Clinical significance of CD44 expression in children with hepatoblastoma

An update on diagnosis and treatment of hepatoblastoma

Hepatoblastoma (HB) remains the most common paediatric liver tumour and survival in children with hepatoblastoma has improved considerably since the advent of sequential surgical regimens of chemotherapy based on platinum-based chemotherapeutic agents in the 1980s. With the advent of modern diagnostic imaging and pathology techniques, new preoperative chemotherapy regimens and the maturation of surgical techniques, new diagnostic and treatment options for patients with hepatoblastoma have emerged and international collaborations are investigating the latest diagnostic approaches, chemotherapy drug combinations and surgical strategies. Diagnosis of hepatoblastoma relies on imaging studies (such as ultrasound, computed tomography, and magnetic resonance imaging), alpha-fetoprotein (AFP) levels, and histological confirmation through biopsy. The standard treatment approach involves a multimodal strategy with neoadjuvant chemotherapy followed by surgical resection. In cases where complete resection is not feasible or tumors exhibit invasive characteristics, liver transplantation is considered. The management of metastatic and recurrent hepatoblastoma poses significant challenges, and ongoing research focuses on developing targeted therapies and exploring the potential of immunotherapy. Further studies are necessary to gain a better understanding of the etiology of hepatoblastoma, develop prevention strategies, and personalize treatment approaches. We aim to review the current status of diagnosis and treatment of hepatoblastoma.

Decreased erythrocyte CD44 and CD58 expression link e-waste Pb toxicity to changes in erythrocyte immunity in preschool children

Lead (Pb) toxicity damages blood cells and disturbs the immune micro-environment. When Pb enters the circulatory system, >95% of Pb accumulates in erythrocytes. We therefore conducted this study to explore the long-term effect of Pb exposure on expression of erythrocyte adhesion molecules (CD44 and CD58) and related downstream cytokine concentrations. We enrolled a total of 267 preschool children, 2-7 years of age, from Guiyu (e-waste-exposed group, n = 132) and Haojiang (reference group, n = 135) in November and December 2015. We measured child blood Pb, biomarkers including erythrocyte CD44 and CD58, erythrocyte count, leukocyte count and inflammatory cytokines (IL-1β, IL-12p70 and IFN-γ), and calculated erythrocyte Pb levels. Regression model demonstrated that higher erythrocyte Pb was associated with lower CD44 and CD58. Compared to low erythrocyte Pb levels (quartile 1), high erythrocyte Pb levels (quartile 4) were related to lower levels of erythrocyte CD44 and CD58. Elevated blood Pb correlated with higher IL-12p70 and IFN-γ, and lower IL-2. The mediation effect of erythrocyte CD44 on the relationship of erythrocyte Pb with IL-1β and IL-12p70 was significant, and the effect of erythrocyte Pb on IFN-γ was mediated by erythrocyte CD58. The data provides novel translational insight into the relationship between elevated Pb exposure and the change of erythrocyte immunity and downstream cytokine secretion in preschool children.

Hepatoblastoma-The Evolution of Biology, Surgery, and Transplantation

The most common primary malignant liver tumor of childhood, hepatoblastoma has increased in incidence over the last 30 years, but little is still known about its pathogenesis. Discoveries in molecular biology provide clues but have yet to define targeted therapies. Disease-free survival varies according to stage, but is greater than 90% in favorable risk populations, in part due to improvements in chemotherapeutic regimens, surgical resection, and earlier referral to liver transplant centers. This article aims to highlight the principles of disease that guide current treatment algorithms. Surgical treatment, especially orthotopic liver transplantation, will also be emphasized in the context of the current Children's Oncology Group international study of pediatric liver cancer (AHEP-1531).