Objective The usefulness of measurement of nuclear DNA content elevation for diagnosis of early hepatocellular carcinoma was evaluated by a study of 186 patients with liver cirrhosis. Methods Nuclear DNA content was measured using an automatic image analysis system.Results ①Hepatocellular carcinoma was found in 37 patients during 10 years follow-up, the cumulative incidence of hepatocellular carcinoma was 19.89%. ②The incidence of hepatocellular carcinoma increased with the increase of the patterns of α-fetoprotein (AFP), 5c exceeding rate (5cER), FORM PE, but positive predictive value of 5cER was the highest of three parameters, the difference among all groups was significant by the χ2 test (Ｐ＜0.05). ③When 5cER joined AFP for monitoring development of hepatocellular carcinoma, the incidence of hepatocellular carcinoma was 72.00%, which was significantly higher than that of 5cER or AFP alone, the difference between groups was highly significant (Ｐ＜0.01). Conclusion Patients who had 5cER levels of 3%-5% or more, who had transient increases in 5cER or who had both, should be treated as being in a super-highrisk group for hepatocellular carcinoma. Frequent and careful examination by ultrasonography of such patients is recommended. It is important that measurement of 5cER join with AFP in cirrhotic patients monitored for early development of hepatocellular carcinoma.
ObjectiveTo study the clinical value of changes of serumα-fetoprotein(AFP) and soluble cell adhesion molecule-1(sICAM-1) levels before and after surgical treatment of primary hepatocellular carcinoma(PHC) as predictors of patient survival.
MethodsThe clinical data and followed-up results of 86 patients with hepatocellular carcinoma received hepatectomy or radiofrequency ablation(RFA) in Xijing Hospital and the 451st Hospital of PLA were retrospectivly analyzed. The changes of peripheral blood AFP and sICAM-1 levels in patients before and in 1 month after treatment were observed and all patients were divided into different groups according to the changes in both two markers. Then survival rates of each group were analyzed.
ResultsThe patients with AFP < 20μg/L or sICAM-1 < 1 000 U/L before treatment had lower tumor recurrence rate and higher survival rate than patients with elevated serum levels of the both markers(AFP:P=0.018, P < 0.001;sICAM-1:P=0.027, P < 0.001). The larger tumor, late TNM stage, and higher rate of recurrence were associated with elevated serum levels of the both markers(AFP:P=0.016, P=0.026 and P=0.025;sICAM-1:P < 0.001, P=0.024 and P=0.032). The better survival situation was closely related with these cases treated with hepatectomy and their levels of both markers were lower than the above cutoff values both before and after treatment, or leves of both markers above the cut-off values returned to within the normal range after treatment (AFP:P=0.006, P=0.001;sICAM-1:P=0.001, P=0.002). The patients who had simultaneous increase of AFP and sICAM-1 after operation showed the worst tumor-free and overall survivals(P=0.007, P < 0.001).
ConclusionTo test the changes of serum AFP and sICAM-1 levels in early stage after treatment for patients who received radical resection of hepatocellular carcinoma has good clinical value for monitoring of tumor recurrence and predict prognosis.
Objective To construct a mammalian vector encoding angiostatin kringle 5 (K5) under the control of αfetoprotein （AFP） enhancer and albumin promoter, and to observe the expression of angiostatin by introducting angiostatin gene into hepatocellular carcinoma cells through gene transfection. Methods Angiostatin cDNA was amplified from normal human eukaryotic cells by using RTPCR. Meanwhile, AFP enhancer and albumin promoter sequences were directed cloned and were inserted into vector pcDNA3.1. The recombinant vector of pcDNA3.1AFABangiostatin K5His was constructed, which contained the angiostatin K5 cDNA sequence that was under the control of the AFP enhancer and promoter. Angiostatin K5 cDNA was introduced into human AFP positive hepatocellular carcinoma cell lines with the transfected cultured cells that were mediated with Lipofectamine 2000. The expression of angiostatin K5 was analyzed by Western blot and the protein was dectected with antiHis antibody. Results The 500base pair of angiostatin K5 was in accordance with the expected sequence and the recombinant vector of pcDNA3.1AFABangiostatin K5His was also confirmed as the anticipated sequence. The expression of angiostatin K5 in AFP positive hepatocellular carcinoma cells was detected both by SDSPAGE and Western blot. Conclusion Efficient construction and expression of angiostatin K5 to AFP positive cells make it possible for antiangiogenesis therapy of human hepatocellular carcinomas, which may provide a promising approach.
Objective To systematically evaluate AFP as the diagnostic standard for Chinese primary liver cancer (PLC). Methods A comprehensive electronic search and additional manual tracking were performed to retrieve relevant studies on AFP in diagnosis of Chinese PLC. All studies were divided into three groups according to the cutoff value of AFP: 20 or 25 ?g/L, 200 ?g/L, 400 ?g/L (Groups 1, 2, and 3, respectively). The data about the accuracy of the included studies were extracted for further heterogeneity studies; statistical pooling and SROC (summary receiver operating characteristics) were analyzed using MetaDisc 1.4 software. Results Twenty studies which were selected from 1,062 references met the inclusion criteria. Heterogeneity (except for threshold effect) was found within the three groups. A Meta-analysis was performed using the random effect model. Compared with the other two groups, the specificity of Group 3 (AFP 400 ?g/L) was the highest (0.977, 95%CI 0.967 to 0.985) and sensitivity was the lowest (0.422, 95%CI 0.403 to 0.441). The values of LR+ and dOR were lower than those of Group 2 (AFP 200?g/L) (17.691: 19.669; 32.820: 53.599, respectively). Area under curve (AUC) of SROC and Q index of Group 3 were also lower than those of Group 2 (0.6575: 0.832 3; 0.633 8: 0.782 2, respectively). Conclusion Four-hundred ?g/L of AFP as the diagnostic standard for PLC is not good enough, and we suggest that 200 ?g/L may be better than 400 ?g/L for PLC diagnosis.
【Abstract】Objective To investigate whether liver resection for hepatocellular carcinoma (HCC) causes dissemination of liver tumor cells into blood circulation. Methods Fourteen patients with HCC, but without evidences of metastasis, were enrolled for the study. Blood samples of peripheral blood before skin incision and after abdominal wall suture, and of hepatic venous blood and portal venous blood after liver parenchyma dissection, were obtained. AFPmRNA was detected by reverse transcription polymerase chain reaction assays, the change of the level of its expression during operation was assessed by semi-quantitative analysis. Results The rate of its expression before and after operation in peripheral blood, and during operation in portal venous blood and in hepatic venous was 42.9%, 35.7%, 42.9% and 57.1% respectively. There were no differences between them. However, the level of its expression in hepatic venous blood was significantly higher than others (P＜0.05). Conclusion Liver resection for HCC induces releases of cells from the liver, probably including tumor cells, into blood circulation.
ObjectivesTo systematically review serum a-L Fucose Gan Enzyme (AFU) combined with serum Alpha-Fetoprotein (AFP) in the diagnosis of primary hepatic carcinoma (PHC).
MethodsWe comprehensively searched databases including PubMed, The Cochrane Library (Issue 2, 2013), WanFang Data, VIP, CBM, CNKI, EMbase, and Medalink for relevant studies on AFU combined with AFP in the diagnosis of PHC from inception to July 2013; meanwhile, manual search for the relevant Chinese journals were also performed. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using Meta-DiSc 1.4 software.
ResultsA total of 20 studies involving 1 350 cases and 2 079 controls were included. The results of meta-analysis showed that, pooled sensitivity, specificity, positive likelihood radio, negative likelihood radio, diagnostic odds ratio, the area under SROC curve and Q index were:a) detection of AFU alone:0.76 (0.74, 0.78), 0.83 (0.82, 0.85), 7.09 (4.34, 11.58), 0.29 (0.23, 0.37), 26.88 (15.04, 48.06), 0.872 6 and 0.803, respectively; b) detection of AFP alone:0.69 (0.67, 0.72), 0.88 (0.86, 0.89), 7.85 (5.35, 11.50), 0.35 (0.30, 0.42), 25.62 (16.35, 40.15), 0.805 4 and 0.740 6, respectively; and c) combined detection of AFU and AFP:0.85 (0.83, 0.87), 0.86 (0.85, 0.88), 7.16 (5.15, 9.96), 0.15 (0.10, 0.23), 54.07 (29.85, 97.95), 0.940 8 and 0.878 5, respectively.
ConclusionThe combination detection of AFU and AFP has good efficacy in the diagnosis of PHC.
Objective
To detect expression of miR-483-5p in surem of patients with hepatocellular carcinoma (HCC) and investigate it’s clinical significance for diagnosis of HCC.
Methods
The rerum samples of 112 patients with HCC (HCC group), 85 patients with chronic viral hepatitis B (CHB group), and 56 healthy people for physical examination (healthy control group) were collected from January 2010 to January 2012 in the First Hospital of Lanzhou University. According to the results of preliminary chip detection of miRCURY LNATM miRNA, the real-time fluorescent quantitative PCR was adopted to quantitate the serum levels of miR-483-5p and miR-500a and the routine electrochemical method was used to detect the serum alpha fetoprotein (AFP) in every group. The receiver operating characteristic (ROC) curve was utilized to analyze the diagnostic values of serum miR-483-5p, miR-500a, and AFP for the HCC.
Results
The serum levels of miR-483-5p and miR-500a in the HCC group were significantly higher than those of the CHB and healthy control groups (both P<0.000 1), which had no significant differences between the CHB group and the healthy control group (P>0.05). The serum miR-483-5p level of the HCC patient decreased markedly at the postoperative 30 d (P<0.000 1) as compared with the preoperative level. The area under the ROC curve (AUC) of miR-483-5p, miR-500a, AFP, or miR-483-5p in combination with AFP for the diagnosis of the HCC was 0.74 (cutoff value=2.842, sensitivity=74% and specificity=66%), 0.66 (cutoff value=1.830, sensitivity=74% and specificity=51%), 0.81 (cutoff value=20 μg/L, sensitivity=78% and specificity=70%), and 0.92 (cutoff value=3.78, sensitivity=81% and specificity=83%), respectively. The AUC values of miR-483-5p in the diagnosis of the HCC patients with positive AFP (AFP>20 μg/L) and negative AFP (0–20 μg/L) were 0.78 and 0.83, respectively.
Conclusions
Serum miR-483-5p highly expresses in HCC, which has a certain accuracy in diagnosis of HCC, it combined with AFP could further increase its diagnostic value. Serum miR-483-5p might play an important supplemental role in diagnosis of HCC patient with negative AFP.
The authors presented CT manifestations of a patient with hepatoid adenocarcinoma of gallbladder with liver involvement and briefly described the clinical features, imaging manifestations, and differential diagnosis of the disease in order to enhance the readers’ better awareness of the imaging manifestations, thus to reduce the misdiagnosis of the disease.
