Analysis of alkaline phosphatase and γ-glutamyltransferase after radiofrequency ablation of primary liver cancer: A retrospective study

BACKGROUND Changes in alkaline phosphatase(ALP)andγ-glutamyltransferase(GGT)levels in patients with primary liver cancer(PLC)after radiofrequency ablation(RFA).Hepatocellular carcinoma is a malignant tumor with high incidence worldwide.As a common local treatment,RFA has attracted much attention for its efficacy and influence on liver function.AIM To investigate the effect of serum ALP and GGT levels on the prognosis of patients with PLC treated by RFA.METHODS The preoperative clinical data of 165 patients who were pathologically or clinically diagnosed with PLC and who received RFA in our hospital between October 2018 and June 2023 were collected.The chi-square test was used to compare the data between groups.The Kaplan-Meier method and Cox regression were used to analyze the associ-ations between serum ALP and GGT levels and overall survival,progression-free survival(PFS)and clinical characteristics of patients before treatment.RESULTS The 1-year survival rates of patients with normal(≤135 U/L)and abnormal(>135 U/L)serum ALP before treatment were 91%and 79%,respectively;the 2-year survival rates were 90%and 68%,respectively;and the 5-year survival rates were 35%and 18%,respectively.The difference between the two groups was statistically significant(P=0.01).Before treatment,the 1-year survival rates of patients with normal serum GGT levels(≤45 U/L)and abnormal serum GGT levels(>45 U/L)were 95%and 87%,the 2-year survival rates were 85%and 71%,and the 5-year survival rates were 37%and 21%,respectively.The difference between the two groups was statist-ically significant(P<0.001).Serum ALP[hazard ratio(HR)=1.766,95%confidence interval(95%CI):1.068-2.921,P=0.027]and GGT(HR=2.312,95%CI:1.367-3.912,P=0.002)is closely related to the overall survival of PLC patients after RF ablation and is an independent prognostic factor.The 1-year PFS rates were 72%and 50%,the 2-year PFS rates were 52%and 21%,and the 5-year PFS rates were 14%and 3%,respectively.The difference between the two groups was statistically significant(P<0001).The 1-year PFS rates were 81%and 56%in patients with normal and abnormal serum GGT levels before treatment,respectively;the 2-year PFS rates were 62%and 35%,respectively;and the 5-year PFS rates were 18%and 7%,respectively,with statistical significance between the two groups(P<0.001).The serum ALP concentration(HR=1.653,95%CI:1.001-2.729,P=0.049)and GGT(HR=1.949,95%CI:1.296-2.930,P=0.001)was closely associated with PFS after RFA in patients with PLC.The proportion of male patients with abnormal ALP levels is high,the Child-Pugh grade of liver function is poor,and the incidence of ascites is high.Among GGT-abnormal patients,the Child-Pugh grade of liver function was poor,the tumor stage was late,the proportion of patients with tumors≥5 cm was high,and the incidence of hepatic encephalopathy was high.CONCLUSION Serum ALP and GGT levels before treatment can be used to predict the prognosis of patients with PLC after RFA,and they have certain guiding significance for the long-term survival of patients with PLC after radiofrequency therapy.

轮枝孢菌素A靶向c-Met抑制结肠癌细胞的迁移和侵袭

目的:结肠癌是全球第三大常见癌症,转移是结肠癌患者死亡的主要原因,因此迫切需要寻找能够抑制结肠癌转移新方法。在前期研究中,我们证明了轮枝孢菌素A在各种类型的癌症中均具有强大的抗肿瘤增殖作用。在本研究中,我们试图确定轮枝孢菌素A对结肠癌细胞的抗转移作用,并阐明其潜在的分子机制。创新点:首次发现轮枝孢菌素A可以有效地抑制结肠癌细胞在体内外的迁移和侵袭。在分子水平上,沉默c-Met显著降低了结肠细胞的侵袭,而轮枝孢菌素A正是有效的c-Met抑制剂;同时,轮枝孢菌素|A还可以通过削弱C-MET磷酸化来抑制c-MET下游Ras/Raf/MEK/ERK信号通路,从而达到抗肿瘤转移效果。方法:采用划痕分析和Transell法来证明轮枝孢菌素A对结肠癌细胞体外迁移和侵袭的影响;采用蛋白质印迹法来确定C-MET及其下游分子的表达水平和活性:采用实时定量聚合酶链式反应(qRT-PCR)分析以评估c-Met的mRNA表达水平;采用RNA干扰测定用于沉默细胞中c-Met的表达:采用质粒瞬时转染以过度表达Erk。结论:轮枝孢菌素A显著抑制结肠癌细胞的迁移和侵袭,抑制c-Met转录表达,削弱C-MET磷酸化,从而抑制其下游Ras/Raf/MEK/ERK信号通路,这是轮枝孢菌素A抗结肠癌细胞转移的主要分子机制。根据本研究结果,我们确定天然产物轮枝孢菌素A具有进一步开发抗癌症转移的巨大潜力。