ObjectiveTo evaluate the relationship between the expression of alpha fetoprotein (AFP) and chemoresistance in hepatocellular carcinoma.MethodsHepatocellular carcinoma was screened from liver tumor tissue samples, which was obtained by puncture before transcatheter arterial chemoembolization (TACE). Immuno-histochemical staining was used to detect the expression of AFP in HCC tissues and the effect of AFP expression in HCC on the effect of chemotherapy was analyzed.ResultsA total of 62 patients met the inclusion criteria, of which 36 were in the chemotherapy resistant group and 26 in the chemotherapy sensitive group. There were 42 patients with positive expression of AFP in tumor tissues (including 29 patients with chemoresistance) and 20 patients with negative expression of AFP in tumor tissues (including 7 patients with chemoresistance). There were no significant difference between the two groups in sex, age, tumor differentiation, Child-Pugh classification of liver function, tumor size, tumor site and hepatitis (P>0.05). In elevated serum AFP level, tumor single, and with portal vein tumor thrombus (PVTT), the proportion of patients in the chemosensitivity group were significantly lower than that in the chemosensitivity group (P<0.05). The results of logistic multivariate regression analysis showed that positive expression of AFP ［OR=0.280, 95%CI (0.092, 0.950), P=0.045］ and PVTT ［OR=0.026, 95%CI (0.004, 0.322), P=0.005］ were independent risk factors for chemotherapeutic resistance in hepatocellular carcinoma.ConclusionAFP positive expression in liver tumor tissues and PVTT are useful indicators of resistance to chemotherapy.
Objective To summarize the research status of circular RNAs (circRNA) in resistance to targeted combined immunotherapy for hepatocellular carcinoma (HCC). MethodsRelevant literatures at home and abroad were retrieved to review the regulatory role and molecular mechanisms of circRNA in resistance to targeted combined immunotherapy for HCC. ResultsAs a class of non-coding RNAs featuring high stability and strong tissue specificity, circRNA mediate resistance to targeted combined immunotherapy in HCC via multiple regulatory mechanisms, including the modulation of cell apoptosis, activation of the growth factor signaling pathway, and induction of epithelial-mesenchymal transition. ConclusionscircRNA interfere with proliferation and survival pathways and reshape the tumor microenvironment through diverse mechanisms, serving as core regulatory factors in resistance to targeted combined immunotherapy for HCC. circRNA is expected to become biomarker for predicting HCC drug resistance and targets for therapeutic intervention, providing important support for breaking through the bottleneck of combined therapy resistance.
