人肝癌裸小鼠常位移植实验研究

采用硫贲妥钠（３０ｍｇ／ｋｇ、３０％乙醇配制）麻醉和蘸上立止血（２５０ｋＩＵ／ｍｌ）的明胶海棉止血措施确保了人肝癌裸小鼠常位移植术能安全、可靠地进行。本中心建立的两株人肝癌裸小鼠移植瘤株（ＨＨＣ４、ＨＨＣ１５）已成功地移植于裸小鼠（ＳＰＦ级）肝脏内,移植瘤生长良好、传代稳定和持续分泌ＡＦＰ。荷瘤（ＨＨＣ１５）３～６周裸小鼠血清ＡＦＰ含量与瘤体积的增加呈正相关。常位移植前（７ｄ）裸小鼠皮下注射０．１ｍｌ０．５％ＣＣ１（Ｖ／Ｖ。橄榄油配制）能明显提高ＨＨＣ４常位移植的成功率（Ｘ２检验、Ｐ＜０．０１）;在微量ＣＣｌ４作用下,裸小鼠肝细胞受损伤,发生肝硬化,在此基础上所移植和生长的人肝癌常位移植瘤与大多数人肝癌病变发生的肝脏病理生理学特点相似,本模型的建立更适用于抗肝癌药物的模拟治疗和筛选。     

B4GALT3促进肝癌细胞增殖和侵袭

β-1,4-半乳糖基转移酶III（β-1,4-galactosyltransferase III,B4GALT3）在肿瘤的作用正受到关注,但其在肝癌中的表达模式及其作用有待阐明。基于TCGA肿瘤组织数据库和GTEx正常组织数据库进行的生物信息学分析,发现相比于人正常肝组织,B4GALT3在人肝癌组织中的表达显著上调。实时荧光定量PCR结果发现肝癌细胞中B4GALT3的mRNA和Western 印迹检测蛋白质表达水平显著上调。其中肝癌细胞SMMC7721中B4GALT3的mRNA表达水平是正常肝细胞L-02的9.85倍。对TCGA数据库进行分析发现,B4GALT3表达水平与肝癌患者的生存率呈负相关。在内源性高表达B4GALT3的SMMC7721肝癌细胞中,干扰B4GALT3表达,可显著抑制该细胞的增殖能力和侵袭能力。干扰B4GALT3表达能显著上调SMMC7721细胞中p27和E-cadherin的蛋白质表达水平,干扰B4GALT3表达后SMMC7721细胞中,p27和E-cadherin的mRNA水平较对照组上调6.15倍和7.83倍。总之,B4GALT3在肝癌中表达上调,且促进肝癌细胞的增殖和侵袭。     

肝细胞癌中抑癌基因的发现与研究进展

肝细胞癌（HCC）的发病率高、治疗效果差。HCC的发病机制复杂,主要有2类：肝炎、酒精、黄曲霉素、代谢紊乱引起的肝损伤,进而导致的肝硬化;致癌基因和抑癌基因的突变或对应染色体区域的扩增或缺失。细胞内一些信号通路参与了HCC的发生发展,包括RAF／MEK／ERK、P13K／AKT／mTOR、WNT/β-catenin、胰岛素样生长因子、肝细胞生长因子／c-MET、生长因子调节的血管新生等6类信号通路。抑癌基因通过调节信号通路而调节细胞增殖、细胞周期、细胞凋亡等对肿瘤的发生、发展起重要作用的过程。我们简要概述HCC相关的肿瘤抑制分子及其所在的信号通路及作用的分子机制。     

精准肝切除术治疗原发性肝癌的临床效果分析

目的:探讨腹腔镜精准肝切除术的特点及效果,为普外科手术提供参考。方法:选取2011年10月-2013年7月我院收治的92例原发性肝癌患者的临床资料进行回顾分析。根据手术方式不同,将病例分为常规肝切除组和精准肝切除组,每组46例。观察并比较两组患者的评均术中出血量、手术时间、住院时间、手术前后的肝功能指标变化、并发症的发生率、肿瘤局部复发率及远期转移率等。结果:与常规肝切除组相比较,精准肝切除组患者的平均术中出血量少、住院时间短、术后并发症的发生率及肿瘤复发转移率低,但手术时间较长,组间比较差异显著,具有统计学意义(P0.05)。与手术前比较,两组患者手术后的血清TBIL、ALT及AST含量降低,ALB升高,精准肝切除组患者各项指标的变化程度更显著,肝功能优于常规肝切除组,组内及组间比较差异具有统计学意义(P0.05)。结论:精准肝切除术对于原发性肝癌的治疗具有良好临床的效果,不仅能够彻底清除病灶,而且降低了术后肝衰竭等并发症的发生率,值得推广应用。     

ZIP4 confers resistance to zinc deficiency-induced apoptosis in pancreatic cancer

Emerging evidence implicates the zinc importer ZIP4 as a critical factor that enhances pancreatic cancer proliferation; however, the role of ZIP4 in promoting pancreatic cancer progression by regulating apoptosis requires elucidation. To determine the effect of ZIP4 on apoptosis, we used cell lines where ZIP4 levels were upregulated or silenced in combination with Chelex 100 treatment to deplete intracellular zinc. Pancreatic cancer xenografts derived from those cells were also included. TUNEL and flow cytometry analysis were used to measure apoptosis and western blotting was used to analyze protein expression for PARP and multiple caspases. Cell cycle profiles were examined by flow cytometry. Zinc depletion by Chelex induced more apoptosis of pancreatic cancer cells in comparison to normal medium, where almost no apoptosis was observed. ZIP4 stably overexpressed MIA PaCa-2 (MIA-ZIP4) cells were more resistant to zinc depletion-induced apoptosis compared with vector control. Conversely, AsPC-1 (AsPC-shZIP4) cells with stable knockdown of ZIP4 were more sensitive to zinc deficiency than control. Resistance to apoptosis mediated by ZIP4 was accomplished by the caspase pathway. In vivo data also confirmed that ZIP4 overexpressed xenografts showed less apoptosis than controls. Cell cycle profiles indicate that silencing of ZIP4 leads to decreased cell population in S phase and G₀/G₁ arrest. These results described a previously uncharacterized role of ZIP4 in apoptosis resistance and elucidated a novel pathway through which ZIP4 regulates pancreatic cancer growth. This research provides additional evidence for ZIP4 and related signaling cascade as a molecular target for therapeutic intervention in pancreatic cancer.     

乙肝相关性肝癌中新基因CHCHD2的生物信息学分析

应用基因芯片技术获取以稳定转染HBx基因的肝癌细胞HepG2(HepG2-X)及非转染的肝癌细胞HepG2的差异表达的基因,利用生物信息学方法对新基因CHCHD2进行初步分析表明,该蛋白开放性读码框长456 bp,编码151个氨基酸残基,相对分子量为15.55 kD,等电点9.43,是主要定位于线粒体中的亲水性蛋白,二级结构均以α-螺旋和无规则卷曲为主要构件。同源性比较分析结果表明,其碱基序列与已经报道的其他17个物种相似性为64%-99%,且符合种属之间的进化关系。     

Quantitative and Qualitative Alterations of Heparan Sulfate in Fibrogenic Liver Diseases and Hepatocellular Cancer

Heparan sulfate (HS), due to its ability to interact with a multitude of HS-binding factors, is involved in a variety of physiological and pathological processes. Remarkably diverse fine structure of HS, shaped by non-exhaustive enzymatic modifications, influences the interaction of HS with its partners. Here we characterized the HS profile of normal human and rat liver, as well as alterations of HS related to liver fibrogenesis and carcinogenesis, by using sulfation-specific antibodies. The HS immunopattern was compared with the immunolocalization of selected HS proteoglycans. HS samples from normal liver and hepatocellular carcinoma (HCC) were subjected to disaccharide analysis. Expression changes of nine HS-modifying enzymes in human fibrogenic diseases and HCC were measured by quantitative RT-PCR. Increased abundance and altered immunolocalization of HS was paralleled by elevated mRNA levels of HS-modifying enzymes in the diseased liver. The strong immunoreactivity of the normal liver for 3-O-sulfated epitope further increased with disease, along with upregulation of 3-OST-1. Modest 6-O-undersulfation of HCC HS is probably explained by Sulf overexpression. Our results may prompt further investigation of the role of highly 3-O-sulfated and partially 6-O-desulfated HS in pathological processes such as hepatitis virus entry and aberrant growth factor signaling in fibrogenic liver diseases and HCC. (J Histochem Cytochem 58:429–441, 2010)     

miR-101 Inhibiting Cell Proliferation,Migration and Invasion in Hepatocellular Carcinoma through Downregulating Girdin

miR-101 is considered to play an important role in hepato-cellular carcinoma (HCC), but the underlying molecular mechanism remains to be elucidated. Here, we aimed to confirm whether Girdin is a target gene of miR-101 and determine the tumor suppressor of miR-101 through Girdin pathway. In our previous studies, we firstly found Girdin protein was overexpressed in HCC tissues, and it closely correlated to tumor size, T stage, TNM stage and Edmondson-Steiner stage of HCC patients. After specific small interfering RNA of Girdin was transfected into HepG2 and Huh7.5.1 cells, the proliferation and invasion ability of tumor cells were significantly inhibited. In this study, we further explored the detailed molecular mechanism of Girdin in HCC. Interestingly, we found that miR-101 significantly low-expressed in HCC tissues compared with that in matched normal tissues while Girdin had a relative higher expression, and miR-101 was inversely correlated with Girdin expression. In addition, after miR-101 transfection, the proliferation, migration and invasion abilities of HepG2 cells were weakened. Furthermore, we confirmed that Girdin is a direct target gene of miR-101. Finally we confirmed Talen-mediated Girdin knockout markedly suppressed cell proliferation, migration and invasion in HCC while down-regulation of miR-101 significantly restored the inhibitory effect. Our findings suggested that miR-101/Girdin axis could be a potential application of HCC treatment.     

人肝细胞癌及其配对非癌肝组织、正常肝组织中热休克蛋白Hsp90基因mRNA水平的分析

 为定量分析和比较 2 2对人肝细胞癌 (HCC)及其配对非癌肝组织 (PNL)和 2例正常肝 (NL)组织中热休克蛋白Hsp(heatshockprotein) 90基因mRNA的表达水平 ,用狭缝杂交法检测hsp90 βmRNA的表达 ;并进一步用以特异性复合cRNA为内参照的定量RT PCR法对hsp90α和hspβmRNA的表达进行分析比较 .狭缝杂交结果显示 ,hsp90 βmRNA在 1 3例 ( 59 1 % )PNL中的表达平均升高至NL的 1 87倍 ;在 2 1例 ( 95 5% )HCC中的表达平均升高至NL的 3 45倍 ;在 2 0例 ( 90 9% )HCC中的表达平均升高至PNL的 2 75倍 .以cRNA为内参照的mRNA定量RT PCR结果显示 ,hsp90αmRNA在1 8例 ( 81 8% )PNL中的表达平均升高至NL的 3 0 6倍 ;在全部 2 2例HCC中的表达平均升高至至PNL的 2 0 8倍和NL的 5 1 0倍 .hsp90 βmRNA仅在小部分 ( 8例 ,36 4% )PNL中的表达轻度升高至NL的 1 2 7倍 ,而在全部 2 2例HCC中的表达显著升高至PNL的 2 95倍和NL的 2 52倍 .hsp90α和hsp90 β可能分别在人HCC发生、发展的不同阶段发挥不同的作用 ;以cRNA为内参照的定量RT PCR法是较狭缝杂交法更为灵敏、准确和快捷的mRNA定量分析方法 .     

原发性肝癌合并下腔静脉癌栓的手术治疗

目的：探讨原发性肝癌合并下腔静脉癌栓的手术治疗方法。方法：采用肝切除加下腔静脉取栓治疗2例肝癌合并下腔静脉癌栓患者,取栓方法包括经荷栓肝静脉取栓（1例）和下腔静脉切开取栓（1例）,又分在全肝血流阻断下取栓和在萨氏钳局部血管阻断下取栓。结果：2例肝癌及下腔静脉癌栓均得到成功切除,术中无明显并发症发生;术后无死亡;随访中一例存活11月;另1例已生存8个月。结论：肝癌合并下腔静脉癌栓的手术治疗安全可行,其基本术式为肝切除加下腔静脉切开取栓。     

Scoring Selection Criteria Including Total Tumour Volume and Pretransplant Percentage of Lymphocytes to Predict Recurrence of Hepatocellular Carcinoma after Liver Transplantation

Aim

The selection criteria for patients with hepatocellular carcinoma (HCC) to undergo liver transplantation should accurately predict posttransplant recurrence while not denying potential beneficiaries. In the present study, we attempted to identify risk factors associated with posttransplant recurrence and to expand the selection criteria.

Patients and Methods

Adult patients with HCC who underwent liver transplantation between November 2004 and September 2012 at our centre were recruited into the current study (N = 241). Clinical and pathological data were retrospectively reviewed. Patients who died during the perioperative period or died of non-recurrence causes were excluded from this study (N = 25). All potential risk factors were analysed using uni- and multi-variate analyses.

Results

Sixty-one recipients of 216 qualified patients suffered from recurrence. Similar recurrence-free and long-term survival rates were observed between living donor liver transplant recipients (N = 60) and deceased donor liver transplant recipients (N = 156). Total tumour volume (TTV) and preoperative percentage of lymphocytes (L%) were two independent risk factors in the multivariate analysis. We propose a prognostic score model based on these two risk factors. Patients within our criteria achieved a similar recurrence-free survival to patients within the Milan criteria. Seventy-one patients who were beyond the Milan criteria but within our criteria also had comparable survival to patients within the Milan criteria.

Conclusions

TTV and L% are two risk factors that contribute to posttransplant recurrence. Selection criteria based on these two factors, which are proposed by our study, expanded the Milan criteria without increasing the risk of posttransplant recurrence.     

肝细胞癌循环肿瘤细胞标志物及检测方法研究进展

肝细胞癌(hepatocellular carcinoma, HCC)在中国是一种高发病率和高死亡率的恶性肿瘤。肿瘤切除、肝移植是治疗该病最有效的手段,但术后的高复发率和高转移率是影响患者预后的重要因素。外周血循环肿瘤细胞(circulating tumor cells, CTCs)是导致肝细胞癌术后复发和转移的必要因子。综述了CTCs的标记物——磷脂酰肌醇蛋白聚糖-3、转铁蛋白受体、甲胎蛋白、α-L岩藻糖苷酶、上皮细胞粘附因子、高尔基蛋白73和异常凝血酶原等,以及利用这些标记物检测CTCs的特异性和灵敏度,以期为肝细胞癌转移的早期检测、术后的复发、预后评估和选择治疗方案等提供依据。     

原发性肝癌合并下腔静脉癌栓的手术治疗

目的:探讨原发性肝癌合并下腔静脉癌栓的手术治疗方法.方法:采用肝切除加下腔静脉取栓治疗2例肝癌合并下腔静脉癌栓患者,取栓方法包括经荷栓肝静脉取栓(1例)和下腔静脉切开取栓(1例),又分在全肝血流阻断下取栓和在萨氏钳局部血管阻断下取栓.结果:2例肝癌及下腔静脉癌栓均得到成功切除,术中无明显并发症发生;术后无死亡;随访中一例存活11月;另1例已生存8个月.结论:肝癌合并下腔静脉癌栓的手术治疗安全可行,其基本术式为肝切除加下腔静脉切开取检.     

不同方式治疗原发性肝癌合并门静脉癌栓的治疗效果比较

目的:对不同方式治疗原发性肝癌(HCC)合并门静脉癌栓(PVTT)的治疗效果进行比较。方法:收取我院2010年2月至2013年3月收治的HCC合并PVTT患者83例进行回顾性分析,按照治疗方法的不同分为A组(手术+经导管动脉化疗栓塞TACE)26例、B组(手术+门静脉化疗PVC)25例以及C组(手术+TACE+PVC)32例。对三组患者不良反应发生情况、生存率、生存质量进行考察与比较,并对可能影响生存率的因素进行分析。结果:三组患者均行手术切除,切除率为100%。三组患者化疗后不良反应发生率方面比较差异无统计学意义(P0.05)。C组患者生存质量提高总有效率及改善率分别为78.13%和50.00%,均显著高于其他两组,差异有统计学意义(P0.05)。C组患者中位生存时间及半年、1年、2年、3年生存率均显著高于A组和B组,差异具有统计学意义(P0.05)。影响HCC合并PVTT患者的主要因素包括肿瘤大小、肿瘤数目、病理分级及癌栓类型(P0.05)。结论:HCC合并PVTT患者术后使用TACE+PVC联合治疗可有效提高患者生存率,改善生活质量。     

多基因模型在肝细胞癌预后中的应用

利用较少分子信息预测肝细胞癌类型对患者的个性化治疗十分关键。探索已知的与肝细胞癌预后相关的信号通路,共发现41个关键基因。随后,运用机器学习的方法对其构建风险预测模型,并在4个肝细胞癌数据集上进行验证。结果显示,该模型能将肝细胞癌患者分成两个预后差异显著的类型:癌症基因图谱(The cancer genome atlas,TCGA)数据集交叉验证的平均log rank P值为0.03;其他测试数据集的log rank P 值分别为0.000 38、0.002 1和0.01。生物信息学分析显示肝细胞癌的预后与细胞周期等信号通路显著相关,并筛选出12个潜在的肝细胞癌分子标志物。研究结果表明,基于41个基因构建的肝细胞癌预后模型具有较好的稳健性和准确的风险预测能力。     

肝细胞肝癌E-Cadherin 蛋白的表达及其对判断肝癌肝移植 疗效的意义

目的:探讨E-Cadherin蛋白在肝细胞肝癌组织中的表达及其对判断肝癌肝移植患者预后的价值。方法:选择肝细胞肝癌行全肝移植患者68例,应用免疫组化方法检测其切除的肝癌组织和癌旁正常肝组织中E-Cadherin蛋白的表达情况,并对患者进行移植术后随访,分析E-Cadherin蛋白表达与肝癌肝移植患者预后的关系。结果:肝癌组织中E-Cadherin蛋白阳性表达率明显低于癌旁组织(P<0.01)。经Logrank检验分析显示,E-Cadherin蛋白低表达组移植后的无瘤生存率明显低于E-Cadherin蛋白高表达组(P<0.01)。多因素Cox回归分析显示,E-Cadherin蛋白表达是影响肝细胞肝癌患者肝移植术后肝癌复发的独立预后因素之一。结论:E-Cadherin蛋白表达是一个预测肝细胞肝癌患者肝移植预后的重要因子。     

肝细胞肝癌E-Cadherin蛋白的表达及其对判断肝癌肝移植疗效的意义

目的：探讨E-Cadherin蛋白在肝细胞肝癌组织中的表达及其对判断肝癌肝移植患者预后的价值。方法：选择肝细胞肝癌行全肝移植患者68例,应用免疫组化方法检测其切除的肝癌组织和癌旁正常肝组织中E-Cadherin蛋白的表达情况,并对患者进行移植术后随访,分析E-Cadherin蛋白表达与肝癌肝移植患者预后的关系。结果：肝癌组织中E-Cadherin蛋白阳性表达率明显低于癌旁组织（P〈0.01）。经Logrank检验分析显示,E-Cadherin蛋白低表达组移植后的无瘤生存率明显低于E-Cadherin蛋白高表达组（P〈0.01）。多因素Cox回归分析显示,E-Cadherin蛋白表达是影响肝细胞肝癌患者肝移植术后肝癌复发的独立预后因素之一。结论：E-Cadherin蛋白表达是一个预测肝细胞肝癌患者肝移植预后的重要因子。