, tumor size, liver cirrhosis and portal vein tumor thrombosis were risk factors for DFS. Tumor size, capsule formation and Ki-67 were risk factors for OS. Satellite nodules acted as a protective factor for DFS and OS. Conclusion: PCCCL is associated with better prognosis in hepatocellular carcinoma. Tumor size and satellite nodules may be independent predictors of OS and DFS.
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Affiliation(s)
- Yongheng Deng
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| | - Shaoliang Zhu
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| | - Wen Yan
- Clinical School of Medicine, Jiamusi University, China
| | - Lunan Qi
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| | - Zushun Chen
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| | - Liang Ma
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
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Chen W, Hu MJ, Zhong XL, Ji LH, Wang J, Zhang CF, Zhang R, Lin HM. Screening of a novel autophagy-related prognostic signature and therapeutic targets in hepatocellular carcinoma. J Gastrointest Oncol 2021; 12:2985-2998. [PMID: 35070424 PMCID: PMC8748040 DOI: 10.21037/jgo-21-664] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/12/2021] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Many studies have indicated that autophagy plays an important role in multiple cancers, including hepatocellular carcinoma (HCC). This study aimed to establish a prognostic signature for HCC based on autophagy-related genes (ARGs) to predict the prognosis of patients. METHODS The list of ARGs was derived from screening National Center for Biotechnology Information (NCBI)-Gene and Molecular Signatures Database (MSigDB) datasets. Differential analysis was conducted via the R limma package in HCC patients based on The Cancer Genome Atlas (TCGA) database. Univariate and multivariate Cox regression analysis were conducted to identify key prognostic ARGs via the survival package. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed by clusterProfiler package. The Estimation of Stromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) algorithm was used to conduct immune analysis. Finally, the correlation between the prognostic model and clinical characteristics was also assessed, including age, tumor-node-metastasis (TNM) stages, and tumor grades. RESULTS Firstly, 106 differential ARGs were identified and 10 candidates were further confirmed via Cox regression analysis, including BAMBI, HIF1A, SERPINE1, EZH2, SLC9A3R1, IGFBP3, HSPB8, DAB2, CXCL1 and PRNP. The receiver operating characteristic (ROC) curve analysis revealed that the ARGs risk model had a well diagnostic positive rate with 1-year area under the curve (AUC) =0.688 and 3-year AUC =0.674. Correlation analysis indicated that only advanced tumor stages were positively associated with high ARGs scores with P=0.0227. There were also significant differences in tumor purity (P=6.71e-05), infiltrating cell analysis (P=7.77e-05), immune analysis (P=7.9e-05), and stromal cells analysis (P=0.0015) in high- and low-risk ARGs samples. The genes HIF1A, IGFBP3, and DAB2 were found to have high frequent missense mutations in samples with high-risk ARGs scores. Lastly, we also established a nomogram to predict overall survival (OS) of HCC by integrating ARGs scores and other clinical parameters. CONCLUSIONS Our study established an autophagy-related signature for predicting the prognosis of HCC patients, providing a thorough understanding of the underlying mechanisms of autophagy in HCC.
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Affiliation(s)
- Wei Chen
- Department of Oncology, People’s Hospital of Huadu District, Guangzhou, China
| | - Ming-Juan Hu
- Department of Pathology, People’s Hospital of Huadu District, Guangzhou, China
| | - Xiao-Lan Zhong
- Department of Gastroenterology, People’s Hospital of Huadu District, Guangzhou, China
| | - Lin-Hua Ji
- Department of Oncology, People’s Hospital of Huadu District, Guangzhou, China
| | - Jian Wang
- Department of Interventional Medicine, People’s Hospital of Huadu District, Guangzhou, China
| | - Cheng-Fang Zhang
- Department of Oncology, People’s Hospital of Huadu District, Guangzhou, China
| | - Rui Zhang
- HBP Surgery Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hao-Ming Lin
- HBP Surgery Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Shen Y, Wang H, Wei J, Li W. Early Prediction of Objective Response of Fibrinogen in a Real-World Cohort of Hepatocellular Carcinoma Cases Treated by Programmed Cell Death Receptor-1 and Lenvatinib. Onco Targets Ther 2021; 14:5019-5026. [PMID: 34675546 PMCID: PMC8513529 DOI: 10.2147/ott.s332351] [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: 08/02/2021] [Accepted: 09/28/2021] [Indexed: 12/24/2022] Open
Abstract
Background This cohort study aimed to investigate the influence of fibrinogen on progression-free survival and overall survival in unresectable HCC cases treated by PD-1 and lenvatinib. Methods A total of 57 unresectable HCC cases who received lenvatinib and PD-1, such as toripalimab, camrelizumab, or sintilimab, in Beijing Ditan Hospital Affiliated to Capital Medical University were enrolled in this study. Results Vascular invasion, high FIB (>2.83g/L), and metastasis were highly correlated with low PFS. There was a significant correlation between a raised risk of death and metastasis and increased FIB (>2.83g/L). Conclusion FIB is associated with outcomes of unresectable HCC cases treated by PD-1 and lenvatinib.
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Affiliation(s)
- Yanjun Shen
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Huige Wang
- Department of Gynecology, Wangjing Hospital of Chinese Academy of Chinese Medical, Beijing, 100102, People's Republic of China
| | - Jianying Wei
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Wendong Li
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
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The preoperative elevated plasma fibrinogen level is associated with the prognosis of hilar cholangiocarcinoma. Surg Today 2021; 51:1352-1360. [PMID: 33651221 DOI: 10.1007/s00595-021-02249-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/22/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE Elevated fibrinogen (Fbg) levels contribute to tumor progression and metastasis. However, little is known regarding the association of the clinicopathological characteristics and the prognosis of hilar cholangiocarcinoma (HC) with plasma fibrinogen. METHODS Data on the plasma Fbg levels, clinicopathological characteristics, and overall survival were retrospectively collected. Plasma fibrinogen concentrations over 4.0 g/L were classified as hyperfibrinogen, elevated fibrinogen, or abnormal fibrinogen levels. We then analyzed the relationships among plasma fibrinogen level, clinicopathological features, and patient prognosis. RESULTS A total of 171 HC patients were included. An elevated plasma fibrinogen level was associated with lymph-node metastasis (P < 0.001), the AJCC stage (P < 0.001), the surgical margin (P = 0.005), and vascular invasion (P = 0.027). Univariate analyses revealed that preoperative plasma fibrinogen (P < 0.001), operative blood loss (P = 0.044), vascular invasion (P < 0.001), CA19-9 (P = 0.003), surgical margin (P < 0.001), T stage (P < 0.001), histologic differentiation (P = 0.007), and lymph-node metastasis (P < 0.001) were associated with OS. The survival time of patients with high Fbg levels was shorter than that of patients with normal fibrinogen levels (P < 0.001). Furthermore, a multivariate analysis showed that fibrinogen was negatively and independently associated with the HC prognosis (P = 0.029). CONCLUSIONS An elevated plasma Fbg level was associated with lymph-node metastasis, vascular invasion, the surgical margin, and the tumor stage, and the Fbg level might therefore be an independent factor associated with poor outcomes in HC patients.
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Dai T, Deng M, Ye L, Lin G, Liu R, Deng Y, Li R, Liu W, Li H, Yang Y, Chen G, Wang G. Nomograms based on clinicopathological factors and inflammatory indicators for prediction of early and late recurrence of hepatocellular carcinoma after surgical resection for patients with chronic hepatitis B. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:12. [PMID: 33553305 PMCID: PMC7859768 DOI: 10.21037/atm-20-1353] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Few studies have focused on the prognostic values of inflammation-related factors for different phases of recurrence in hepatocellular carcinoma (HCC). We aimed to identify the different risk factors for overall, early, and late recurrence, and to establish nomograms based on inflammation-related parameters for predicting the risks of recurrence in a group of HCC patients undergoing hepatectomy. Methods We retrospectively enrolled 383 HCC patients with chronic hepatitis B (CHB) who underwent hepatectomy. Univariate and multivariate Cox analyses were conducted to identify independent risk factors for recurrence. Nomograms for overall, early, and late recurrence-free survival (RFS) were established. The discrimination and calibration abilities of the nomograms were evaluated by concordance indexes (C-index), calibration plots, and Kaplan-Meier curves. Finally, receiver operating characteristic (ROC) curves were used to compare the derived nomograms with other existing models. Results Fibrinogen, lymphocyte-to-monocyte ratio, and S-index inflammation-related factors were independently related to overall and early RFS, but only the S-index correlated with late recurrence. Nomograms with tumor number, diameter, and pathological differentiation for overall and early RFS were established, while nomogram for late recurrence was constructed with tumor number and Child-Pugh grade. The C-indexes for overall, early, and late RFS were 0.679, 0.677, and 0.728, respectively. The calibration plots fit well. The nomograms showed superior discrimination capacities and better performance prediction with larger areas under the curve for recurrence. Conclusions The developed nomograms that integrated inflammation-related factors showed high predictive accuracy for overall, early, and late recurrence in HCC patients with CHB after hepatectomy.
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Affiliation(s)
- Tianxing Dai
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Mingbin Deng
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Linsen Ye
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Guozhen Lin
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Rongqiang Liu
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yinan Deng
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.,Organ Transplantation Institute of Sun Yat-Sen University, Guangzhou, China
| | - Rong Li
- Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wei Liu
- Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hua Li
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.,Organ Transplantation Institute of Sun Yat-Sen University, Guangzhou, China
| | - Yang Yang
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.,Organ Transplantation Institute of Sun Yat-Sen University, Guangzhou, China
| | - Guihua Chen
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.,Organ Transplantation Institute of Sun Yat-Sen University, Guangzhou, China
| | - Guoying Wang
- Department of Hepatic Surgery and Liver Transplant Program, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.,Organ Transplantation Institute of Sun Yat-Sen University, Guangzhou, China
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