Diagnostic Value of the Combination of Golgi Protein 73 and Alpha-Fetoprotein in Hepatocellular Carcinoma: A Meta-Analysis

Conflicting results have been widely reported on the use of Golgi protein 73 (GP73) as a serum biomarker for diagnosing hepatocellular carcinoma (HCC). This study evaluated the accuracy of GP73, alpha-fetoprotein (AFP), and GP73 + AFP for diagnosing HCC. The meta-analysis was performed on 11 studies that were selected by means of a comprehensive systematic literature review. Summary diagnostic accuracy, meta-regression analysis for heterogeneity and publication bias, and other statistical analyses were performed using Meta-Disc (version 1.4) and Stata (version 12.0). Pooled sensitivity, specificity, and diagnostic odds ratio were 0.77 (95% CI: 0.75–0.79), 0.91 (95% CI: 0.90–0.92), and 12.49 (95% CI: 4.91–31.79) for GP73; 0.62 (95% CI: 0.60–0.64), 0.84 (95% CI: 0.83–0.85), and 11.61 (95% CI: 8.02–16.81) for AFP; and 0.87 (95% CI: 0.85–0.89), 0.85 (95% CI: 0.84–0.86), and 30.63 (95% CI: 18.10–51.84) for GP73 + AFP. The area under the curve values were 0.86, 0.84, and 0.91 for GP73, AFP, and GP73 + AFP, respectively. These results indicate that for HCC diagnosis, the accuracy of GP73 was higher than that of AFP, and that GP73 + AFP exhibited significantly higher diagnostic accuracy than did GP73 or AFP alone.     

原发性肝癌MRI检查图像特征分析及联合血清AFP、TK1、DKK1的诊断价值研究

摘要 目的：研究原发性肝癌（PHC）磁共振成像（MRI）检查图像特征及其联合血清甲胎蛋白（AFP）、胸苷激酶1（TK1）、Dickkopf相关蛋白1（DKK1）的诊断价值。方法：将我院从2017年1月～2020年1月收治的PHC患者76例纳入研究,记作观察组。另取同期我院收治的70例良性肝病患者记作对照组。对所有受试者均进行MRI扫描,比较两组MRI图像特征。检测并对比两组血清AFP、TK1、DKK1水平的差异。通过受试者工作特征（ROC）曲线分析MRI及上述各项血清学指标诊断PHC的效能。结果：PHC患者T1WI主要表现为均匀低或稍低信号,T2WI主要表现为不均匀高信号,DWI均表现为均匀高信号。观察组血清AFP、TK1、DKK1水平均高于对照组（均P＜0.05）。经ROC曲线分析可得：MRI检查联合血清AFP、TK1、DKK1诊断PHC的曲线下面积、灵敏度、特异度、准确度均高于上述各项检查方式单独诊断。结论：PHC患者MRI图像特征如下：T1WI主要表现为均匀低或稍低信号,T2WI主要表现为不均匀高信号,DWI均表现为均匀高信号。此外,MRI检查联合血清AFP、TK1、DKK1诊断PHC的效能较高,具有一定的临床应用价值。     

HOXD10和P53蛋白在肝细胞癌组织中表达及其临床病理学意义

目的:探讨同源异型盒基因HOXD10和P53蛋白在原发性肝细胞癌hepatocellular carcinoma,HCC组织中的表达及其临床病理学意义。方法:采用免疫组化法检测62例HCC及癌旁肝组织、20例肝脏良性病变组织中HOXD10、P53蛋白的表达,并分析HCC组织中HOXD10、P53蛋白的表达与HCC患者临床病理特征的关系。结果:低分化HCC组织中HOXD10蛋白的表达显著低于中、高分化HCC、癌旁及良性病变肝组织(P0.05)。而低分化HCC组织中P53的表达显著高于中高分化HCC组织(P0.05)。HCC组织中HOXD10蛋白的表达与脉管内癌栓呈负相关(r=-0.299,P=0.026),而HCC组织中HIXD10、P53蛋白表达与患者的性别、年龄、肿瘤大小、多结节、周边肝硬化均无显著相关性(P0.05)。结论:HOXD10的低表达和P53的高表达与低分化HCC密切相关,可能作为HCC治疗和预后预测的参考指标。     

The Diagnostic Value of Tumor Biomarkers for Detecting Hepatocellular Carcinoma Accompanied by Portal Vein Tumor Thrombosis

Tumor biomarkers commonly used for the detection of hepatocellular carcinoma (HCC) complicated with portal vein tumor thrombosis (PVTT) do not show satisfactory sensitivity and specificity. This study assesses the diagnostic value of the tumor biomarkers for the diagnosis of HCC with PVTT. A retrospective study was conducted on 475 patients diagnosed as HCC with PVTT and 977 patients diagnosed with HCC by imaging and requiring surgery at our hospital from January 1993 to January 2011. Serum alpha-fetoprotein AFP, carcinoembryonic antigen, and cancer antigen 125 (Ca125) of the patients were studied. No significant differences were observed in the patients’ general characteristics. The receiver operating characteristic (ROC) analysis showed that the cut-off of AFP and Ca125 was 32.91 ng/ml and 113.65 U/ml, respectively (AUC = 0.814 and 0.783). The parallel testing with AFP and Ca125 has a sensitivity of 0.909 and a specificity of 0.410; the serial testing has a sensitivity of 0.520 and a specificity of 0.97. The condition of AFP ≥ 20,000 ng/ml can detect HCC with PVTT with a sensitivity of 0.24, a specificity of 0.96, and an accuracy of 0.73 and positive screening of 0.76. The standard of both AFP > 32.91 ng/ml and Ca125 > 113.65 U/ml or AFP ≥ 20,000 ng/ml can detect HCC with PVTT with a specificity of 0.97 and 0.96, respectively, providing important guidance for clinical practice.     

趋化因子受体CX3CR1对人肝癌细胞7721和HepG2的作用及其机制的研究

目的:探究趋化因子受体CX3CR1(C-X3-C motif chemokine receptor 1,CX3CR1)对人肝癌细胞7721和Hep G2增殖、迁移和侵袭的影响及其机制。方法:采用Q-PCR和Western blot法分别检测人正常肝细胞LO2和两种肝癌细胞(7721和Hep G2)中CX3CR1的基因表达情况(mRNA和蛋白质);以过表达CX3CR1的质粒转染7721细胞,用抑制CX3CR1的干扰RNA转染Hep G2细胞,通过Q-PCR和Western blot法检测CX3CR1的变化;应用MTT和流式细胞实验检测各组细胞的增殖能力;用集落形成实验检测各组细胞的自我更新和增殖能力;借助划痕愈合和Transwell检测各组细胞的迁移和侵袭能力;利用Western blot法检测PI3K/AKT、MAPK/ERK信号通路的激活情况。结果:CX3CR1在7721细胞中mRNA和蛋白质呈低表达趋势,而在Hep G2细胞中则呈高表达趋势;转染过表达CX3CR1质粒后7721细胞中CX3CR1的mRNA和蛋白水平有明显的升高,细胞的增殖、迁移、侵袭能力增强,p-AKT和p-ERK水平升高;转染干扰RNA后Hep G2细胞中的CX3CR1表达水平明显下降,增殖、迁移、侵袭能力减弱,p-AKT和p-ERK水平降低。结论:趋化因子受体CX3CR1可以促进人肝癌细胞增殖、迁移和侵袭能力,该作用可能与PI3K/AKT、MAPK/ERK信号通路激活有关。     

Genetic Polymorphism of the Kinesin-Like Protein KIF1B Gene and the Risk of Hepatocellular Carcinoma

Background

Frequent deletions of the kinesin-like protein gene 1B (KIF1B) have been reported in neural tumors. Recently, a genome-wide association study revealed an association between polymorphisms in the KIF1B gene and the risk of hepatocellular carcinoma (HCC), and several case-control studies have further investigated this relationship. However, these studies have yielded controversial results. We therefore performed a meta-analysis to derive a more precise estimation of the association between the KIF1B gene polymorphisms and HCC risk.

Methodology/Principal Finding

PubMed, EMBASE, the ISI Web of Science and the CNKI databases were systematically searched to identify relevant studies. A total of 5 studies containing 13 cohorts with 5,773 cases and 6,404 controls were included. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to assess the strength of the associations. Subgroup analyses were conducted based on ethnicities, sample sizes and quality scores. Overall, the G allele at rs17401966 of the KIF1B gene was associated with a significantly decreased risk for HCC (OR  = 0.81, 95%CI: 0.70–0.93; P = 0.003). Furthermore, subgroup analyses showed that the G allele at rs17401966 of the KIF1B gene significantly reduced the risk for HCC in Chinese cohorts (OR  = 0.76, 95%CI: 0.64–0.90; P = 0.002), large-sample-size cohorts (OR  = 0.80, 95%CI: 0.73–0.88, P<0.01) and high-quality cohorts (OR  = 0.78, 95%CI: 0.71–0.87, P<0.01). However, no significant associations were found in small-sample-size cohorts, studies with low-quality scores and when excluding the cohorts from the study reporting the original discovery.

Conclusion/Significance

These findings demonstrate that the presence of the G allele at rs17401966 of the KIF1B gene may decrease the risk for HCC and suggest that KIF1B may play a critical role in the development of HCC. High-quality studies with larger sample sizes and different ethnic populations will be of great value to further confirm these findings.     

Bmi1在肝癌组织中的表达及其与细胞增殖和凋亡的关系

目的：探讨Bmi1在肝细胞肝癌（HCC）中的表达及与增殖和凋亡的关系。方法：收集HCC标本54例及相应的癌旁组织,10例正常肝组织标本,采用免疫组织化学EnVision二步法显示Bmi1的表达并结合增殖与凋亡特征进行分析。结果：在肝癌组织、癌旁组织细胞中Bmi1表达定位于胞核中,阳性表达率分别为79.6%（43/54）,31.2%（17/54）,10例正常肝组织未见表达,3组差异有统计学意义（P〈0.005）。HCC中Bmi1的高表达与年龄、性别、肿瘤大小、肿瘤数目、临床TNM分期、是否有肝硬化及是否有HBsAg感染无显著相关（P〉0.05）,但与组织学分级有关,高、中分化组Bmi1表达率显著高于低分化组（P〈0.05）。肝癌Bmi1阳性组增殖指数（PI）（50.3±21.4）%显著高于阴性表达组（17.3±7.1）%（P〈0.05）,凋亡指数（AI）无明显差异（P〉0.05）。结论：Bmi1在HCC中高表达,其表达增高可能与HCC的进展相关。     

线粒体分裂蛋白FIS1通过诱导上皮间质转化促进肝癌侵袭与迁移

目的:研究线粒体分裂蛋白1(Mitochondrial fission protein 1,FIS1)介导的线粒体分裂对肝癌细胞侵袭与迁移的调控作用与机制。方法:采用免疫组化实验比较10对肝癌原发灶与转移灶组织中FIS1表达,以明确FIS1与肝癌转移的关系。通过si RNA干扰FIS1的表达后,用Transwell实验检测肝癌细胞迁移与侵袭能力的变化,q PCR与Western Blot检测上皮间质转化标志分子上皮型钙黏蛋白(epithelia cadherin,E-cadherin)、紧密连接蛋白(zonula occludens-1,ZO-1)、神经型钙黏蛋白(neural cadherin,N-cadherin)、波形蛋白Vimentin的表达。结果:肝癌转移灶组织中FIS1的表达显著高于原发灶组织。干扰FIS1表达后,肝癌细胞迁移和侵袭能力均明显下降,细胞上皮间质转化标志蛋白E-cadherin和ZO-1的表达上调,而N-cadherin和Vimentin的表达下调。结论:线粒体分裂蛋白FIS1在肝癌转移灶组织中高表达,并可能通过调节细胞上皮间质转化促进肝癌细胞转移。     

Bmi1 在肝癌组织中的表达及其与细胞增殖和凋亡的关系

目的:探讨Bmi1在肝细胞肝癌(HCC)中的表达及与增殖和凋亡的关系。方法:收集HCC标本54例及相应的癌旁组织,10例正常肝组织标本,采用免疫组织化学EnVision二步法显示Bmi1的表达并结合增殖与凋亡特征进行分析。结果:在肝癌组织、癌旁组织细胞中Bmi1表达定位于胞核中,阳性表达率分别为79.6%(43/54),31.2%(17/54),10例正常肝组织未见表达,3组差异有统计学意义(P<0.005)。HCC中Bmi1的高表达与年龄、性别、肿瘤大小、肿瘤数目、临床TNM分期、是否有肝硬化及是否有HBsAg感染无显著相关(P>0.05),但与组织学分级有关,高、中分化组Bmi1表达率显著高于低分化组(P<0.05)。肝癌Bmi1阳性组增殖指数(PI)(50.3±21.4)%显著高于阴性表达组(17.3±7.1)%(P<0.05),凋亡指数(AI)无明显差异(P>0.05)。结论:Bmi1在HCC中高表达,其表达增高可能与HCC的进展相关。     

Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus

Background and Aim

To investigate the value of changes in alpha-fetoprotein (AFP) levels for the prediction of radiologic response and survival outcomes in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) who received combined treatment of 3-dimensional conformal radiotherapy (3D-CRT) and transarterial chemoembolization (TACE).

Methods

A database of 154 HCC patients with PVTT and elevated AFP levels (>20 ng/mL) treated with 3D-CRT and TACE as an initial treatment between August 2002 and August 2008 was retrospectively reviewed. AFP levels were determined 1 month after radiotherapy, and AFP response was defined as an AFP level reduction of >20% from the initial level. Radiologic response, overall survival (OS), and progression-free survival (PFS) rates were compared between AFP responders and non-responders. Propensity-score based matching analysis was performed to minimize the effect of potential confounding bias.

Results

The median follow-up period was 11.1 months (range, 3.1–82.7 months). In the propensity-score matching cohort (92 pairs), a best radiologic response of CR or PR occurred in more AFP responders than AFP non-responders (41.3% vs. 10.9%, p < 0.001). OS and PFS were also longer in AFP responders than in non-responders (median OS 13.2 months vs. 5.6 months, p < 0.001; median PFS 8.7 months vs. 3.5 months, p < 0.001).

Conclusions

AFP response is a significant predictive factor for radiologic response. Furthermore, AFP response is significant for OS and PFS outcomes. AFP evaluation after combined radiotherapy and TACE appears to be a useful predictor of clinical outcomes in HCC patients with PVTT.     

COTE1在肝细胞癌中的表达及其与临床病理参数及预后的相关性

目的:探究重组人序列相似性家族189成员B(FAM189B,别名COTE1)在肝细胞癌组织中的表达及与肝细胞癌患者预后的相关性.方法:收集59例行肝细胞癌根治术的患者,取其肝细胞癌组织及癌旁组织,采用免疫组织化学法检测COTE1表达,分析COTE1表达与临床病理参数的关系,采用Kaplan-Meier生存曲线分析COT...     

血清AFP、CEA与肝癌患者临床病理分期和预后的关系及其诊断价值分析

目的:探讨血清甲胎蛋白(AFP)、癌胚抗原(CEA)与肝癌患者临床病理分期和预后的关系及其诊断价值。方法:选取2010年3月至2014年4月期间我院就诊的90例肝癌患者作为肝癌组,并选择同期在我院进行体检的90例健康体检者作为健康组。统计两组的血清AFP、CEA水平及阳性率,比较不同TNM分期肝癌患者的血清AFP和CEA水平。分析肝癌患者的5年无复发生存率以及血清AFP和CEA水平对肝癌的诊断价值。结果:与健康组相比,肝癌组血清AFP、CEA水平及阳性率明显升高(P0.05)。Ⅳ期血清AFP和CEA水平最高,其次Ⅲ期,Ⅱ期次之,Ⅰ期最低(P0.05)。血清AFP、CEA阳性患者5年无复发生存率明显低于血清AFP、CEA阴性患者(P0.05),血清AFP、CEA联合诊断具有较高的敏感性和特异性。结论:肝癌患者的血清AFP和CEA水平升高,并随TNM分期增加而上调。血清AFP阳性以及CEA阳性患者的5年无复发生存率明显下降,血清AFP联合血清CEA检测在肝癌诊断中具有一定的临床价值。     

乙型肝炎病毒和黄曲霉素协同作用诱发人肝细胞癌细胞株的建立

为了研究人乙型肝炎病毒（HBV）和黄曲霉素（AFB1）在肝癌发生过程中的作用,我们用HBV感染的人胚胎肝细胞移植至裸鼠背部皮下,以后每周皮下注射AFB1,在裸鼠体内成功地诱发了人肝细胞癌。选3只裸鼠所形成的肿瘤组织,分别再接种裸鼠传代。在裸鼠体内传至5代后,将瘤组织在体外培养、传代,建立了3个肝癌细胞株,分别为CBH－1a、CBH－1b和CBH－2。对3个细胞株进行生物学特性分析发现,细胞生长迅速,接触抑制消失,细胞增殖核主数Ki67阳性细胞占38．2％,用EMA单抗检测证实为人来源细胞,核酸原位杂交显示,细胞中HBV－X和HBV－S基因阳性,PCR可扩增出X基因,证明HBV基因已到瘤细胞中,3个细胞株细胞再接种裸鼠皮下,可再生成肿瘤,此实验证明了HBV协同AFB1在个肝细胞癌发生过程中的病因作用。同时,为进一步研究HBV和AFB1在肝癌发生过程中的分子机制提供了细胞水平的模型。     

刺参酸性粘多糖对诱发性肝癌大鼠的干预作用及免疫功能的影响*

目的:通过建立诱发性大鼠肝癌动物模型,研究用刺参酸性粘多糖(SJAMP)对大鼠诱发性肝癌的干预作用及免疫功能的影响。方法:将雄性Wistar大鼠50只随机均分为5个组,正常对照组、模型组和3个SJAMP干预组(A组,B组和C组),模型组和SJAMP干预组灌胃0.2%DEN生理盐水溶液以诱发肝癌,同时SJAMP干预组按照不同剂量(0.175μg/g,0.35μg/g,0.7μg/g)给予SJAMP,至16周处死大鼠,取血,无菌取脾、胸腺,计算脾指数、胸腺指数。比较各组>3mm和>5mm的结节数以及最大结节的体积,计算肿瘤抑制率。贴壁法纯化巨噬细胞,用中性红吞噬实验检测巨噬细胞吞噬功能,MTT法检测巨噬细胞杀伤功能。结果:SJAMP干预组>3mm和>5mm的结节数明显少于模型组,最大结节的平均体积明显小于模型组(P<0.05);与模型组相比,SJAMP干预组脾指数和胸腺指数明显升高(P<0.05),SJAMP干预组巨噬细胞吞噬能力和杀伤功能显著提高(P<0.05)。结论:刺参酸性粘多糖对大鼠诱发性肝癌有明显的抑制作用;其机制可能是通过刺激免疫器官生长,增强机体的细胞免疫能力来实现的。