Dynamic alteration of telomerase expression and its diagnostic significance in liver or peripheral blood for hepatocellular carcinoma

AIM： To investigate the dynamic alteration of telomerase expression during development of hepatocellular carcinoma （HCC） and its diagnostic implications in liver tissues or peripheral blood mononuclear cells for HCC. METHODS： Dynamic expressions of liver telomerase during malignant transformation of hepatocytes were observed in Sprague-Dawly （SD） rats fed with 0.05% of 2-fluoenyacetamide （2-FAA）. Total RNA and telomerase were extracted from rat or human liver tissues. The telomerase activities in livers and in circulating blood were detected by a telomeric repeat amplification protocol-enzyme-linked immunosorbent assay （TRAP- ELISA）, and its diagnostic value was investigated in patients with benign or malignant liver diseases. RESULTS： The hepatoma model displayed the dynamic expression of hepatic telomerase during HCC development. The telomerase activities were consistent with liver total RNA levels （r = 0.83, P 〈 0.01） at the stages of degeneration, precancerosis, and cancerization of hepatocytes. In HCC patients, the telomerase levels in HCC tissues were significantly higher than in their adjacent non-cancerous tissues, but liver total RNA levels were lower in the former than in the latter. Although the circulating telomerase of HCC patients was abnormally expressed among patients with chronic liver diseases, the telomerase activity was a non-specific marker for HCC diagnosis, because the incidence was 15.7% in normal control, 25% in chronic hepatitis, 45.9% in liver cirrhosis, and 85.2% in HCC, respectively when absorbance value of telomerase activity was more than 0.2. If the value was over 0.6, the incidence was 60% in HCC group and 0% in any of the others （P 〈 0.01） except in two cases with liver cirrhosis. However, the combination of circulating telomerase with serum alpha-fetoprotein level could increase the positive rate and the accuracy （92.6%, 125 of 135） of HCC diagnosis. CONCLUSION： The overexpression of telomerase is associated with HCC development, and its abnormality in liver tissues or in peripheral blood could be a useful marker for diagnosis and prognosis of HCC.

Comparison of clinical efficacy and postoperative inflammatory response between laparoscopic and open radical resection of colorectal cancer

BACKGROUND In recent years,the incidence of colorectal cancer(CRC)has increased annually,which has seriously threatened the health and quality of life of patients.In the treatment of CRC,both laparoscopic and radical resection are widely used.AIM To explore and discuss clinical efficacy and postoperative inflammatory response of laparoscopic and open radical resection of CRC.METHODS A total of 96 patients with CRC diagnosed in our hospital from March 2016 to April 2021 were selected,and were divided into the study group(n=48)and control group(n=48)using a simple random method.The control group was treated with open radical resection of CRC,and the study group was treated with laparoscopic radical resection of CRC.The perioperative conditions(operation time,intraoperative blood loss,the recovery time of gastrointestinal function,number of lymph node dissections and length of hospital stay),inflammatory response index levels[interleukin(IL)-6,IL-8,IL-10,C-reactive protein(CRP)]before and after operation,pain stress response indices[levels of neuropeptide(NPY),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)],and the incidence of the complications between the two groups were counted.RESULTS The operation time in the study group was(186.18±33.54 min),which was longer than that of the control group(129.38±26.83 min),but the intraoperative blood loss(111.34±21.45 mL),recovery time of gastrointestinal function(25.35±4.55 h),and hospital stay(10.09±2.38 d)were better than those in the control group(163.77±32.41 mL,36.06±7.13 h,13.51±3.66 d)(P<0.05).There was no significant difference in the number of lymph node dissections between the study group(15.19±3.04)and the control group(16.20±2.98)(P>0.05).There was no significant difference between the levels of serum IL-6(9.79±4.11 ng/mL),IL-8(3.79±1.71 ng/L),IL-10(48.96±12.51 ng/L)and CRP(7.98±2.33 mg/L)in the study group and the control group(10.56±3.78 ng/mL,4.08±1.45 ng/L,50.13±11.67 ng/L,8.29±2.60 mg/L)before the operation(P>0.05).After the operation,there was no significant difference between the levels of serum IL-6(19.11±6.68 ng/mL).There was no significant difference in serum NPY(109.79±13.46 UG/L),PGE2(269.54±37.34 ng/L),5-HT(151.70±18.86 ng/L)between the study group and the control group(113.29±15.01 UG/L,273.91±40.04 ng/L,148.85±20.45 ng/L)before the operation(P>0.05).The incidence of the complications in the study group(4.17%)was lower than that of the control group(18.75%)(P<0.05).CONCLUSION Laparoscopic radical resection of CRC can reduce surgical trauma,inflammatory response and pain stress caused by surgery,which shortens rehabilitation of patients,with a low incidence of complications.