Serum N-glycan fingerprint helps to discriminate intrahepatic cholangiocarcinoma from hepatocellular carcinoma

Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are two main types of primary liver cancer, and reliable discrimination is important for optimal treatment. Aberrant glycosylation was detected in HCC and ICC. Both cross-sectional and follow-up studies were performed to establish a differential diagnosis model using N-glycans. A total of 420 participants were enrolled, with 310 patients in training cohort and 110 patients in validation cohort. The follow-up cohort was used to assess the prognosis of ICC. As the results, the diagnostic efficacy of the model was superior to alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) when identifying ICC from HCC (AUC of the nomogram: 0.845, 95%CI: 0.788–0.902; AFP: 0.793, 95%CI: 0.732–0.854; CEA: 0.592, 95%CI: 0.496–0.687; CA 19-9: 0.674, 95%CI: 0.582–0.767) in training cohort. In validation cohort, this model (AUC: 0.810, 95% CI: 0.728–0.891) also demonstrated high efficacy in distinguishing ICC from HCC. Furthermore, the nomogram helps to stratify ICC into two subgroups with high or low risk of survival and recurrence. Therefore, a nomogram integrating six N-glycans [NGA2FB(Peak2), NG1A2F (Peak3), NA2 (Peak5), NA2F (Peak6), NA3 (Peak8) and NA4 (Peak11)] was established for ICC and HCC differentiation, and for prognosis assessment in ICC patients.     

Delivery of triptolide with reduction-sensitive polymer nanoparticles for liver cancer therapy on patient-derived xenografts models

Hepatocellular carcinoma (HCC) has become the fourth predominant cause of cancer-related deaths worldwide, and HCC is still one of the worst prognoses for survival as it is poorly responsive to both chemotherapy and surgical treatment due to drug resistance and great toxic effects. Triptolide (TP), a key ingredient from the traditional Chinese medical herb, has been utilized to treat inflammation and antitumor for centuries. However, investigations of this potent agent have been met with only limited success due to the severe systemic toxicities in patients and low water solubility as well as its high toxicity over the past two decades. Herein, we reported the development of a reduction-responsive drug delivery system loaded with TP for glutathione (GSH)-triggered drug release for cancer therapy. With the GSH-sensitive TP loaded nanoparticles, the remarkable increases in tumor accumulation and amelioration of drug toxicity in animals are demonstrated, which is likely due to sustained stepwise release of active TP within cancer cells. Moreover, in a patient-derived tumor xenograft model of liver cancer, administration of tritolide nanoparticles enhances the antitumor efficacy relative to administration of free TP. These findings indicate that GSH-sensitive release of TP may be a promising strategy for cancer treatment.     

HCC-to-liver contrast on arterial-dominant phase images of EOB-enhanced MRI: comparison with dynamic CT

The purpose of this study was to assess the efficacy of arterial-dominant phase images of gadolinium–ethoxybenzyl–diethylenetriamine pentaacetic acid (EOB)-enhanced magnetic resonance imaging (MRI) for evaluation of arterial blood supply in hepatocellular carcinoma (HCC) in comparison with that of multiphasic dynamic computed tomography (CT). This study comprised 30 patients (22 men and 8 women, mean age: 68.0 years) with 40 pathologically proven HCCs (well differentiated: 3, moderately differentiated: 30, poorly differentiated: 7, mean diameter: 45.1 mm), all of whom underwent EOB-enhanced MRI and dynamic CT preoperative assessment. Regions of interest were placed over HCCs and the adjacent normal liver, and signal intensities or CT values were measured by two experienced abdominal radiologists on the arterial-dominant phase images of EOB-enhanced MRI and dynamic CT images. HCC-to-liver contrasts [Michelson's contrast: C_M=(S_HCC− S_Liver)/(S_HCC+ S_Liver)] were calculated and compared among the modalities. HCC-to-liver contrasts were also visually scored on a 5-point scale and compared. The mean C_M and visual score for dynamic CT were significantly higher than those for EOB-enhanced MRI. Good agreements were obtained among the two observers. Dynamic CT is a more suitable modality than EOB-enhanced MRI for evaluation of arterial blood supply in HCC. This should be taken into account for diagnosis and management of HCC.     

Gadoxetic acid-enhanced MRI compared with CT during angiography in the diagnosis of hepatocellular carcinoma

Purpose

To assess the value of gadoxetic acid-enhanced magnetic resonance imaging (MRI) for the pre-therapeutic detection of hepatocellular carcinoma (HCC) using receiver operating characteristic (ROC) analysis with the combination of computed tomography (CT) arterial portography and CT hepatic arteriography (CTAP/CTHA).

Materials and Methods

A total of 54 consecutive patients with 87 nodular HCCs were retrospectively analyzed. All HCC nodules were confirmed pathologically. Three blinded readers independently reviewed 432 hepatic segments, including 78 segments with 87 HCCs. Each reader read two sets of images: Set 1, CTAP/CTHA; Set 2, gadoxetic acid-enhanced MRI including a gradient dual-echo sequence and diffusion-weighted imaging (DWI). The ROC method was used to analyze the results. The sensitivity, specificity, positive predictive value, negative predictive value and sensitivity according to tumor size were evaluated.

Results

For each reader, the area under the curve was significantly higher for Set 2 than for Set 1. The mean area under the curve was also significantly greater for Set 2 than for Set 1 (area under the curve, 0.98 vs. 0.93; P = .0009). The sensitivity was significantly higher for Set 2 than for Set 1 for all three readers (P = .012, .013 and .039, respectively). The difference in the specificity, positive predictive values and negative predictive values of the two modalities for each reader was not significant (P > .05).

Conclusion

Gadoxetic acid-enhanced MRI including a gradient dual-echo sequence and DWI is recommended for the pre-therapeutic evaluation of patients with HCC.     

希罗达治疗晚期结肠癌18例临床分析

目的观察希罗达作为一线药物治疗晚期结肠癌的疗效及安全性.方法对18例具有可测量指标的晚期结肠癌患者采用希罗达2 500 mg/(m2.d),分早晚2次服用,用药前予格拉司琼预防呕吐,防止喉痉挛,减少末梢神经副反应,21 d为1周期,完成2周以上评价疗效.18例患者共完成78周期.结果CR 0例,PR 8例(44.4%),总有效率44.4%,NC 8例(44.5%),PD 2例(11.1%).结论希罗达作为一线药物治疗晚期结肠癌有较好疗效,副作用小,特别适宜于年老体弱患者.     

乳腺癌组织中蛋白质二级结构的Fourier变换红外光谱研究

根据乳腺大汗腺癌、小管癌、黏液癌、浸润导管癌、单纯癌和髓样癌组织Ｆｏｕｒｉｅｒ变换红外光谱酰胺Ⅰ带的去卷积和拟合分析,获得组织中蛋白质二级结构的数目及其组成。结果表明：这些组织中蛋白质二级结构的数目及其组成存在着显著的差异,并与组织的类型、分化、坏死等密切相关其中,髓样癌的差异性最大;高分化癌中螺旋结构的含量及非典型螺旋和α－螺旋含量的比值均比低分化癌的相应值高;肿瘤边缘坏死的乳腺癌组织也表现出明     

肝细胞癌特异抗原的筛选

应用重组克隆表达抗原的血清学鉴定技术,从广西肝细胞癌中初步筛选出９个基因克隆,与肝癌患者及其他人血清的反应证明对肝癌有特异性。ＤＮＡ测序结果与基因库核对,发现其中７个有同源结构;２个为无同源结构的新分子。     

Simultaneous Determination of Trace Elements in Hepatocellular Carcinoma Tissue by Sector Field Inductively Coupled Plasma Mass Spectrometry

An analytical method using sector field inductively coupled plasma mass spectrometry (SF-ICP-MS) for rapid simultaneous determination of Na, Mg, K, Ca, Cr, Mn, Fe, Co, Ni, Cu, Zn, Se, Sr, Mo, and Cd elements in hepatocellular carcinoma (HCC) tissue is reported. The sample was dissolved in HNO₃ and H₂O₂ by microwave digestion and then the aforementioned 15 elements in the solution were analyzed directly by SF-ICP-MS. Most of the spectral interferences were avoided by measuring in medium resolution mode (MRM, M/?M = 4400) and high resolution mode (HRM, M/ΔM = 8000). Correction for matrix effects was made using Sc and Rh as internal standards. The optimum conditions for the determination were tested and discussed. The results showed that SF-ICP-MS is a useful tool for simultaneous determination of multi-elements in HCC tissue and could be widely used in other biological samples analysis.     

Small hepatocellular carcinomas in cirrhosis: differences in contrast enhancement effects between helical CT and MR imaging during multiphasic dynamic imaging

PURPOSE: The purpose of this study was to evaluate differences in the degrees of contrast enhancement effects of small hepatocellular carcinomas (HCCs) in patients with cirrhosis between helical computed tomography (CT) and magnetic resonance (MR) imaging during multiphasic contrast-enhanced dynamic imaging and to determine the diagnostic value of MR imaging especially in assessing hypovascular HCCs detected as hypoattenuating nodules on late-phase CT. SUBJECTS AND METHODS: This study included 64 small HCCs (<3 cm in diameter) in 40 patients with chronic hepatitis or cirrhosis who underwent multiphasic (arterial, portal and late phases) contrast-enhanced dynamic helical CT and MR imaging. The contrast enhancement patterns of each lesion in the arterial and late phases were evaluated by two radiologists experienced in liver MR imaging and categorized as one of five grades (1=hypoattenuated/hypointense; 2=slightly hypoattenuated/hypointense; 3=isoattenuated/isointense; 4=slightly hyperattenuated/hyperintense; 5=hyperattenuated/hyperintense), compared with the surrounding liver parenchyma. RESULT: Forty-three (67%) of 64 lesions showed Grade 4 (n=24) or Grade 5 (n=19) enhancement on arterial-phase CT, while 51 (80%) of 64 lesions showed Grade 4 (n=20) or Grade 5 (n=31) enhancement on arterial-phase MR imaging, indicating hypervascular HCCs. The grading score of hypervascular HCCs on arterial-phase MR imaging (mean: 4.61) was significantly (P<.01) higher than that for hypervascular HCCs on arterial-phase CT (mean: 4.20), showing better detection of the hypervascularity (arterial enhancement) of the lesion on arterial-phase MR imaging. Regarding hypovascular HCCs, all (100%) of 21 hypovascular HCCs on CT showed Grade 1 (n=10) or Grade 2 (n=11) enhancement on late-phase CT, seen as hypoattenuation. In contrast, 8 (62%) of 13 hypovascular HCCs on MR imaging showed Grade 1 (n=1) or Grade 2 (n=7) enhancement on late-phase MR imaging, seen as hypointensity. Grading scores of hypovascular HCCs on late-phase images were significantly (P<.001) lower on CT than on MR imaging (mean score: 1.52 vs. 2.31), indicating better washout effects for hypovascular HCCs on late-phase CT. CONCLUSION: The washout effects for small HCCs on late-phase MR imaging were inferior to those for small HCCs on late-phase CT. Especially, hypovascular HCCs demonstrated as hypoattenuating nodules on late-phase CT were often not seen on late-phase MR imaging, requiring careful evaluation of other sequences, including unenhanced T(1)-weighted and T(2)-weighted MR images.