Stereotactic body radiation therapy and radiofrequency ablation for the treatment of liver metastases: How and when?

Limited liver metastases represent a clinical challenge. Surgical approach is the most frequently reported treatment option, however, some patients are not eligible for surgical interventions. Relatively recent technologic advances have permitted the safe use of ablative techniques employed in the cure of hepatic metastases. Among these, radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) have emerged as valid treatments in a significant proportion of patients with intrahepatic oligometastatic disease. This review offers an up-to-date of current available literature on this issue focusing on the use and outcomes of RFA and SBRT, according to the PICO (Population, Intervention, Comparison and Outcomes) criteria.     

Expression profiles of MUC mucins and trefoil factor family (TFF) peptides in the intrahepatic biliary system: physiological distribution and pathological significance

Mucin secreted by mucosal epithelial cells plays a role in the protection of the mucosal surface and also is involved in pathological processes. So far, MUC1-4, 5AC, 5B, 6-8, 11-13 and 15-17 genes coding the backbone mucin core protein have been identified in humans. Their diverse physiological distribution and pathological alterations have been reported. Trefoil factor family (TFF) peptides are mucin-associated molecules co-expressed with MUC mucins and involved in the maintenance of mucosal barrier and the biological behavior of epithelial and carcinoma cells. Intrahepatic biliary system is a route linking the bile canaliculi and the extrahepatic bile duct for the excretion of bile synthesized by hepatocytes. Biliary epithelial cells line in the intrahepatic biliary system, secreting mucin and other molecules involved in the maintenance and regulation of the system. In this review, the latest information regarding properties, expression profiles and regulation of MUC mucins and TFF peptides in the intrahepatic biliary system is summarized. In particular, we focus on the expression profiles and their significance of MUC mucins in developmental and normal livers, various hepatobiliary diseases and intrahepatic cholangiocarcinoma.     

MiR-605 represses PSMD10/Gankyrin and inhibits intrahepatic cholangiocarcinoma cell progression

The aberrant expression of PSMD10 has important functions in various malignancies. This study showed that PSMD10 was highly expressed and inversely correlated with the expression of miR-605 in intrahepatic cholangiocarcinoma (ICC) specimens. MiR-605 directly targeted and repressed PSMD10 expression. In addition, over-expression of miR-605 inhibited ICC cell progression both in vitro and in vivo. This effect of miR-605 on ICC cells was similar to that of PSMD10 knock-down by RNAi. Moreover, restoration of PSMD10 could reverse the phenotypic alteration caused by miR-605 in ICC cells. These results suggest a new therapeutic strategy in ICC by restoring miR-605, which is regulated by p53.     

人肝内胆管癌细胞PRL-3 的表达与侵袭转移研究

目的:探讨PRL-3在人肝内胆管癌侵袭转移中的作用.方法:利用小RNA技术干扰肝内胆管癌细胞株PRL-3表达,并采用细胞划痕实验和Transwell体外侵袭实验评价PRL-3对肝内胆管癌细胞侵袭转移能力的影响.结果:RT-PCR和Western blot结果均显示转染PRL-3特异性siRNA-2组PRL-3表达明显降低(P＜0.05).PRL-3 siRNA-2组在划痕培养24h后划痕区域宽度占初始划痕区域宽度的百分比为(62.12±6.28)％,阴性对照组为(23.88±2.55)％,空白对照HCCC-9810组为(21.20±6.07)％.PRL-3siRNA-2组细胞的划痕两端距离相比明显较宽,分别与阴性对照组细胞和空白对照HCCC-9810组细胞相比均有统计学意义(P＜0.05),后两者无显著性差异(P＞0.05).Transwell体外侵袭实验结果显示,PRL-3 SiRNA-2组细胞侵袭能力明显减弱,穿膜细胞数为(19.40±2.30)个/HP,明显少于阴性对照组(64.00±2.73)个/HP和正常HCCC-9810组(67.20±3.l1)个/HP,差异有显著性(P＜0.05);正常HCCC-9810组和阴性对照组无明显差异(P＞0.05).结论:PRL-3特异性siRNA能够抑制肝内胆管癌细胞HC-CC-9810中内源性PRL-3的表达,并可以明显抑制肝内胆管癌细胞的迁移侵袭能力.     

In vivo imaging of hepatic excretory function in the rat by fluorescence microscopy

Applying intravital fluorescence microscopy, we assessed sinusoidal delivery and biliary clearance of two different polymethine dyes. DY635, a benzopyrylium‐based hemocyanine dye with shorter excitation wavelength than indocyanine green (ICG), was validated for assessment of hepatic excretory function. Decrease of DY635 and ICG reflecting transcellular transport was 83 ± 4% (DY635) and 14 ± 2% (ICG; p < 0.05) over 35 minutes, respectively. In cholestasis, hepatobiliary excretion of DY635 was markedly impaired (control 3176 ± 148 pmol vs. cholestatic 1929 ± 179 pmol; p < 0.05). DY635 even enabled an analysis at high resolution suggesting 1.) hepatocyte uncoupling and 2.) failure of primarily the canalicular pole, allowing in vivo insights into molecular mechanisms of this critical facet of hepatobiliary function. (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

熊去氧胆酸联用思美泰对妊娠期肝内胆汁淤积症重症患者瘙痒程度、妊娠结局及肝功能的影响

目的:探讨熊去氧胆酸联用思美泰对妊娠期肝内胆汁淤积症(ICP)重症患者瘙痒程度、妊娠结局及肝功能的影响。方法:选取2016年6月到2017年12月期间在我院接受治疗的ICP重症患者76例,根据随机数字表法将患者均分为研究组(n=38)和对照组(n=38)。对照组采用熊去氧胆酸进行治疗,研究组采用熊去氧胆酸联用思美泰进行治疗。比较两组患者治疗前、治疗7d后的Ribaha皮肤瘙痒程度评分、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆汁酸(TBA)、血清总胆红素(TB)的水平,比较两组患者的妊娠结局。结果:治疗7d后两组患者的瘙痒程度评分均明显降低,且研究组低于对照组(P0.05)。治疗7d后两组患者的AST、ALT、TBA、TB水平均明显降低,且研究组患者的AST、ALT、TBA、TB水平低于对照组,差异有统计学意义(P0.05)。两组患者的新生儿窒息发生率和新生儿体质量比较无统计学差异(P0.05),研究组患者早产、胎儿窘迫、羊水胎粪污染的发生率低于对照组,差异有统计学意义(P0.05)。结论:熊去氧胆酸联用思美泰可有效缓解ICP重症患者的瘙痒程度,改善肝功能和妊娠结局,临床疗效显著,具有积极的临床意义。     

Maturation of rat dendritic cells during intrahepatic translocation evaluated using monoclonal antibodies and electron microscopy

Specific populations of hepatic sinusoidal cells were stained with monoclonal antibodies that recognize monocytes/macrophages (ED1), tissue macrophages (Kupffer cells) (ED2), MHC class II (Ia) antigen (MRC OX6), and dendritic cells/γ,δ T-cells (MRC OX62) and analyzed by light and electron microscopy. The majority of ED1⁺ and/or ED2⁺ cells were localized to the hepatic parenchyma, whereas OX6⁺ and/or OX62⁺ cells were more densely distributed within Glisson’s sheath than in the hepatic parenchyma. Double-immunoperoxidase staining of normal liver for ED1, ED2, and OX6 identified dendritic cells (DC) of two different phenotypes, ED1⁺ED2^–OX6⁺ and ED1^–ED2^–OX6⁺. DC can be classified into three different types based on ultrastructural characteristics. The first type (type I) is characterized by one or more long cytoplasmic processes and a well-developed lysosomal system. The second type (type II) has an inconspicuous lysosomal system, abundant hyaloplasm, and characteristic short cytoplasmic processes. The third type (type I–II) has cytologic features intermediate between those of type I and type II DC. At the electron-microscopic level, these three cell types are found in the sinusoidal lumen, whereas the majority of type II DC are located in the space of Disse and Glisson’s sheath. Furthermore, some OX6-labeled elongated DC appeared to traverse the lumen of sinusoids through endothelial pores to enter the space of Disse. One hour after intravenous injection of latex particles (0.81 μm in diameter), numerous latex-laden dendritic cells (ED1⁺OX6⁺, type I and type I–II) were detected in the lumen of hepatic sinusoids, but not in the space of Disse or Glisson’s sheath. These findings suggest that normal rat liver contains resident dendritic cells which downregulate phagocytic activity and mature into potent accessory cells during migration from the portal vein toward the central vein. These DC then traverse the sinusoidal lumen to the hepatic lymph system via the space of Disse. Received: 8 May 1998 / Accepted: 15 June 1998     

Scanning laser cytometry: alterations induced by cholestatic agents in isolated rat hepatocyte couplets

Scanning laser cytometry, an analytic technique that provides an accurate fluorescent measurement in adherent cells, was used to study cholestatic mechanisms in isolated rat hepatocyte couplets (IRHC). Treatment of IRHC with cholestatic compounds induced a pericanalicular F-actin accumulation and an increase in cytosolic free calcium. These data obtained with a scanning cytometer used in conjunction with anin vitro model representing the primary secretory unit suggest that abnormalities of pericanalicular F-actin filaments and calcium homeostasis play a key role in cholestasis. Considering the necessity for the development of mechanistic studies in toxicology, this technique should prove to be an outstanding tool.Abbreviations ANIT -naphthylisothiocyanate - [Ca²⁺]_i cytosolic calcium - CF/TF canalicular area fluorescence/total couplet fluorescence - EE ethynil estradiol - ERY erythromycin estolate - FCS fetal calf serum - FITC-phalloidin fluorescein isothiocyanate phalloidin - Indo-1-AM indo-1-acetyloxymethyl ester - IRHC isolated rat hepatocyte couplet - L15 Leibovitz 15 - PH phalloidin - TEST methyltestosterone