Molecular mechanisms of gender disparity in hepatitis B virus-associated hepatocellular carcinoma

Chronic hepatitis B virus(HBV)infection is one of the most common causes of hepatocellular carcinoma(HCC),a malignant tumor with high mortality worldwide.One remarkable clinical feature of HBVrelated HCC is that its incidence is higher in males and postmenopausal females compared to other females.Increasing evidence indicates that HBV-associated HCC may involve gender disparity and that it may be a type of hormone-responsive malignant tumor.Sex hormones,such as androgen and estrogen,have been shown to play very different roles in the progression of an HBV infection and in the development of HBVrelated HCC.Through binding to their specific cellular receptors and affecting the corresponding signaling pathways,sex hormones can regulate the transactivation of HBx,cause the chronic release of inflammatory cytokines in the hepatocellular microenvironment,and participate in epigenetic and genetic alternations in hepatocytes.All of these functions may be related to the initiation and progression of HBV-associated HCC.A thorough investigation of the molecular mechanisms underlying the gender-related disparity in HBV-related HCC should provide a new perspective for better understanding its pathogenesis and exploring more effective methods for the prevention and treatment of this disease.

Peri-operative use of sorafenib in liver transplantation:A time-to-event meta-analysis

AIM:To evaluate whether the application of sorafenib during the peri-operative period of liver transplantation improves prognosis in liver cancer patients.METHODS:We searched Pub Med,EMBASE and MEDLINE for eligible articles.A total of 4 studieswere found that fulfilled the previously agreed-upon standards.We then performed a systematic review and meta-analysis on the enrolled trials that met the inclusion criteria.RESULTS:Out of the 104 studies identified in the database,82 were not clinical experiments,and 18 did not fit the inclusion standards.Among the remaining 4 articles,only 1 was related to the preoperative use of sorafenib,whereas the other 3 were related to its postoperative use.As the heterogeneity among the 4 studies was high,with an I2 of 86%,a randomized effect model was applied to pool the data.The application of sorafenib before liver transplantation had a hazard ratio(HR) of 3.29 with a 95% confidence interval(CI) of 0.33-32.56.The use of sorafenib after liver transplantation had an HR of 1.44(95%CI:0.27-7.71).The overall pooled HR was 1.68(95%CI:0.41-6.91).CONCLUSION:The results showed that the use of sorafenib during the peri-operative period of liver transplantation did not improve patient survival significantly.In fact,sorafenib could even lead to a worse prognosis,as its use may increase the hazard of poor survival.