甲胎蛋白异质体在肝细胞癌中的诊断价值分析

目的:探讨甲胎蛋白异质体(AFP-L3)的检测对肝细胞肝癌(HCC)的诊断价值。方法:选取2009年2月至2012年11月在本院治疗的90例HCC患者为研究组,另选择同期接受治疗的慢性乙型肝炎患者30例和肝炎肝硬化患者30例作为对照组。观察三组患者的AFP、AFP-L3阳性率。结果:肝癌患者AFP和AFP-L3阳性率显著高于乙肝和肝硬化患者,差异具有统计学意义(P0.05)。乙肝和肝硬化两组患者的AFP及AFP-L3阳性率无显著差异(P0.05)。AFP400 ng/m L:肝癌组AFP-L3阳性率显著高于乙肝组和肝硬化组,差异具有统计学意义(P0.05)。结论:AFP-L3在HCC中的诊断价值较甲胎蛋白大,更适合在临床诊断中应用。     

甲胎蛋白异质体分离方法的优化

目的:优化现有的甲胎蛋白异质体(AFP-L3)分离和检测方法,找到一个最有效的AFP-L3的提取方法,为今后的AFP-L3研究奠定前期基础。方法:应用北京热景生物技术公司的甲胎蛋白异质体(AFP-L3)亲和吸附离心管,通过改变亲和介质使用量和洗脱液体积的配伍梯度变化来优化实验流程,排除提取AFP-L3的影响因素,分离血清中的AFP-L3,并用罗氏公司的甲胎蛋白检测试剂盒检测分离的效果。结果:发现在不改变亲和介质体积的情况下,随着洗脱液体积的减少AFP-L3回收浓度逐渐增加,且在75 ul洗脱液时能够获得最高AFP-L3回收浓度。结论:成功地优化了北京热景生物技术公司的甲胎蛋白异质体(AFP-L3)亲和吸附离心管及其配套试剂的使用方法。     

GALAD模型对肝细胞癌的诊断价值及微血管侵犯的预测作用

[目的]探讨GALAD模型对原发性肝细胞癌的诊断价值及在微血管侵犯预测中的作用.[方法]回顾性研究,选择2018年8月～2020年10月在西安交通大学第一附属医院接受手术治疗的HCC患者200例,选择同期确诊为肝硬化患者49例,良性肝脏疾病患者53例,健康对照者30例,采用罗氏Cobas e602全自动免疫分析仪检测血...     

甲胎蛋白异质体在原发性肝癌患者血清中的表达

为了揭示原发性肝癌患者血清中甲胎蛋白异质体(AFP-L3)的表达及意义,本研究选取2014年2月至2016年3月在本院治疗的原发性肝癌患者80例,同时选取肝硬化患者60例,慢性乙肝患者60例及健康志愿者60例,采用亲和吸附离心管法检测不同受试者血清中AFP-L3水平。研究显示,原发性肝癌患者的血清AFP-L3 (122.13 ng/mL)水平显著低于肝硬化患者,并且显著高于慢性乙肝患者和健康者,差异具有统计学意义(p0.05);原发性肝癌患者中,血清AFP-L3水平在肿瘤大小≤3 cm (171.14 ng/mL)和TNM分期为Ⅰ～Ⅱ期(147.53 ng/mL)患者中显著高于肿瘤大小3 cm和TNM分期为Ⅲ～Ⅳ期患者(p0.05);血清AFP-L3高表达(≥122.13 ng/mL)的肝癌患者中位生存时间(22.76月)与血清AFP-L3低表达的肝癌患者(122.13 ng/mL)(22.04月)差异不显著(p0.05)。本项研究表明原发性肝癌患者血清中AFP-L3水平明显上升,并且与患者的肿瘤大小和TNM分期具有相关性。     

外泌体源性微小RNA在肝细胞癌及其早期诊断中的作用

肝细胞癌(hepatocellular carcinoma,HCC)是全球第六大最常见的恶性肿瘤。外泌体中微小RNA(microRNAs,miRNAs)可通过在细胞间传递交流来参与调控血管生成、上皮-间充质转化和介导免疫微环境等多种通路途径,从而促进HCC细胞的生长增殖和迁移侵袭,以及诱导肿瘤细胞耐药。此外,外泌体源性miRNAs展现了显著的组织特异性和作为新颖生物标志物的巨大潜力,已成为当前HCC早期液体活检研究的热门领域。本文综述了外泌体源性miRNAs在HCC发生发展和耐药中的作用机制,揭示了其潜在的系统性分子调控网络,归纳了其在HCC早期诊断中的应用价值。     

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。     

血清PIVKA-Ⅱ与AFP检测在原发性肝细胞癌诊断中的应用

为探究血清PIVKA-Ⅱ与AFP检测在原发性肝细胞癌诊断中的优劣性,对237例患者的血清PIVKA-Ⅱ与AFP进行检测,其中乙肝病毒相关性原发性肝细胞癌(hepatocellular carcinoma, HCC)患者115例、乙肝携带者(asymptomatic carrier, As C) 55例、乙肝病毒相关肝硬化(liver cirrhosis, LC)患者47例、非肝癌肿瘤患者20例。检测结果显示:肝癌组PIVKA-Ⅱ的中位表达量高于非肝癌组(包括As C组、LC组、非肝癌肿瘤组), P均小于0.05;使用AFP、PIVKA-Ⅱ和AFP+PIVKA-Ⅱ诊断肝癌的灵敏度分别为67.8%、81.7%和90.4%,对应的ROC曲线下面积为0.881、0.945和0.962, PIVKA-Ⅱ检测肝癌的cut-off值为32 m AU/m L。已有研究报道以40 m AU/m L为PIVKA-Ⅱ的cut-off值,本研究根据PIVKA-Ⅱ是否≥40 m AU/m L将HCC组分为PIVKA-Ⅱ≥40组、PIVKA-Ⅱ40组,对两组患者的性别、年龄、病毒载量、肿瘤分期、癌结节数目、肿块直径和是否抗病毒治疗进行比较,采用logistic回归分析两组患者的差异性指标,结果显示病毒载量[OR=1.150, 95%CI (1.022, 1.295), P=0.02]为PIVKA-Ⅱ检测肝癌的独立影响因素。相关分析表明PIVKA-Ⅱ与肝癌肿块直径呈正相关。此外, AFP、PIVKA-Ⅱ的cut-off值分组结果表明, PIVKA-Ⅱ≥32且AFP20组的肝癌肿块直径大于PIVKA-Ⅱ32且AFP≥20组(P=0.035)。因此, PIVKA-Ⅱ是优于AFP筛查肝细胞癌的血清学肿瘤标志物,其表达量与肿瘤肿块直径呈正相关。     

miRNA在肝细胞癌中的研究进展和展望

微小RNA(microRNA, miRNA)是一类长度为二十几个核苷酸的内源性非编码调控RNA,通过序列特异性翻译抑制或mRNA裂解来调控基因表达,参与细胞发育、增殖、分化、凋亡等一系列重要生物学进程。近期的研究发现,miRNA具有癌基因和抑癌基因的作用,在肿瘤的发生和发展中起着重要的作用。已发现若干miRNA直接参与肝细胞癌的发生和发展,miRNA表达谱与肝细胞癌的诊断、分期、进展和预后等相关。作为一类新的分子靶标,miRNA应用于肝细胞癌的诊断和生物治疗具有广阔的前景。     

AFP阴性与阳性肝细胞癌免疫组化和免疫电镜的比较性研究

目的比较性研究AFP阴性与阳性原发性肝细胞癌超微结构特征及AFP和Tn (Thomsen-Friedenreich-related antigen)蛋白表达及意义.方法 43例原发性肝细胞癌组织和5例正常肝组织分为三组:对照组(正常肝组织,5例);AFP阳性肝细胞癌组 (血清AFP>10ng/ml,22例);AFP阴性肝细胞癌组(血清AFP<10ng/ml,21例).应用透射电镜、免疫组织化学和细胞图象分析技术对AFP阴性与阳性肝癌细胞超微结构及AFP和Tn蛋白表达进行观察,并进行AFP和Tn蛋白免疫电镜标记.结果 1. 免疫组织化学结果显示:在AFP阴性肝细胞癌组癌细胞中(1)Tn蛋白表达强度(0.1498±0.0371)明显高于AFP阳性肝细胞癌组(0.0685±0.0156)(P<0.01);(2)AFP蛋白表达强度(0.1269±0.0347) 低于AFP阳性肝细胞癌组(0.1852±0.0234)(P<0.01).2.透射电镜观察:在AFP阴性组肝癌细胞中,癌细胞最突出的形态特征是胞质内细胞器大多十分简单,唯游离多聚核糖核蛋白体十分丰富.而在AFP阳性组肝癌细胞中,癌细胞胞质内细胞器相对较多,特别是粗面内质网尤为丰富.此外,线粒体及高尔基器也较明显.3.免疫电镜标记显示:AFP蛋白阳性标记主要位于粗面内质网,Tn蛋白阳性标记多位于游离多聚核糖核蛋白体,粗面内质网仅见有散在阳性分布.结论 (1)AFP和Tn蛋白在AFP阴性与阳性肝细胞癌组织中具有差异性分布特征,Tn蛋白有望成为AFP阴性肝细胞癌诊断辅助指标之一.(2)透射电镜和免疫电镜观察表明:AFP和Tn蛋白在肝癌细胞中的合成部位明显不同.     

microRNAs在肝细胞癌中的调控机制及临床应用

microRNA（miRNA）在人类恶性肿瘤的发生发展过程中起着重要作用。近期研究表明,miRNA通过结合特定靶标参与调控肝细胞癌（hepatocellularcarcinoma,HCC）的发生,可作为辅助生物标志物用于指导肝细胞癌的诊断和治疗,并为有效地监控和预防肝病提供了新途径。寻找miRNA靶标,阐明miRNA参与肝癌发生的调控机理,有利于肝癌的临床靶向基因治疗。通过总结miRNA在肝细胞癌中的调控机制及临床应用的研究进展,为寻找肝细胞癌早期诊断的生物标志物及介入治疗的靶点提供了参考。     

Evaluation of serum alpha fetoprotein-L3 as an accuracy novel biomarker for the early diagnosis of hepatocellular carcinoma in Egyptian patients

BackgroundMost Hepatocellular Carcinomas (HCCs) are diagnosed at an advanced stage. However, HCC early diagnosis is complicated by the coexistence of inflammation and cirrhosis. The unsatisfactory sensitivity and specificity of Alpha-fetoprotien (AFP) for screening of early-stage HCC paved the way for new novel biomarkers to complement AFP such as AFP-L3. The aim of this study was the Evaluation of alpha fetoprotein-L3 (AFP-L3) as earlier marker in diagnosis of hepatocellular carcinoma in Egyptian patients. This study was conducted on 80 patients categorized into 2 groups; group 2 (40 patients with chronic active hepatitis) and group 3 (40 patients with HCC). HCC diagnosis was done by clinical, triphasic CT and positive US for focal lesion, in addition to 20 healthy individuals as controls (group 1).ResultsThe median range of AFP and AFP-L3 were highly statistically significant difference between HCC group and other groups [p < 0.001]. In this study ALT, AST, Total & direct bilirubin and albumin results showed highly significant differences between HCC group and other groups. Serum AFP-L3 shows sensitivity 100%, specificity 100%, positive predictive value 100% and negative predictive value 100% with AUC = 1 in HCC cases.ConclusionSerum AFP-L3 may serve as a diagnostic biomarker for the detection of early stage of HCC and show higher sensitivity than AFP.     

Single-cell transcriptomics analysis reveals intratumoral heterogeneity and identifies a gene signature associated with prognosis of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) tumors exhibit high heterogeneity. However, current understanding of tumor cell heterogeneity of HCC and the association with prognosis remains very limited. In the present study, we collected and examined tumor tissue from one HCC patient by single-cell RNA sequencing (scRNA-seq). We identified 5753 cells and 16 clusters including hepatocytes/cancer cells, T cells, macrophages, endothelial cells, fibroblasts, NK cells, neutrophils, and B cells. In six tumor cell subclusters, we identified a cluster of proliferative tumor cells associated with poor prognosis. We downloaded scRNA-seq data of {"type":"entrez-geo","attrs":{"text":"GSE125449","term_id":"125449"}}GSE125449 from the NCBI-GEO as validation dataset, and found that a cluster of hepatocytes exhibited high proliferation activity in HCC. Furthermore, we identified a gene signature related to the proliferation of HCC cells. This gene signature is efficient to classify HCC patients into two groups with distinct prognosis in both TCGA and ICGC database cohorts. Our results reveal the intratumoral heterogeneity of HCC at single cell level and identify a gene signature associated with HCC prognosis.     

Low use of surveillance and early diagnosis of hepatocellular carcinoma in Norway—A population-based cohort study

Background and aimsCurative treatment of hepatocellular carcinoma (HCC) is dependent on early diagnosis. Surveillance of patients at high risk for HCC is a key determinant to achieve this goal, but may be an underutilized tool. The aim of this study was to determine the rate of pre-diagnosis surveillance in patients with HCC in a large population-based cohort and to assess to what extent cirrhosis was known prior to the diagnosis of HCC.MethodsAll patients diagnosed with HCC during 2000–2009 in The South-Eastern Regional Health Authority, representing 56% of the Norwegian population, were identified from The National Cancer Registry and the medical records were reviewed.ResultsFifteen out of 486 patients (3%) were diagnosed by surveillance. Potential curative treatment was offered to 58% of the patients who underwent surveillance as opposed to 15% in the non-surveillance group. Only age ≤65 years was an independent predictor of screening in a multivariate model. Almost two thirds of the patients with cirrhosis were unrecognized prior to the HCC diagnosis. Two hundred and fourteen patients (44%) were non-cirrhotics.ConclusionRegular HCC surveillance in at-risk populations is virtually not applied in Norway and this may contribute to inferior overall survival. Failure to recognize cirrhosis and a high rate of HCC in non-cirrhotic patients will be limiting factors for the overall effectiveness of a potential surveillance program.     

Outer arm fucosylation of N-glycans increases in sera of hepatocellular carcinoma patients

Serum glycans are promising markers for early-stage cancer detection, but the research remains challenging because low concentrations of serum glycoproteins are secreted from early-stage tumors. We have established an N-glycan profiling method using liquid chromatography electrospray ionization-mass spectrometry with high sensitive derivative, trimethyl(4-aminophenyl)ammonium chloride (TMAPA). The mass sensitivity of TMAPA-labeled oligosaccharides was enhanced more than 50 times compared with 2-aminopyridine (PA) labeled oligosaccharides, and the analytical period was significantly shortened compared with traditional HPLC 2D-mapping. Using this method, we found about 28 major N-linked oligosaccharides in human sera, and we investigated their alterations in patients who developed hepatocellular carcinoma (HCC). We found that outer arm fucosylation (attached GlcNAc via an alpha 1-3/4 linkage) in highly branched oligosaccharides increased significantly in sera of HCC patients. Normalizing the level of outer arm fucosylation by taking into account platelet concentration allowed us to distinguish more clearly between HCC and LC patients.     

Transcriptional and epigenetic landscape of Ca2+-signaling genes in hepatocellular carcinoma

Calcium (Ca²⁺) signaling has a major role in regulating a wide range of cellular mechanisms, including gene expression, proliferation, metabolism, cell death, muscle contraction, among others. Recent evidence suggests that ~ 1600 genes are related to the Ca²⁺ signaling. Some of these genes’ expression is altered in several pathological conditions, including different cancer types, and epigenetic mechanisms are involved. However, their expression and regulation in hepatocellular carcinoma (HCC) and the liver are barely known. Here, we aimed to explore the expression of genes involved in the Ca²⁺-signaling in HCC, liver regeneration, and hepatocyte differentiation, and whether their expression is regulated by epigenetic mechanisms such as DNA methylation and histone posttranslational modifications (HPM). Results show that several Ca²⁺-signaling genes’ expression is altered in HCC samples; among these, a subset of twenty-two correlate with patients’ survival. DNA methylation correlates with eight of these genes’ expression, and Guadecitabine, a hypomethylating agent, regulates the expression of seven down-regulated and three up-regulated genes in HepG2 cells. The down-regulated genes displayed a marked decrease of euchromatin histone marks, whereas up-regulated genes displayed gain in these marks. Additionally, the expression of these genes is modulated during liver regeneration and showed similar profiles between in vitro differentiated hepatocytes and liver-derived hepatocytes. In conclusion, some components of the Ca²⁺-signaling are altered in HCC and displayed a correlation with patients’ survival. DNA methylation and HMP are an attractive target for future investigations to regulate their expression. Ca²⁺-signaling could be an important regulator of cell proliferation and differentiation in the liver.Electronic supplementary materialThe online version of this article (10.1007/s12079-020-00597-w) contains supplementary material, which is available to authorized users.     

Polyclonal antibody production against rGPC3 and their application in diagnosis of hepatocellular carcinoma

Glypican-3 (GPC3) is an integral membrane proteoglycan, which contains a core protein anchored to the cytoplasmic membrane through a glycosylphosphatidylinositol linkage. The glypican-3 can regulate the signaling pathways, thereby enhances cell division, growth, and apoptosis in certain cell types. It is almost nonexistent on the surface of the human normal cell membrane and highly expresses on the membrane of hepatocellular carcinoma (HCC) cells. It has been well established that GPC3 provides a useful diagnostic marker. For generating the polyclonal antibody of GPC3, we expected that GPC3 N-terminal region (amino acid sequence 26–358) could be expressed in Escherichia coli system, however, no active expression was observed after IPTG induction. Interestingly, after deletion of six proline residues from position 26 to 31 in the N-terminus, expression of recombinant GPC3 was clearly detected. We further analyzed the expressed protein deprived of six prolines, to immunize the New Zealand male rabbits for production of active antibodies. The binding affinity of antibody was analyzed by immunofluorescence analysis, immunohistochemical detection, and western blotting. The functional GPC3 N-terminal protein recombinant development, expression, purification, and the polyclonal antibody have been generated provide the basis for the diagnosis of HCC in cancer therapy.     

肠道微生态在肝癌诊疗应用中的研究进展

肠道微生态是由数量巨大且结构复杂的肠道菌群与肠黏膜屏障组成,参与机体多种重要生理功能,与多种疾病密切相关。由于肠道与肝脏有着密切而特殊的关系,肠道微生态可通过肠―肝循环及其与宿主的相互作用来调节肝脏疾病的进展。肠道微生态失调与肝癌进展密切相关,肠道中关键功能菌可作为肝癌早期预防、诊断和治疗的新的预测标记物与新的治疗靶点。本文将对肠道微生态在肝癌发病机制中的作用以及基于肠道微生态理论的多种肝癌防治策略进行综述。     

TRAIL联合顺铂对小鼠移植型肝癌抑制作用及机制研究

目的探讨肿瘤坏死因子相关的凋亡诱导配体(tumor necrosis factor-related apoptosis inducing ligand,TRAIL)联合顺铂(cisplatin,DDP)对小鼠移植型肝癌的抑制作用及机制。方法将H22小鼠移植型肝癌模型随机分为生理盐水组、TRAIL组、TRAIL+DDP组和DDP组,称取瘤重并分析抑瘤率,Hoechst 33342荧光染色法检测细胞凋亡,免疫组织化学染色检测Caspase-3表达。结果与生理盐水组比较,TRAIL、DDP对小鼠移植型肝癌生长具有明显的抑制作用(P<0.05);TRAIL与DDP联合用药具有增效作用(P<0.05),可明显提高肝癌细胞的凋亡率(P<0.05)、上调Caspase-3表达(P<0.01)。结论 TRAIL与DDP联合用药对小鼠移植型肝癌生长具有协同抑制作用,其机制可能与其协同促进Caspase-3的表达有关。     

Immunotherapy against programmed death-1/programmed death ligand 1 in hepatocellular carcinoma: Importance of molecular variations,cellular heterogeneity,and cancer stem cells

Hepatocellular carcinoma (HCC) is a heterogeneous malignancy related to diverse etiological factors. Different oncogenic mechanisms and genetic variations lead to multiple HCC molecular classifications. Recently, an immune-based strategy using immune checkpoint inhibitors (ICIs) was presented in HCC therapy, especially with ICIs against the programmed death-1 (PD-1) and its ligand PD-L1. However, despite the success of anti-PD-1/PD-L1 in other cancers, a substantial proportion of HCC patients fail to respond. In this review, we gather current information on biomarkers of anti-PD-1/PD-L1 treatment and the contribution of HCC heterogeneity and hepatic cancer stem cells (CSCs). Genetic variations of PD-1 and PD-L1 are associated with chronic liver disease and progression to cancer. PD-L1 expression in tumoral tissues is differentially expressed in CSCs, particularly in those with a close association with the tumor microenvironment. This information will be beneficial for the selection of patients and the management of the ICIs against PD-1/PD-L1.