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Dong X, Zhang P, Ye C, Li L. A personalized prognostic model for long-term survival in patients with intrahepatic cholangiocarcinoma: a retrospective cohort study. Ann Surg Treat Res 2024; 107:16-26. [PMID: 38978684 PMCID: PMC11227918 DOI: 10.4174/astr.2024.107.1.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/30/2024] [Accepted: 04/19/2024] [Indexed: 07/10/2024] Open
Abstract
Purpose This study aimed to determine the optimal cutoff points for age and tumor size of patients with intrahepatic cholangiocarcinoma (ICC) and to establish and verify a predictive nomogram of overall survival at 1, 3, and 5 years. Methods From the SEER (Surveillance, Epidemiology, and End Results) database, 1,325 ICC patients were selected and randomly divided into training and testing cohorts at a 7:3 ratio. Using the X-tile software, age and tumor size were classified into 3 subgroups: ≤61, 62-74, and ≥75 years and ≤35, 36-55, and ≥56 mm. Subsequently, univariate and multivariate Cox regression analyses were performed using the R software in the training cohort to determine independent risk factors, compile the prediction nomogram, and verify it with the testing cohort findings. Results The C-indexes of the new prediction nomograms in the training and testing cohorts were 0.738 (95% confidence interval [CI], 0.718-0.758) and 0.750 (95% CI, 0.72-0.78), respectively. Furthermore, the areas under the 1-, 3-, and 5-year receiver operating characteristic (ROC) curves based on the nomogram were 0.792, 0.853, and 0.838, respectively, higher than the ROC based on the 7th and 8th editions of the American Joint Cancer Commission (AJCC) staging system. Conclusion This study established and verified a prognostic nomogram that improved the accuracy of the 1-, 3-, and 5-year survival predictions for ICC patients, compared with that based on the 7th and 8th editions of the AJCC staging system, and can help clinicians make personalized survival predictions.
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Affiliation(s)
- Xianhui Dong
- Center for Pre-Disease Treatment and Health Management, Affiliated Hospital of Hangzhou Normal University, Hangzhou Normal University, Hangzhou, China
| | - Pengwei Zhang
- Center for Pre-Disease Treatment and Health Management, Affiliated Hospital of Hangzhou Normal University, Hangzhou Normal University, Hangzhou, China
| | | | - Li Li
- Hangzhou Normal University, Hangzhou, China
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Wang N, Wang L, Huang A, Han J, Cao T, Mei X, Yao J, Xiao Y, Ma H. Case Report: A novel mixture of dose-fractioned radiation and immunotherapy for treatment of cholangiocarcinoma. Front Immunol 2023; 14:1273962. [PMID: 38162668 PMCID: PMC10756898 DOI: 10.3389/fimmu.2023.1273962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Malignant tumors of the biliary tract exhibit a high degree of malignancy and heterogeneity with a poor overall prognosis. Immunotherapy has limited benefits for patients with cholangiocarcinoma. Radiation therapy can change the tumor microenvironment, but its effect heavily depends on radiation dose and fraction. We report a case of advanced intrahepatic cholangiocarcinoma in a 43-year-old male patient, with a huge liver mass of 16.5 cm in diameter, with bone and liver metastases at the first diagnosis. First-line treatment with chemotherapy and PD1 inhibitor was sustained only for 8 months. In second-line treatment, radiotherapy was administered, with 5 Gy in 5 fractions administered to the entire tumor area and 25 Gy in 5 fractions to the solid lesions of the tumor. After the completion of radiotherapy, programmed cell death 1 inhibitor combined with tyrosine kinase inhibitor was maintained. The patient achieved a progression-free-survival time of 12 months and an overall survival time of 25 months. The success of our case suggests that mixed low- and high-dose radiation can significantly improve tumor control and survival time. In clinical practice, based on the characteristics of the tumor and existing treatment options, the rational combination of existing treatment regimens can improve the prognosis of cholangiocarcinoma.
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Affiliation(s)
- Ningyu Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linfang Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ai Huang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Han
- Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Cao
- Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangping Mei
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Yao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Xiao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Ma
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lin Q, Chen J, Li K, Yang J, Luo X, Cai Q, Lin W, Peng G, Chen D, Qin C, He T, Wang Z. Is Lymphadenectomy Reasonable for Elderly Intrahepatic Cholangiocarcinoma Patients? J Gastrointest Surg 2023; 27:2451-2463. [PMID: 37783911 PMCID: PMC10661814 DOI: 10.1007/s11605-023-05846-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND In this study, we aimed to determine the impact of lymphadenectomy (LND) on clinical outcomes in ICC patients aged ≥ 70 years. METHODS Four hundred and three eligible patients diagnosed with ICC who underwent hepatectomy between 2004 and 2019 were enrolled in the Surveillance, Epidemiology, and End Results database. The impact of LND on perioperative mortality and overall survival (OS) as well as the optimal total number of lymph nodes examined (TNLE) was estimated. RESULTS One hundred thirty-nine pairs of patients were matched by propensity score matching. Perioperative mortality was comparable between the LND and non-LND (nLND) groups (0.7% vs. 2.9%, P = 0.367). The median OS in the LND group was significantly longer (44 vs. 32 months, P = 0.045) and LND was identified as an independent protective factor for OS by multivariate analysis (HR 0.65, 95% CI 0.46-0.92, P = 0.014). Patients with the following characteristics were potential beneficiaries of LND: white, female, no/moderate fibrosis, tumor size > 5 cm, solitary tumor, and localized invasion (all P < 0.05). TNLE ≥ 6 had the greatest discriminatory power for identifying lymph node metastasis (area under the curve, 0.704, Youden index, 0.365, P = 0.002). Patients with pathologically confirmed lymph node metastasis are likely to benefit from adjuvant therapy (40 months vs. 4 months, P = 0.052). CONCLUSIONS Advanced age (≥ 70 years) was not a contraindication for LND, which facilitates accurate nodal staging and guides postoperative management. Appropriately selected elderly populations could benefit from LND.
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Affiliation(s)
- Qianyi Lin
- Sixth Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Jianjun Chen
- Second Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Kangde Li
- Sixth Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Junxing Yang
- Seventh Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Xiaofeng Luo
- Seventh Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Qi Cai
- Sixth Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Weihong Lin
- Sixth Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Guanjing Peng
- Sixth Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Dexiong Chen
- Sixth Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Chunhong Qin
- Sixth Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Tao He
- Sixth Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Zhenlong Wang
- Seventh Department of General Surgery, Central People's Hospital of Zhanjiang, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, Guangdong Province, China.
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Autophagy as a self-digestion signal in human cancers: Regulation by microRNAs in affecting carcinogenesis and therapy response. Pharmacol Res 2023; 189:106695. [PMID: 36780958 DOI: 10.1016/j.phrs.2023.106695] [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: 01/10/2023] [Revised: 02/05/2023] [Accepted: 02/10/2023] [Indexed: 02/13/2023]
Abstract
Autophagy is defined as a "self-digestion" signal, and it is a cell death mechanism its primary function is degrading toxic agents and aged organelles to ensure homeostasis in cells. The basic leve ls of autophagy are found in cells, and when its levels exceed to standard threshold, cell death induction is observed. Autophagy dysregulation in cancer has been well-documented, and regulation of this pathway by epigenetic factors, especially microRNAs (miRNAs), is interesting and noteworthy. miRNAs are considered short endogenous RNAs that do not encode functional proteins, and they are essential regulators of cell death pathways such as apoptosis, necroptosis, and autophagy. Accumulating data has revealed miRNA dysregulation (upregulation or downregulation) during tumor progression, and their therapeutic manipulation provides new insight into cancer therapy. miRNA/autophagy axis in human cancers has been investigated an exciting point is the dual function of both autophagy and miRNAs as oncogenic and onco-suppressor factors. The stimulation of pro-survival autophagy by miRNAs can increase the survival rate of tumor cells and mediates cancer metastasis via EMT inductionFurthermore, pro-death autophagy induction by miRNAs has a negative impact on the viability of tumor cells and decreases their survival rate. The miRNA/autophagy axis functions beyond regulating the growth and invasion of tumor cells, and they can also affect drug resistance and radio-resistance. These subjects are covered in the current review regarding the new updates provided by recent experiments.
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Associations between ultrasound screening findings and cholangiocarcinoma diagnosis in an at-risk population. Sci Rep 2022; 12:13513. [PMID: 35933509 PMCID: PMC9357059 DOI: 10.1038/s41598-022-17794-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/31/2022] [Indexed: 11/18/2022] Open
Abstract
The rate of cholangiocarcinoma (CCA) is increasing every year, especially in northeastern Thailand. Screening for CCA using ultrasonography (US) is the fastest technique to identify patients in early stage of CCA development. Currently, few studies have examined patterns of hepatobiliary abnormalities identified using US, which can be indicative of CCA. We aim to evaluate the rate of CCA and its relations to history of US findings. Our study included participants who underwent US and pathological diagnosis of CCA from the Cholangiocarcinoma Screening and Care Program, Northeast Thailand between 2013 and 2020. Data on histological findings were based on the standard protocol of the tertiary hospital at Khon Kaen University. CCA data is categorized into two groups (yes/no) to find the relationship with history of US findings. The adjusted odds ratio (AOR) and their 95% confidence intervals (CI) were used to evaluate the relationship obtained by multiple logistic regression. Of 1880 subjects who underwent US and a pathological diagnosis of CCA, the overall rate of CCA was 35.74%. CCA rate among those with liver mass (LM) was 54.85% and with dilated bile duct (DBD) was 62.01%. The relationship between DBD and CCA was highly significant (AOR = 3.46; 95% CI 2.74–4.36) followed by LM (AOR = 2.28; 95% CI 1.81–2.86) P value < 0.001. Our study reveals that US findings history have a strong association with CCA, especially in people diagnosed with DBD and LM. Therefore, these abnormalities can be indicators for suspected CCA diagnosis through US.
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NOV/CCN3 Promotes Cell Migration and Invasion in Intrahepatic Cholangiocarcinoma via miR-92a-3p. Genes (Basel) 2021; 12:genes12111659. [PMID: 34828265 PMCID: PMC8621878 DOI: 10.3390/genes12111659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/25/2022] Open
Abstract
Intrahepatic cholangiocarcinoma (ICC) is a common type of human cancer with a poor prognosis, and investigating the potential molecular mechanisms that can contribute to gene diagnosis and therapy. Herein, based on the recently concerned vertebrate-specific Cyr61/CTGF/NOV (CCN) gene family because of its important roles in diverse diseases, we obtained NOV/CCN3 to query for its potential roles in tumorigenesis via bioinformatics analysis. Experimental validations confirmed that both NOV mRNA and protein are up-regulated in two ICC cell lines, suggesting that it may promote cell migration and invasion by promoting EMT. To elucidate the detailed regulatory mechanism, miR-92a-3p is screened and identified as a negative regulatory small RNA targeting NOV, and further experimental validation demonstrates that miR-92a-3p contributes to NOV-mediated migration and invasion of ICC via the Notch signaling pathway. Our study reveals that NOV may be a potential target for diagnosing and treating ICC, which will provide experimental data and molecular theoretical foundation for cancer treatment, particularly for future precision medicine.
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Rojas-Pintor KP, Arizmendi-Villarreal MA, Aparicio-Salas JE, Moreno-Peña DP, Hernández-Barajas D, Cordero-Pérez P, Muñoz-Espinosa LE. Differences in the presentation and treatment of primary liver tumors at a hepatology center and an oncology center. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2021; 86:370-377. [PMID: 34384724 DOI: 10.1016/j.rgmxen.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 08/05/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION AND AIMS Primary liver cancer is a public health problem in Mexico and the world. Liver transplantation (LT) is the ideal treatment for early hepatocellular carcinoma (HCC). Our aim was to evaluate the characteristics of patients with HCC and cholangiocarcinoma (CC) at two centers and identify transplantation candidates. MATERIALS AND METHODS A retrospective observational study was conducted at the Hepatology Center (HC) and the University Center Against Cancer (UCAC), within the time frame of 2012-2018. HCC or intrahepatic CC was confirmed in 109 patients. Staging classifications, transplant selection models, and a predictive model for post-LT recurrence were applied to the HCC patients. RESULTS Of the total population, 93% (n=102) presented with cirrhosis, 86% (n=94) had HCC (HC: 58%, UCAC: 42%), and 14% (n=15) had intrahepatic CC (HC: 40%, UCAC: 60%). Of the HC patients with HCC, Okuda I-II, BCLC A-B, and AFP levels <100ng/m predominated, whereas Okuda II-III, BCLC C-D, and AFP levels >1000ng/mL predominated in the UCAC patients. Half of the HC population with HCC met the criteria for LT, in contrast to 23% of the UCAC patients. Fifteen patients were evaluated for LT, and at present, six have undergone transplantation. CONCLUSIONS The most frequent primary liver tumor was HCC. Patients from the HC presented with earlier-stage disease and a high number of them met the criteria for LT. Only patients from the HC underwent transplantation.
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Affiliation(s)
- K P Rojas-Pintor
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - M A Arizmendi-Villarreal
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - J E Aparicio-Salas
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - D P Moreno-Peña
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - D Hernández-Barajas
- Centro Universitario Contra el Cáncer, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - P Cordero-Pérez
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - L E Muñoz-Espinosa
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico.
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Yuan C, Hu Z, Wang K, Zou S. Development and Validation a Nomogram for Predicting Overall Survival in Patients With Intrahepatic Cholangiocarcinoma. Front Surg 2021; 8:659422. [PMID: 34079814 PMCID: PMC8165311 DOI: 10.3389/fsurg.2021.659422] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/26/2021] [Indexed: 12/27/2022] Open
Abstract
Background: This study aims to establish an effective nomogram to predict the overall survival of patients with intrahepatic cholangiocarcinoma (ICC). Patients and Methods: Data used to build the nomogram comes from the Surveillance, Epidemiology, and End Results (SEER) database. Patients diagnosed with ICC between 2005 and 2016 were retrospectively collected. Prediction accuracy and discrimination ability of the nomogram was evaluated by concordance index (C-index) and calibration curve. The area under receiver operating characteristic (ROC) curve (AUC) and decision curve analysis (DCA) were used to compare the precision of the 1-, 3-, and 5-year survival of the nomogram with 8th American Joint Commission on Cancer (AJCC) tumor–node–metastasis (TNM) staging system. Finally, it was verified in a prospective study of patients diagnosed with ICC in the Second Affiliated Hospital of Nanchang University from 2013 to 2020 by bootstrap resampling. Result: The study contains two parts of data; we establish a nomogram using external data, and we conducted internal verification and external verification. The nomogram that we have established has good calibration, with a concordance index (C-index) of 0.75 (95% CI, 0.74–0.76) for overall survival (OS) prediction. The AUC value of the nomogram predicting 1-, 3-, and 5-year OS rates were 0.821, 0.828, and 0.836, which were higher than those of the 8th AJCC TNM staging systems. The calibration curve for the probability of survival between prediction by nomogram and actual observation shows good agreement. The nomogram showed better accuracy than the 8th edition AJCC TNM staging. Conclusion: The nomogram established can provide a more accurate prognosis for patients with intrahepatic cholangiocarcinoma.
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Affiliation(s)
- Chen Yuan
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhigang Hu
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Kai Wang
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shubing Zou
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Rojas-Pintor KP, Arizmendi-Villarreal MA, Aparicio-Salas JE, Moreno-Peña DP, Hernández-Barajas D, Cordero-Pérez P, Muñoz-Espinosa LE. Differences in the presentation and treatment of primary liver tumors at a hepatology center and an oncology center. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2021; 86:S0375-0906(21)00002-1. [PMID: 33676785 DOI: 10.1016/j.rgmx.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 07/30/2020] [Accepted: 08/05/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION AND AIMS Primary liver cancer is a public health problem in Mexico and the world. Liver transplantation (LT) is the ideal treatment for early hepatocellular carcinoma (HCC). Our aim was to evaluate the characteristics of patients with HCC and cholangiocarcinoma (CC) at two centers and identify transplantation candidates. MATERIALS AND METHODS A retrospective observational study was conducted at the Hepatology Center (HC) and the University Center Against Cancer (UCAC), within the time frame of 2012-2018. HCC or intrahepatic CC was confirmed in 109 patients. Staging classifications, transplant selection models, and a predictive model for post-LT recurrence were applied to the HCC patients. RESULTS Of the total population, 93% (n = 102) presented with cirrhosis, 86% (n = 94) had HCC (HC: 58%, UCAC: 42%), and 14% (n = 15) had intrahepatic CC (HC: 40%, UCAC: 60%). Of the HC patients with HCC, Okuda I-II, BCLC A-B, and AFP levels < 100 ng/m predominated, whereas Okuda II-III, BCLC C-D, and AFP levels > 1,000 ng/mL predominated in the UCAC patients. Half of the HC population with HCC met the criteria for LT, in contrast to 23% of the UCAC patients. Fifteen patients were evaluated for LT, and at present, six have undergone transplantation. CONCLUSIONS The most frequent primary liver tumor was HCC. Patients from the HC presented with earlier-stage disease and a high number of them met the criteria for LT. Only patients from the HC underwent transplantation.
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Affiliation(s)
- K P Rojas-Pintor
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México
| | - M A Arizmendi-Villarreal
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México
| | - J E Aparicio-Salas
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México
| | - D P Moreno-Peña
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México
| | - D Hernández-Barajas
- Centro Universitario Contra el Cáncer, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México
| | - P Cordero-Pérez
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México
| | - L E Muñoz-Espinosa
- Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México.
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Wu H, Wei Y, Jian M, Lu H, Song Q, Hao L, Yue Y. Clinicopathological and Prognostic Significance of Immunoscore and PD-L1 in Intrahepatic Cholangiocarcinoma. Onco Targets Ther 2021; 14:39-51. [PMID: 33442265 PMCID: PMC7797318 DOI: 10.2147/ott.s288982] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background An increasing amount of evidence reveals that immunosuppression is a major issue in cancer progression. The association of immunoscore (IS) and its impact on clinical outcome have been studied in many tumor types, but its significance in intrahepatic cholangiocarcinoma (ICC) is poorly known. Methods By immunohistochemistry, CD3 and CD8 expressions were assessed in tissue samples of 50 cases of postoperative ICC. The IS was determined by analyzing CD3+ and CD8+ expression data in different areas (intratumor and invasion margins). The relationship between IS and clinicopathological characteristics, including the overall survival (OS) and recurrence-free survival (RFS), was analyzed. In addition, PD-L1, a major regulator of immune escape, was also assessed in tumor cells by immunohistochemistry. Results IS was related to histological differentiation (P=0.026), the presence of lymphoid metastasis (P=0.034), and TNM clinical stages (P = 0.031) of ICC. High IS was significantly associated with better RFS (P=0.033) and OS (P=0.014). IS was an independent prognostic factor for better OS in multivariate analysis. PD-L1 expression was closely related to tumor vascular invasion (P=0.044). Although there was no association between PD-L1 expression and IS, high PD-L1 expression in tumor cells indicated poor RFS (P=0.017) and OS (P=0.004) in ICC. Conclusion The IS and PD-L1 may be used as a complement to the TNM system for predicting the prognosis of patients with ICC.
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Affiliation(s)
- Hong Wu
- Department of Ultrasound, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China
| | - Yulong Wei
- Department of Pathology, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China
| | - Mei Jian
- Department of Ultrasound, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China
| | - Hong Lu
- Department of Pathology, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China
| | - Qingzhu Song
- Department of Clinical Laboratory, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China
| | - Liheng Hao
- Department of Hepatobiliary Surgery, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China
| | - Yong Yue
- Department of Hepatobiliary Surgery, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China
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Wang K, Zhang Y, Yang X, Chen T, Han T. Analysis of differentially expressed mRNAs and the prognosis of cholangiocarcinoma based on TCGA database. Transl Cancer Res 2020; 9:4739-4749. [PMID: 35117837 PMCID: PMC8799208 DOI: 10.21037/tcr-20-812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/10/2020] [Indexed: 12/20/2022]
Abstract
Background The effective evaluation of cholangiocarcinoma (CCA) is challenging due to a lack of accurate screening tools. Consequently, there is an urgent need to screen out effective biomarkers. Bioinformatics analysis on a substantial amount of transcriptomic data to screen biomolecules allows for the verification of histological samples, and can provide a new method for CCA biomolecule screening in diagnosis and prognosis. Methods EdgeR model was used to analyze The Cancer Genome Atlas (TCGA)-extracted CCA data set, and to determine the differential expression of mRNAs. Based on this, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to perform functional and pathway enrichment analysis. Subsequently, a protein interaction network was also established to identify the key differential node genes. Then, the previously determined differential genes were analyzed to establish a link between these genes and clinical prognosis. Finally, we used tissue samples to realize our results via IHC, Western blot and qRT-PCR. Results A total of 5,561 differential mRNAs were screened, including 3,473 upregulated genes and 2,088 downregulated genes. GO and KEGG enrichment analysis showed that the upregulated genes had significantly enriched cell adhesion, concentrated chromosomal motility, and microtubule motility. Downregulated genes were significantly enriched in heterologous metabolism and exosomes. Furthermore, we found upregulated genes were significantly enriched in the cancer pathways and cell cycle. Downregulated genes were enriched in the metabolic pathways and biosynthesis of antibiotics. Ten hub genes were screened out through the protein interaction network; among these, the AURKB and PLK1 genes were closely related to the clinical prognosis of patients. Results of the immunohistochemical staining, Western blot and qRT-PCR all showed that the expression of AURKB and PLK1 in cancer tissues was higher than that in the adjacent tissues, and this difference was statistically significant (P<0.05). Conclusions The upregulated genes were significantly enriched in the biological processes of cell division, cell cycle, and related cell components. AURKB and PLK1 play a key role in differentially expressed gene nodes. These genes are closely related to the prognosis of patients and can be used as potential diagnostic tools and prognostic biomarkers.
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Affiliation(s)
- Kun Wang
- Department of Hepatobiliary Surgery, Cancer Hospital of China Medical University/Liaoning Cancer Hospital, Shenyang, China
| | - Yue Zhang
- Department of Oncology II (Interventional Therapy), The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaodan Yang
- Department of Oncology, The General Hospital of Northern Theater Command, Shenyang, China
| | - Tingsong Chen
- Department of Oncology II (Interventional Therapy), The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tao Han
- Department of Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Oncology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
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12
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Geramizadeh B. Precursor Lesions of Cholangiocarcinoma: A Clinicopathologic Review. CLINICAL PATHOLOGY 2020; 13:2632010X20925045. [PMID: 32596664 PMCID: PMC7297471 DOI: 10.1177/2632010x20925045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/18/2020] [Indexed: 12/12/2022]
Abstract
Cholangiocarcinoma (CCA) develops through multistep carcinogenesis. During the past decades, 2 precursors have been proved to evolve to CCA. The 2 main precursor lesions of CCA are biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct. It is an interesting and relatively novel entity for the hepatobiliary surgeons, radiologists, oncologists, and pathologists. It worth being familiar with these 2 entities for better communication between pathologists, oncologists, and surgeons to improve the treatment and follow-up of these lesions, which can definitely decrease their evolvement to CCA as an aggressive, poor prognostic, and life-threatening cancer. In this narrative review, I collected and discussed all published studies about these 2 precursor lesions of CCA including radiologic, clinical, and pathological manifestation.
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Affiliation(s)
- Bita Geramizadeh
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.,Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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13
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Ichikawa S, Isoda H, Shimizu T, Tamada D, Taura K, Togashi K, Onishi H, Motosugi U. Distinguishing intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma by computed tomography and magnetic resonance imaging using the Bayesian method: a bi-center study. Eur Radiol 2020; 30:5992-6002. [PMID: 32500195 DOI: 10.1007/s00330-020-06972-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 05/20/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To determine imaging hallmarks for distinguishing intrahepatic mass-forming biliary carcinomas (IMBCs) from hepatocellular carcinoma (HCC) and to validate their diagnostic ability using Bayesian statistics. METHODS Study 1 retrospectively identified clinical and imaging hallmarks that distinguish IMBCs (n = 41) from HCC (n = 247) using computed tomography (CT) and magnetic resonance imaging (MRI). Study 2 retrospectively assessed the diagnostic ability of these hallmarks to distinguish IMBCs (n = 37) from HCC (n = 111) using Bayesian statistics with images obtained from a different institution. We also assessed the diagnostic ability of the hallmarks in the patient subgroup with high diagnostic confidence (≥ 80% of post-test probability). Two radiologists independently evaluated the imaging findings in studies 1 and 2. RESULTS In study 1, arterial phase peritumoral parenchymal enhancement on CT/MRI, delayed enhancement on CT/MRI, diffusion-weighted imaging peripheral hyperintensity, and bile duct dilatation were hallmarks indicating IMBCs, whereas chronic liver disease, non-rim arterial phase hyperenhancement on CT/MRI, enhancing capsule on CT/MRI, and opposed-phase signal drop were hallmarks indicating HCC (p = 0.001-0.04). In study 2, Bayesian statistics-based post-test probability combining all hallmark features had a diagnostic accuracy of 89.2% (132/148) in distinguishing IMBCs from HCC for both readers. In the high diagnostic confidence subgroup (n = 120 and n = 124 for readers 1 and 2, respectively), the accuracy improved (95.0% (114/120) and 93.5% (116/124) for readers 1 and 2, respectively). CONCLUSIONS Combined interpretation of CT and MRI to identify hallmark features is useful in discriminating IMBCs from HCCs. High post-test probability by Bayesian statistics allows for a more reliable non-invasive diagnosis. KEY POINTS • Combined interpretation of CT and MRI to identify hallmark features was useful in discriminating intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma. • Bayesian method-based post-test probability combining all hallmark features determined in study 1 showed high (> 90%) sensitivity and specificity for distinguishing intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma. • If the post-test probability or the confidence was ≥ 80% when combining the imaging features of CT and MRI, the high specificity of > 95% was achieved without any loss of sensitivity to distinguish hepatocellular carcinoma from intrahepatic mass-forming biliary carcinomas.
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Affiliation(s)
- Shintaro Ichikawa
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
| | - Hiroyoshi Isoda
- Preemptive Medicine and Lifestyle-related Disease Research Center, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tatsuya Shimizu
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Daiki Tamada
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Kojiro Taura
- Department of Surgery, Graduate School of Medicine, Division Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Utaroh Motosugi
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
- Department of Diagnostic Radiology, Kofu Kyoritsu Hospital, 1-9-1 Takara, Kofu-shi, Yamanashi, 400-0034, Japan
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14
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Jiang W, Deng X, Zhu T, Wei Y, Lei Z, Guo M, Yang J. Identification of Cholangiocarcinoma Associated with Hepatolithiasis via the Combination of miRNA and Ultrasound. Cancer Manag Res 2020; 12:1845-1853. [PMID: 32210627 PMCID: PMC7075433 DOI: 10.2147/cmar.s241870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/02/2020] [Indexed: 12/13/2022] Open
Abstract
Background Identification of cholangiocarcinoma (CCA) associated with hepatolithiasis (HL) is difficult. There is no effective method to discriminate CCA associated with HL (HL-CCA) from HL currently. Objective To explore the value of clinical data, ultrasonic characteristics and miRNA expression level in the identification of HL-CCA. Methods Thirty-one patients with HL-CCA in Huazhong University of Science and Technology Union Shenzhen Hospital were enrolled in the observation group, while 40 patients with HL alone were included in the control group. The clinical data, ultrasonic characteristics, and miRNA expression level of the two groups were recorded and analyzed to explore the potential indicators for the identification of HL-CCA. Results The accuracy of ultrasound in the diagnosis of HL-CCA was low (54.84%). Multivariate logistic regression analysis showed that liver abscess (P=0.021), indistinct border demarcation (P=0.015), non-homogenous echotexture (P=0.019), missed portal vein around lesion (P=0.032), miRNA-21 (P=0.018) and miRNA-221 (P=0.009) were the potential indicators for the identification of HL-CCA. The combined diagnosis based on logistic regression contained liver abscess, border demarcation, echotexture, portal vein around lesion, miRNA-21 and miRNA-221. The results showed that the accuracy of combined diagnosis identifying HL-CCA was the most accurate (AUC=0.911), which was significantly greater than the AUC of miRNA-21 or miRNA-221 individually (P<0.05), with a sensitivity and specificity of 77.42% and 97.50%, respectively. Conclusion Patients with HL-CCA show high incidence of hepatic abscess and elevated miRNA-21 and miRNA-221 expression level. The ultrasonic features are more likely to show indistinct border demarcation, non-homogenous echotexture, and missed portal vein around lesion. The combined diagnosis is more accurate in the identification of HL-CCA.
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Affiliation(s)
- Wei Jiang
- Department of Ultrasound, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, People's Republic of China
| | - Xiaofei Deng
- Department of Ultrasound, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, People's Republic of China
| | - Ting Zhu
- Department of Ultrasound, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, People's Republic of China
| | - Yuya Wei
- Department of Ultrasound, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, People's Republic of China
| | - Zhen Lei
- Department of Ultrasound, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, People's Republic of China
| | - Meimei Guo
- Department of Gastroenterology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, People's Republic of China
| | - Jiong Yang
- Department of Gastroenterology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, People's Republic of China
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15
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Dong Z, Liao B, Shen W, Sui C, Yang J. Expression of Programmed Death Ligand 1 Is Associated with the Prognosis of Intrahepatic Cholangiocarcinoma. Dig Dis Sci 2020; 65:480-488. [PMID: 31410753 DOI: 10.1007/s10620-019-05787-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 08/07/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Programmed death ligand 1 (PD-L1) is expressed in many malignancies and plays a critical role in escape from immune surveillance through inhibition of its receptor programmed death 1. The role of PD-L1 in intrahepatic cholangiocarcinoma (ICC) and mechanisms of its regulation, however, remain largely unknown. AIMS To analyze the expression and prognostic significance of PD-L1 in ICC and to study the regulatory mechanisms of PD-L1. METHODS Samples were obtained from 125 patients diagnosed with ICC in the Eastern Hepatobiliary Surgery Hospital from January 2012 to January 2013. The records of each patient were analyzed to examine the relationship between PD-L1 and clinical data. In vitro experiments were performed to investigate the relationship between PD-L1 and the IL-6/mTOR signaling pathway and the feedback mechanism pathway of PD-L1. RESULTS Expression of PD-L1 is closely related to tumor vascular invasion, lymphatic metastasis and TNM staging. High PD-L1 expression is closely related to poor prognosis in ICC. Mechanically, IL-6 induces PD-L1 expression through mTOR signaling in ICC cells. In addition, PD-L1 has a negative feedback inhibition effect on AKT signaling. CONCLUSIONS In summary, high PD-L1 expression was found to be associated with poor prognosis. The IL-6/mTOR pathway upregulates expression of PD-L1, thus promoting tumor invasion, and PD-L1 negatively inhibits the AKT pathway.
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Affiliation(s)
- Zhitao Dong
- Department of Special Medical Care, Shanghai Eastern Hepatobiliary Surgery Hospital, The 13th Floor, No. 700 North Moyu Road, Jiading District, Shanghai, 200438, China
| | - Boyi Liao
- Department of Special Medical Care, Shanghai Eastern Hepatobiliary Surgery Hospital, The 13th Floor, No. 700 North Moyu Road, Jiading District, Shanghai, 200438, China
| | - Weifeng Shen
- Department of Special Medical Care, Shanghai Eastern Hepatobiliary Surgery Hospital, The 13th Floor, No. 700 North Moyu Road, Jiading District, Shanghai, 200438, China
| | - Chengjun Sui
- Department of Special Medical Care, Shanghai Eastern Hepatobiliary Surgery Hospital, The 13th Floor, No. 700 North Moyu Road, Jiading District, Shanghai, 200438, China
| | - Jiamei Yang
- Department of Special Medical Care, Shanghai Eastern Hepatobiliary Surgery Hospital, The 13th Floor, No. 700 North Moyu Road, Jiading District, Shanghai, 200438, China.
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16
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Nio M, Wada M, Sasaki H, Tanaka H, Hashimoto M, Nakajima Y. Correctable biliary atresia and cholangiocarcinoma: a case report of a 63-year-old patient. Surg Case Rep 2019; 5:185. [PMID: 31784849 PMCID: PMC6884610 DOI: 10.1186/s40792-019-0748-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background Although cancer occurrence following surgery for biliary atresia has gradually increased, the development of cholangiocarcinoma in a native liver survivor of biliary atresia is extremely rare. Case presentation A 3-month-old female patient with the correctable type of biliary atresia underwent a cystoduodenostomy. At 16 years of age, she underwent multiple surgeries including lysis of intestinal adhesions, ileostomy, and gastrojejunostomy at another hospital. At 54 years of age, she underwent lithotomy at the porta hepatis, resection of the residual cystic bile duct with gallbladder, and hepaticojejunostomy in Roux-en-Y fashion. As she approached the age of 63, her computed tomography scan showed no liver tumors. In the following year, she developed cholangiocarcinoma at the porta hepatis and underwent chemotherapy. However, the cancer progressed, and she died before she reached the age of 64 years. Conclusions Cholangiocarcinoma is extremely rare in patients with biliary atresia. However, physicians should follow up patients with biliary atresia as closely as possible, as malignant tumors secondary to biliary atresia may increase in number in the near future because of the growing number of long-term survivors with biliary atresia.
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Affiliation(s)
- Masaki Nio
- Department of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
| | - Motoshi Wada
- Department of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Hideyuki Sasaki
- Department of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Hiromu Tanaka
- Department of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Masatoshi Hashimoto
- Department of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yudai Nakajima
- Department of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
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17
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Chascsa DM, Lindor KD. Cancer risk, screening and surveillance in primary sclerosing cholangitis. MINERVA GASTROENTERO 2019; 65:214-228. [DOI: 10.23736/s1121-421x.19.02586-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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18
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Ma K, Dong B, Wang L, Zhao C, Fu Z, Che C, Liu W, Yang Z, Liang R. Nomograms for predicting overall survival and cancer-specific survival in patients with surgically resected intrahepatic cholangiocarcinoma. Cancer Manag Res 2019; 11:6907-6929. [PMID: 31440084 PMCID: PMC6664419 DOI: 10.2147/cmar.s212149] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 07/04/2019] [Indexed: 12/25/2022] Open
Abstract
Purpose To develop and validate nomograms for predicting overall survival (OS) and cancer-specific survival (CSS) in patients with surgically resected intrahepatic cholangiocarcinoma (ICC). Patients and methods The nomograms were developed using a development cohort of 947 ICC patients after surgery selected from Surveillance, Epidemiology, and End Results database, and externally validated using a training cohort of 159 patients admitted at our institution. Nomograms for OS and CSS were established based on the independent prognostic factors identified by COX regression models and Fine and Grey’s models, respectively. The performance of the nomograms was validated internally and externally by using the concordance index (c-index), and calibration plot, and compared with that of AJCC 8th edition TNM staging system by using c-index and decision curve analysis. Results Age, T stage, M stage, lymph node ratio (LNR) level and tumor grade were independent prognostic predictors for OS in ICC patients, while T stage, M stage, LNR level and tumor grade were independent prognostic predictors for CSS. Nomogram predicting OS was with a c-index of 0.751 on internal validation and 0.725 up to external validation, while nomogram for CSS was with a c-index of 0.736 on internal validation and 0.718 up to external validation. Calibration plots exhibited that the nomograms-predicted and actual OS/CSS probabilities were fitted well on both internal and external validation. Additionally, the nomograms exhibited superiority over AJCC 8th edition TNM staging system with higher c-indices and net benefit gains, in predicting OS and CSS in ICC patients after surgery. Conclusion The constructed nomograms could predict OS and CSS with good performance, which could be served as an effective tool for prognostic evaluation and individual treatment strategies optimization in ICC patients after surgery in clinical practice.
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Affiliation(s)
- Kexin Ma
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Bing Dong
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Liming Wang
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Chongyu Zhao
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Zhaoyu Fu
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Chi Che
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Wuguang Liu
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Zexuan Yang
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Rui Liang
- Department of Hepatobiliary Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
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19
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Down-regulation of lncRNA-NEF indicates poor prognosis in intrahepatic cholangiocarcinoma. Biosci Rep 2019; 39:BSR20181573. [PMID: 31015363 PMCID: PMC6527927 DOI: 10.1042/bsr20181573] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/26/2019] [Accepted: 03/18/2019] [Indexed: 11/17/2022] Open
Abstract
LncRNA-NEF is a tumor suppressor lncRNA in liver cancer. The present study aimed to investigate the role of lncRNA-NEF in intrahepatic cholangiocarcinoma (IHCC), which is second most common type of primary cancer of the hepatobiliary system that causes high mortality rate. In the present study we found that lncRNA-NEF was down-regulated, while Runt-related transcription factor 1 (RUNX1) was up-regulated in tumor tissues than in adjacent healthy tissues of IHCC patients. Expression levels of lncRNA-NEF and RUNX1 were significantly and reversely correlated in tumor tissues but not in adjacent healthy tissues. Plasma levels of lncRNA-NEF were significantly lower in IHCC patients than in healthy controls. Down-regulation of lncRNA-NEF effectively distinguished stage I and II IHCC patients from healthy controls. Patients were followed up for 5 years, patients with high plasma levels of lncRNA-NEF showed significantly better survival conditions compared with patients with low expression levels of lncRNA-NEF. LncRNA-NEF overexpression led to inhibited expression of RUNX1 in cells of IHCC cell lines and inhibited cancer cell migration and invasion. In contrast, RUNX1 overexpression showed no significant effects on lncRNA-NEF expression, but attenuated the effects of lncRNA-NEF overexpression on cancer cell migration and invasion. We therefore concluded that lncRNA-NEF participated in IHCC possibly by interacting with RUNX1.
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20
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Masetti C, Brega A, Angelico M. Acute Cholangitis with Atypical Clinical Presentation and Imaging. Dig Dis Sci 2019; 64:1383-1385. [PMID: 30392151 DOI: 10.1007/s10620-018-5361-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 10/29/2018] [Indexed: 12/09/2022]
Affiliation(s)
- Chiara Masetti
- Liver and Transplant Unit, Tor Vergata University Hospital, Rome, Italy.
| | - Arianna Brega
- Liver and Transplant Unit, Tor Vergata University Hospital, Rome, Italy
| | - Mario Angelico
- Liver and Transplant Unit, Tor Vergata University Hospital, Rome, Italy
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21
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Wu Y, Ren F, Chai Y, Xue Z, Shen C, Zhang X, Lv Y, Hu L. Prognostic value of inflammation-based indexes for intrahepatic cholangiocarcinoma following curative resection. Oncol Lett 2018; 17:165-174. [PMID: 30655752 PMCID: PMC6313216 DOI: 10.3892/ol.2018.9618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022] Open
Abstract
It is widely acknowledged that inflammatory indices may serve as effective prognosis indicators for various malignancies. In the present study, the prognostic value of systemic inflammatory biomarkers for patients undergoing curative resection for intrahepatic cholangiocellular carcinoma (ICC) was investigated. Clinical data of ICC patients who underwent curative resection between September 2008 and July 2017 were collected. Inflammatory indictors were analyzed using the Area Under the Receiver Operating Characteristic Curve. Indictors that were significantly associated with the overall survival (OS) were used to establish a systemic inflammation-based score system and tested via nomogram using R software. The neutrophil To lymphocyte ratio (NLR) and lymphocyte to macrophages ratio (LMR) were significantly associated with the OS and disease-free survival of the patients. High NLR and low LMR were associated with worse clinicopathological and survival outcomes. The univariate and multivariate analyses indicated that tumor T stage, incisal margin, NLR and LMR were associated with the OS of the patients. The systemic inflammation-based scoring system based on LMR and NLR demonstrated a stronger discriminatory capacity and may serve as a useful prognostic parameter for patients undergoing curative resection for ICC. Low LMR and high NLR were observed to be associated with poor prognosis and worse clinical outcomes for patients with ICC undergoing curative surgery. A combined inflammation-based scoring system based on LMR and NLR may effectively predict the outcomes and serve as a novel prognostic predictor for these patients.
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Affiliation(s)
- Yunhua Wu
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi 710061, P.R. China
| | - Fenggang Ren
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi 710061, P.R. China
| | - Yichao Chai
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi 710061, P.R. China
| | - Zhao Xue
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi 710061, P.R. China
| | - Cong Shen
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Xufeng Zhang
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi 710061, P.R. China
| | - Yi Lv
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi 710061, P.R. China
| | - Liangshuo Hu
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi 710061, P.R. China
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Wei Y, Gao F, Zheng D, Huang Z, Wang M, Hu F, Chen C, Duan T, Chen J, Cao L, Song B. Intrahepatic cholangiocarcinoma in the setting of HBV-related cirrhosis: Differentiation with hepatocellular carcinoma by using Intravoxel incoherent motion diffusion-weighted MR imaging. Oncotarget 2018; 9:7975-7983. [PMID: 29487707 PMCID: PMC5814274 DOI: 10.18632/oncotarget.23807] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/13/2017] [Indexed: 02/05/2023] Open
Abstract
Accurate preoperative differentiation of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) in the setting of cirrhotic liver is of great clinical significance because the treatment and prognosis of these entities differ markedly. Through a retrospectively research, we sought to determine the diagnostic performances of intravoxel incoherent motion (IVIM) and diffusion weighted imaging (DWI) parameters in the differentiating of ICC and HCC. According to the results, we found that apparent diffusion coefficient (ADC) derived from mono-exponential model and true ADC (ADCslow) derived from bi-exponential model can be used to distinguish the ICC and HCC, and ADCslowentailed the higher diagnostic performance than ADC. However, pseudo-ADC (ADCfast) and perfusion fraction (f) can not be used to differentiate ICC and HCC. These results suggested that IVIM and DWI parameters can be useful in differentiating ICC and HCC and might be helpful in selecting the treatment plan and predicting prognosis.
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Affiliation(s)
- Yi Wei
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Feifei Gao
- 2 Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | | | - Zixing Huang
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Min Wang
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Fubi Hu
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Chenyang Chen
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Duan
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Chen
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Likun Cao
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Song
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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23
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Cruz-Ramón V, Chinchilla-López P, Ramírez-Pérez O, Qi X, Méndez-Sánchez N. The Changing Face of the Diagnosis of Chronic and Malignant Liver Diseases: Potential New Biomarkers. Ann Hepatol 2018; 17:14-17. [PMID: 29311406 DOI: 10.5604/01.3001.0010.7531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The early diagnosis of primary sclerosing cholangitis, hepatocellular carcinoma, and cholangiocarcinoma is often challenging. In a recent study in 134 patients (Arbelaiz, Hepatology 2017; 66:1125-1143), it was reported that specific proteins found in serum extracellular vesicles of patients with primary sclerosing cholangitis, hepatocellular carcinoma,orcholangiocarcinomamay be useful as noninvasive diagnostic and prognostic tools. This current article critically appraises this study.
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Affiliation(s)
- Vania Cruz-Ramón
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Departments of Gastroenterology & Hepatology
| | - Paulina Chinchilla-López
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Departments of Gastroenterology & Hepatology
| | - Oscar Ramírez-Pérez
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Departments of Gastroenterology & Hepatology
| | - Xingshun Qi
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, China
| | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Departments of Gastroenterology & Hepatology
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