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Zhang L, Song ZS, Wang ZS, Guo YL, Xu CG, Shen H. High Expression of SLC16A1 as a Biomarker to Predict Poor Prognosis of Urological Cancers. Front Oncol 2021; 11:706883. [PMID: 34631536 PMCID: PMC8493816 DOI: 10.3389/fonc.2021.706883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/12/2021] [Indexed: 11/15/2022] Open
Abstract
Objective Tumor metabolism has always been the focus of cancer research. SLC16A1, as a key factor in catalysis of monocarboxylate transport across the plasma membrane, has been found to be associated with the occurrence and metastasis of a variety of cancers, but its prognostic significance and mechanism in different tumors are still unclear. Methods Based on the gene expression matrix and clinical information of human cancer tissues acquired from TCGA and GTEX databases, the differential expression of SLC16A1 in different tumors and normal tissues was analyzed. To confirm the association between its expression, the mutation of MMRS gene, and the expression level of DNMTs. Univariate Cox regression was applied to analyze the association between SLC16A1 expression and patient prognosis. The effect of SLC16A1 expression on patient survival was examined by Kaplan Meier analysis. GSEA was used to identify related signaling pathways. Results The expression of SLC16A1 was differentially expressed in most tumors, especially in the urinary tract where it is commonly highly expressed, and differential expression of SLC16A1 in different clinical stages. SLC16A1 expression was significantly positively correlated with MMRS gene mutation and DNMTS expression. Moreover, high SLC16A1 expression was associated with poorer overall survival (OS) and progression-free survival (PFS) in urological cancers. In particular, the results of the enrichment analysis showed that SLC16A1 was associated with processes such as cell adhesion and many signaling pathways affecting cell cycle were significantly enriched in the group with high-expressed SLC16A1. Conclusion SLC16A1 expression was upregulated in urological cancer. SLC16A1 may promote tumor development by regulating the epigenetic process of urological cancer and demonstrated a great potential as a prognostic biomarker of urological cancer patients.
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Affiliation(s)
- Ling Zhang
- Department of Pathology, Wuhan No.1 Hospital, Wuhan, China
| | - Zheng-Shuai Song
- Department of Urology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi-Shun Wang
- Department of Urology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong-Lian Guo
- Department of Urology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chang-Geng Xu
- Department of Urology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Shen
- Department of Urology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Gao SS, Song ZS, Jia Q, Li X, Li CL, Chen XW, Zheng CB. [Serum levels of periostin and their influencing factors in the beta-lactam antibiotic enterprise workers]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2019; 35:261-264. [PMID: 28614923 DOI: 10.3760/cma.j.issn.1001-9391.2017.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe serum levels of periostin, ECP, IgE in the antibiotic enterprise workers, and study the role of periostin, ECP, IgE in the development of allergic inflammation. Methods: 90 cases with asthma or rhinitis were enrolled as disease group, another 117 workers exposed to 7-ACA、6-APA dust without suffering from allergic illness, are chosen as group of dust exposed, and 192 healthy workers who didn't contact dust were chosen as control group. Questionnaires were used to learn their basic information.Lung function was determined with a portable spirometer.The expression levels of periostin、ECP and IgE in serum were measured by enzyme-linked immuno sorbent assay. Results: The exposure group and disease group had significantly lower forced vital capacity (FVC) , forced expiratory volume in 1 second (FEV(l.0)) , and FEV(l.0)/FVC ratio than the control group (P<0.05) . The disease group had significantly higher eosinophil than the control group (P<0.05) . Compared with the control group, the exposure group, the disease group, asthma subgroup, rhinitis subgroup of serum periostin and IgE increased, the differences are statistically significant (P<0.05) . Serum levels of ECP in the workers of asthma subgroup were significantly higher than that in control group (P<0.05) . Serum expression levels of periostin were positively correlated with IgE, ECP in workers (P<0.001) , serum levels of periostin were negatively correlated with FEV(1.0) in workers (P<0.05) . Multiple logistics regression analysis found that exposure to 7-ACA or 6-APA (OR=3.09, 95%CI: 1.83-5.21) , age>47years (OR=2.53, 95%CI: 1.22-5.26) , higher ECP (OR=1.04, 95%CI: 1.01-1.06) were risk factors for increased serum periostin level. Conclusion: Occupational exposure to 7-ACA or 6-APA can result in higher serum periostin level, exposure to 7-ACA or 6-APA, age>47 years, higher ECP are risk factors for increased serum periostin level.
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Affiliation(s)
- S S Gao
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Academy of Occupational Health and Occupational Medicine, Jinan 250062, China
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Wang K, Ruan H, Song Z, Cao Q, Bao L, Liu D, Xu T, Xiao H, Wang C, Cheng G, Tong J, Meng X, Yang H, Chen K, Zhang X. PLIN3 is up-regulated and correlates with poor prognosis in clear cell renal cell carcinoma. Urol Oncol 2018; 36:343.e9-343.e19. [PMID: 29773494 DOI: 10.1016/j.urolonc.2018.04.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 01/15/2018] [Accepted: 04/16/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND PLIN3, one of the members of the perilipin family, has been reported to be involved in the formation and accumulation of lipid droplets. However, the expression levels and diagnostic and prognostic value of PLIN3 in renal cell carcinoma (RCC) remain unclear. METHODS Bioinformatic analysis was used to assess the levels of PLIN3 and the correlation between PLIN3 levels and clinicopathological parameters in renal cancer. The expression levels of PLIN3 were determined in human RCC tissues and cell lines by western blot, immunofluorescence and immunohistochemistry assays. Receiver operating characteristic curves and Kaplan-Meier curves were used to analyze the diagnostic and prognostic significance of PLIN3 in RCC. RESULTS The expression level of PLIN3 was elevated in RCC tissues and cell lines, which was consistent with the analysis of the TCGA and Oncomine cancer database. The receiver operating characteristic curve indicated that high PLIN3 expression can distinguish cancer tissues from normal kidney tissues (area under the curve = 0.7270, P<0.0001). Kaplan-Meier curves revealed that elevated PLIN3 predicted poor disease-free survival and overall survival. CONCLUSIONS PLIN3 is highly expressed in kidney cancer, and high expression of PLIN3 can serve as a useful diagnostic and prognostic biomarker. PLIN3 functional inhibition can be used as a new clinical treatment option.
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Affiliation(s)
- Keshan Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - HaiLong Ruan
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - ZhengShuai Song
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Qi Cao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lin Bao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Di Liu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - TianBo Xu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - HaiBing Xiao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Cheng Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Gong Cheng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - JunWei Tong
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - XianGui Meng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - HongMei Yang
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ke Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - XiaoPing Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Liu XL, Meng HB, Wang YX, Song GD, Ma ZL, Song ZS. [A case of liver abscess complicated by suppurative endophthalmitis]. Zhonghua Gan Zang Bing Za Zhi 2018; 26:624-625. [PMID: 30317797 DOI: 10.3760/cma.j.issn.1007-3418.2018.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X L Liu
- Department of Hepatobiliary and Pancreatic Surgery, Tenth People's Hospital of Tongji University, Shanghai 200072, China
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Ruan H, Li X, Yang H, Song Z, Tong J, Cao Q, Wang K, Xiao W, Xiao H, Chen X, Xu G, Bao L, Xiong Z, Yuan C, Liu L, Qu Y, Hu W, Gao Y, Ru Z, Chen K, Zhang X. Corrigendum to "Enhanced expression of caveolin-1 possesses diagnostic and prognostic value and promotes cell migration, invasion and sunitinib resistance in the clear cell renal cell carcinoma" [Exp. Cell Res. (2017) 269-278]. Exp Cell Res 2018; 362:244. [PMID: 29174910 DOI: 10.1016/j.yexcr.2017.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- HaiLong Ruan
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xiang Li
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - HongMei Yang
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - ZhengShuai Song
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - JunWei Tong
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Qi Cao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - KeShan Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wen Xiao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - HaiBin Xiao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - XuanYu Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Urology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China; Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - GuangHua Xu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lin Bao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - ZhiYong Xiong
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - ChangFei Yuan
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lei Liu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yan Qu
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - WenJun Hu
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - YaoYing Gao
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - ZeYuan Ru
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - Ke Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - XiaoPing Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Ruan H, Li X, Yang H, Song Z, Tong J, Cao Q, Wang K, Xiao W, Xiao H, Chen X, Xu G, Bao L, Xiong Z, Yuan C, Liu L, Qu Y, Hu W, Gao Y, Ru Z, Chen K, Zhang X. Enhanced expression of caveolin-1 possesses diagnostic and prognostic value and promotes cell migration, invasion and sunitinib resistance in the clear cell renal cell carcinoma. Exp Cell Res 2017; 358:269-278. [PMID: 28684115 DOI: 10.1016/j.yexcr.2017.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 06/29/2017] [Accepted: 07/01/2017] [Indexed: 01/01/2023]
Abstract
Caveolin-1 (CAV1) has been identified to be up-regulated in many cancers, including clear cell renal cell carcinoma (ccRCC). However, its potential function is still unclear in ccRCC. In this study, we demonstrated that CAV1 was frequently overexpressed in renal cell carcinoma tissues and cells, and was significantly associated with various clinicopathological parameters. In addition, high CAV1 expression was associated with poor disease-free survival (DFS) rate and could serve as a useful diagnostic indicator in ccRCC patients with different clinicopathological stages. Functional experiments demonstrated that CAV1 knockdown inhibited cell migration and invasion, whereas overexpression of CAV1 promoted cell migration and invasion in ccRCC. Moreover, CAV1 expression was up-regulated in sunitinib-resistant renal cancer cell lines, and its overexpression promoted sunitinib resistance. In general, our results confirm that CAV1 plays an important role in the metastasis of kidney cancer and induces sunitinib resistance, so CAV1 function suppression may become a promising clinical treatment strategy during renal cell carcinoma metastasis and sunitinib resistance.
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Affiliation(s)
- HaiLong Ruan
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - Xiang Li
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - HongMei Yang
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - ZhengShuai Song
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - JunWei Tong
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - Qi Cao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - KeShan Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - Wen Xiao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - HaiBin Xiao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - XuanYu Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China; Department of Urology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China; Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - GuangHua Xu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - Lin Bao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - ZhiYong Xiong
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - ChangFei Yuan
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - Lei Liu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - Yan Qu
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - WenJun Hu
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - YaoYing Gao
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - ZeYuan Ru
- Department of Pathogenic Biology, School of Basic Medicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei Province, China
| | - Ke Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China
| | - XiaoPing Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China.
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Liu Y, Wang YR, Dingi GH, Yang TS, Jiang SL, Wang L, Xun LJ, Song RM, Song ZS, Zhou B. Influence of surgical resection of hepatocellular carcinoma(HCC) for hematogenous dissemination of HCC cells and its effect on recurrence and metastasis: 3 years prospective study. Neoplasma 2015; 62:635-40. [PMID: 25997973 DOI: 10.4149/neo_2015_076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aims was to study whether hepatal surgery leads to hematogenous dissemination of hepatocellular carcinoma (HCC) cells and determine period of its persistence by nested reverse transcription-polymerase chain reaction (RT-PCR). Peripheral vein blood (5ml) samples were obtained from 54 HCC patients of T1N0M0 and 6 HCC patients of T2N0M0 stage and 20 patients with liver cavernous hemangioma(LCH) before operation and 48h,72h and 1 week after surgical resection of hepatoma between Janurary 1st, 2007 and December 31th, 2010. We detected alpha-fetoprotein (AFP) messenger RNA(mRNA) by nested RT-PCR perioperatively.FPmRNA of all 60 cases of HCC patients and 20 cases of LCH were negative before hepatal surgery, 28 of 60 HCC cases became positve at 48h after surgery (46.7%), 16 of 60 HCC cases remained positive at 72h postoperatively(26.7%), none of 60 HCC patients AFPmRNA was detected at 1 week after hepatal surgery(0.0%). None of LCH patients were detected AFPmRNA after hepatal surgery(0.0%). For 28 HCC patients with AFPmRNA positive after hepatal surgery, 4 HCC patients developed intrahepatic tumor recurrences in 1st year (4/28, 14.3%),6 HCC patients relapsed in the second year(6/28,21.4%),10 HCC patients relapsed in the third year(10/28,35.7%). For 32 HCC patients with AFPmRNA negative group postoperation, 5 cases relapsed in 1st year (5/32, 15.6%),7 cases developed intrahepatic tumor recurrences in the second year (7/32, 21.9%),11 cases relasped in the third year (11/32, 34.4%,P>0.05),none of HCC patients occured distal metastasis after surgical resection of hepatoma. None of LCH patients relapsed postoperation within three years.Hepatal surgery may cause HCC cells spreading into peripheral blood shortly, but it may be not concerning with recurrence or metastasis of HCC.
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Wu GS, Korsgren O, Zhang JG, Song ZS, Van Rooijen N, Tibell A. Role of macrophages and natural killer cells in the rejection of pig islet xenografts in mice. Transplant Proc 2000; 32:1069. [PMID: 10936361 DOI: 10.1016/s0041-1345(00)01127-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- G S Wu
- Department of Transplantation Surgery, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden
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