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Okada R, Otsuka Y, Kajiwara Y, Maeda T, Ishii J, Kimura K, Matsumoto Y, Ito Y, Funahashi K, Shimada H. Prognostic and diagnostic effects of high serum midkine levels in patients with hepatocellular carcinoma. Oncol Lett 2024; 27:283. [PMID: 38736738 PMCID: PMC11082639 DOI: 10.3892/ol.2024.14416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/26/2024] [Indexed: 05/14/2024] Open
Abstract
Midkine (MK) is a soluble cytokine, and its serum levels strongly correspond to protein expression levels in tumors. The present study aimed to clarify the clinicopathological and prognostic significance of serum MK (s-MK) in patients with hepatocellular carcinoma (HCC). Serum samples were obtained before surgery from 123 patients with HCC who had undergone surgery between January 2012 and December 2020. The receiver operating characteristic curve revealed that the best cut-off value for s-MK in differentiating HCC from healthy cases was 426 pg/ml. The clinicopathological variables and overall survival of patients were compared between the s-MK-positive group and s-MK-negative group. The sensitivity, specificity and accuracy of s-MK were 82.1, 97.4 and 88.0%, respectively. An s-MK-positive status was significantly associated with the number of tumors (≥2). The positivity rate of s-MK was significantly higher compared with that of α-fetoprotein and protein-induced by vitamin K absence-II. In total, only 28% of the patients were positive for s-MK. The s-MK-positive group showed significantly worse overall survival compared with the s-MK-negative group. Moreover, multivariate analysis revealed that an s-MK-positive status was independently associated with poor prognosis. s-MK was useful in detecting early HCC. The findings of this study indicated that the s-MK-positive status is associated with the number of tumors and can act as an independent prognostic risk factor.
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Affiliation(s)
- Rei Okada
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Yuichiro Otsuka
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Yoji Kajiwara
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Tetsuya Maeda
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Jun Ishii
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Kazutaka Kimura
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Yu Matsumoto
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Yuko Ito
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Kimihiko Funahashi
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
| | - Hideaki Shimada
- Department of Surgery, School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
- Department of Gastroenterological Surgery and Clinical Oncology, Graduate School of Medicine, Toho University, Ota City, Tokyo 143-8541, Japan
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Pang BY, Leng Y, Wang X, Wang YQ, Jiang LH. A meta-analysis and of clinical values of 11 blood biomarkers, such as AFP, DCP, and GP73 for diagnosis of hepatocellular carcinoma. Ann Med 2023; 55:42-61. [PMID: 36476015 PMCID: PMC9744221 DOI: 10.1080/07853890.2022.2153163] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma lacks ideal diagnostic biomarkers. There is a lack of scientific evaluation of relevant promising biomarkers as well. Therefore this study reanalyzes the related studies of 11 blood biomarkers of HCC, and compares the diagnostic value of these biomarkers for HCC systematically. METHODS The relevant literatures on the diagnostic value in HCC of 11 blood indexes in recent 5 years were searched in PubMed, Embase, and Cochrane libraries. Data were extracted and analyzed. RESULTS Finally, 83 literature studies were brought into meta-analysis. The pooled sensitivity and specificity of AFP were 0.61 and 0.87, respectively. The AUC of AFP were 0.78. The AUC and sum of sensitivity and specificity of the combination of AFP and other biomarkers were all significantly higher than that of AFP, including AFP + AFP-L3 + DCP, AFP + DCP, AFP/DCP, AFP + GPC3. Among other biomarkers, the AUC and sum of sensitivity and specificity of biomarkers including DCP, GPC3, GP73, Hsp90alpha, midkine, and OPN were significantly higher than that of AFP. In this study, GP73 had the highest sum of sensitivity and specificity (1.78) and AUC (0.95). CONCLUSIONS The pooled sensitivity and specificity of AFP were 0.61 and 0.87, respectively. The AUC of AFP were 0.78. The combination of AFP and other biomarkers improved the diagnostic efficiency. The diagnostic value of biomarkers including DCP, GPC3, GP73, Hsp90alpha, midkine, and OPN was higher than that of AFP. GP73 had the best diagnostic value for HCC with the highest sum of sensitivity and specificity (1.78) and AUC (0.95).KEY MESSAGESThe pooled sensitivity and specificity of AFP were 0.61 and 0.87, respectively. The AUC of AFP were 0.78. The combination of AFP and other biomarkers improved the diagnostic efficiency of HCC.The diagnostic value of biomarkers including DCP, GPC3, GP73, Hsp90alpha, midkine, and OPN was higher than that of AFP.GP73 had the best diagnostic value for HCC.
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Affiliation(s)
- Bing-Yao Pang
- Changchun University of Traditional Chinese Medicine, Changchun, Jilin, China
| | - Yan Leng
- Department of Hepatology, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin, China
| | - Xiaoli Wang
- Department of Cardiology, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin, China
| | - Yi-Qiang Wang
- Department of Cardiology, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin, China
| | - Li-Hong Jiang
- Department of Cardiology, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin, China
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Long J, Liu L, Yang X, Lu X, Qin L. Impact of combining Lenvatinib with Transarterial chemoembolization for unresectable hepatocellular carcinoma. Pak J Med Sci 2023; 39:1847-1852. [PMID: 37936761 PMCID: PMC10626123 DOI: 10.12669/pjms.39.6.7944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/01/2023] [Accepted: 08/08/2023] [Indexed: 11/09/2023] Open
Abstract
Objectives To investigate the impact of combining lenvatinib with transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (HCC). Methods This was a retrospective observational study which reviewed the medical records of 103 unresectable HCC patients from January 2017 to June 2020 in The First Affiliated Hospital of Soochow University. It included 46 patients who received TACE plus lenvatinib and 57 patients who received TACE alone. The levels of serum indicators, clinical effect, adverse events, overall survival (OS), and progression-free survival (PFS) were compared between the two groups. Results AFP and VEGF levels in the TACE+lenvatinib group post-treatment were significantly lower than the TACE group (P<0.05). The clinical efficacy in the TACE+lenvatinib group (69.57%) was higher than that in the TACE group (40.35%) post-treatment (P<0.05). There were significant differences in hypertension, diarrhea, and bleeding (gingiva) between the two groups (P<0.05). There were no significant differences in one or two year PFS rate or one year OS between groups (P>0.05), while the two years survival rate in the TACE+lenvatinib group was significantly higher than that in the TACE group (P<0.05). Conclusions TACE combined with lenvatinib have a high clinical effective rate, with reduced AFP and VEGF levels, higher two year survival rate, and acceptable incidence of adverse events.
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Affiliation(s)
- Jianwu Long
- Jianwu Long, Department of General Surgery, The First Affiliated Hospital of Soochow University, Soochow, Jiangsu province, P.R. China
| | - Longfei Liu
- Longfei Liu, Department of Hepatobiliary Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan province, P.R. China
| | - Xuefeng Yang
- Xuefeng Yang, Department of Hepatobiliary Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan province, P.R. China
| | - Xianzhou Lu
- Xianzhou Lu Department of General Surgery, Hengyang County People’s Hospital, Hengyang, Hunan province, P.R. China
| | - Lei Qin
- Lei Qin, Department of General Surgery, The First Affiliated Hospital of Soochow University, Soochow, Jiangsu province, P.R. China
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Guven DC, Erul E, Sahin TK, Dizdar O, Yalcin S, Sahin IH. The benefit of immunotherapy in patients with hepatocellular carcinoma: a systematic review and meta-analysis. Future Oncol 2022; 18:4119-4136. [PMID: 36533987 DOI: 10.2217/fon-2022-0642] [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: 12/23/2022] Open
Abstract
Background: A systemic review of the survival benefit of immune checkpoint inhibitors (ICIs) in phase III hepatocellular carcinoma (HCC) trials was conducted. Methods: Meta-analyses were performed with the generic inverse-variance method with a fixed-effects model. Results: In 10 trials encompassing 6123 patients, ICI-based therapy (monotherapy/combination) improved overall survival (OS) compared with the control arm (hazard ratio [HR]: 0.77; 95% CI: 0.70-0.84; p < 0.001). The survival benefit was consistent across variable treatment lines, Eastern Cooperative Oncology Group performance status and AFP levels. While the OS benefit was more pronounced in hepatitis B-related HCC (HR: 0.70; 95% CI: 0.63-0.77; p < 0.001), OS was improved in hepatitis C-related (HR: 0.83; 95% CI: 0.71-0.98) and nonviral HCC (HR: 0.86; 95% CI: 0.77-0.97). Conclusion: ICI-based therapies should be the standard for all patients with advanced HCC.
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Affiliation(s)
- Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06100, Turkey
| | - Enes Erul
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey
| | - Taha Koray Sahin
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey
| | - Omer Dizdar
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06100, Turkey
| | - Suayib Yalcin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06100, Turkey
| | - Ibrahim Halil Sahin
- Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
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Abd-Rabou AA, Ahmed HH, Mohamed SH, Kotob SE, Kishta MS. Nanotherapy: New Approach for Impeding Hepatic Cancer Microenvironment via Targeting Multiple Molecular Pathways. Asian Pac J Cancer Prev 2022; 23:4261-4274. [PMID: 36580009 PMCID: PMC9971455 DOI: 10.31557/apjcp.2022.23.12.4261] [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: 07/30/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Hepatocellular carcinoma (HCC) microenvironment has been recognized as a key contributor for cancer progression, metastasis, and drug resistance. The crosstalk between tumor cells, the vascular endothelial growth factor (VEGF), and the chemokine (C-C motif) ligand 2 (CCL2) signaling networks mediates immunoinhibitory impact and facilitates tumor angiogenesis. The current investigation aimed at exploring the potent anti-cancer activity of the newly designed nano-based anti-cancer therapy comprising anti-VEGF drug, avastin (AV), and CCR2 antagonist (CR) to counteract HCC and tracking its mode of action in vivo. METHODS The prepared AV, CR, and AVCR nanoprototypes were characterized by nanoscale characterization techniques in our previous work. Here, they are applied for unearthing their anti-cancer properties / mechanisms in hepatic cancer-induced rats via analyzing protein levels and genetic expression of the elements incorporated in the angiogenesis, apoptosis, and metastasis signalling pathways. RESULTS The present results revealed a significant down-regulation in the angiogenesis, survival and metastasis indices along with up-regulation in the pro-apoptotic mediators upon treatment of hepatic cancer-bearing rats with the novel synthesized nanomaterials when compared with the untreated counterparts. We showed across HCC model that anti-VEGF in combination with CCR2 antagonism therapy leads to sensitization and enhanced tumor response over anti-VEGF or CCR2 antagonism monotherapy, particularly in its nanoscale formulation. CONCLUSION The present approach provides new mechanistic insights into the powerful anti-hepatic cancer advantage of the novel nanoprototypes which is correlated with modulating critical signal transduction pathways implicated in tumor microenviroment such as angiogenesis, apoptosis and metastasis. This research work presents a substantial foundation for future studies focused on prohibiting cancer progression and recovery by targeting tumor microenviroment.
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Affiliation(s)
- Ahmed A Abd-Rabou
- Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt. ,Stem Cell Lab, Center of Excellence for Advanced Sciences, National Research Centre, Dokki, Giza, P.O 12622, Egypt. ,For Correspondence:
| | - Hanaa H Ahmed
- Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt. ,Stem Cell Lab, Center of Excellence for Advanced Sciences, National Research Centre, Dokki, Giza, P.O 12622, Egypt.
| | - Safaa H Mohamed
- Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt.
| | - Soheir E Kotob
- Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt.
| | - Mohamed S Kishta
- Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt. ,Stem Cell Lab, Center of Excellence for Advanced Sciences, National Research Centre, Dokki, Giza, P.O 12622, Egypt.
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Zheng L, Huang Z, Li X, He M, Liu X, Zheng G, Zhou X, Liu L. Construction and validation of a predictive model for hepatocellular carcinoma based on serum markers. BMC Gastroenterol 2022; 22:418. [PMID: 36100887 PMCID: PMC9472335 DOI: 10.1186/s12876-022-02489-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/25/2022] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
Early hepatocellular carcinoma (HCC) detection with non-invasive biomarkers remains an unmet clinical need. We aimed to construct a predictive model based on the pre-diagnostic levels of serum markers to predict the early-stage onset of HCC.
Methods
A total of 339 HCC patients (including 157 patients from Changzhou cohort and 182 patients from Wuxi cohort) were enrolled in our retrospective study. Levels of 25 baseline serum markers were collected. Propensity score matching (PSM) analysis was conducted to balance the distributions of patients’ gender, age, and the surveillance time between HCC group and control group. Then, Receiver operating characteristic (ROC) and Logistic regression analysis were performed to screen the independent predictive variables and construct a non-invasive predictive model. Subsequently, ROC curve and Kaplan–Meier (K–M) curve were used to evaluate the predictive values of the model. Clinical net benefit of the model was demonstrated by decision curve analysis (DCA) and clinical impact curve.
Results
Five independent predictive variables for HCC onset and two general characteristics of patients (age and gender) were incorporated into the score model. ROC and DCA curves showed that the score model had better predictive performance in discrimination and clinical net benefit compared with single variable or other score systems, with the area under the curve (AUC) of 0.890 (95% CI 0.856–0.925) in Changzhou cohort and 0.799 (95% CI 0.751–0.849) in Wuxi cohort. Meanwhile, stratification analysis indicated that the score model had good predictive values for patients with early tumor stage (AJCC stage I) or small tumors (< 2 cm). Moreover, the score of HCC patient began to increase at 30 months before clinical diagnosis and reach a peak at 6 months.
Conclusion
Based on this model, we could optimize the current risk stratification at an early stage and consider further intensive surveillance programs for high-risk patients. It could also help clinicians to evaluate the progression and predict the prognosis of HCC patients.
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