Hepatocellular carcinoma(HCC) is one of the most commonly diagnosed and deadly cancers worldwide; its incidence has been rising in the United States due to the increase in hepatitis C associated cirrhosis and the grow...Hepatocellular carcinoma(HCC) is one of the most commonly diagnosed and deadly cancers worldwide; its incidence has been rising in the United States due to the increase in hepatitis C associated cirrhosis and the growing epidemic of obesity. There have been no effective therapeutic options in the advanced disease setting beyond sorafenib, a multi-targeted tyrosine kinase inhibitor that showed significant survival benefit. Because of this, there is an urgent need to search for novel pathways in sorafenib experienced patients. This review will focus on the role of hypoxia and hypoxiainducible factor alpha(HIF-1α) in cancer development, specifically in HCC. We will discuss the biology of HIF-1α, the pathways with which it interacts, and the function of HIF-1α in HCC. Furthermore, we will review studies highlighting the relevance of HIF-1α in the clinical setting, as well as the pre-clinical data supporting its further investigation. Finally, we will conclude with a discussion of the potential role of a HIF-1α m RNA antagonist for the treatment of HCC, and hypothesize the ways in which such an inhibitor may be best utilized in the management of advanced HCC. Hypoxia plays a significant role in the development of HCC. HIF-1α is a key transcription factor involved in the hypoxic response of cancer cells. It activates transcription of genes responsible for angiogenesis, glucose metabolism, proliferation, invasion and metastasis in HCC. Its involvement in multiple, essential tumor pathways makes it an attractive potential therapeutic target in HCC.展开更多
AIM: To investigate the effects of single nucleotide polymorphisms(SNPs) in glutathione S-transferase(GST) genes on survival of hepatocellular carcinoma(HCC) patients.METHODS: Twelve tagging SNPs in GST genes(includin...AIM: To investigate the effects of single nucleotide polymorphisms(SNPs) in glutathione S-transferase(GST) genes on survival of hepatocellular carcinoma(HCC) patients.METHODS: Twelve tagging SNPs in GST genes(including GSTA1, GSTA4, GSTM2, GSTM3, GSTO1, GSTO2 and GSTP1) were genotyped using Sequenom Mass ARRAY i PLEX genotyping method in a cohort of 214 Chinese patients with resected HCC.The Cox proportional hazards model and log-rank test were performed to determine the SNPs related to outcome.Additionally, stratified analysis was performed at each level of the demographic and clinical variables.An SNP-gene expression association model was further established to investigate the correlation between SNP and gene expression.RESULTS: Two SNPs(GSTO2 : rs7085725 and GSTP1 : rs4147581) were significantly associated with overall survival in HCC patients(P = 0.035 and 0.042, respectively).In stratified analysis, they were more significantly associated with overall survival in patients with younger age, male gender and cirrhosis.We further investigated cumulative effects of these two SNPs on overall survival in HCC patients.Compared with the patients carrying no unfavorable genotypes, those carrying 2 unfavorable genotypes had a 1.70-fold increased risk of death(P < 0.001).The cumulative effects were more significant in those patients with younger age, male gender and cirrhosis(HR = 2.00, 1.94 and 1.97, respectively; all P < 0.001).Additionally, we found that heavy smoking resulted in a significantly worse overall survival in those patients carrying variantalleles of rs7085725(HR = 2.07, 95%CI: 1.13-3.76, P = 0.018).The distributions of GSTO2 : rs7085725 and GSTP1 : rs4147581 genotypes were associated with altered gene expression and contributed to influences on overall survival.CONCLUSION: Our study provides the first evidence that GSTO2 and GSTP1 gene polymorphisms may serve as independent prognostic markers for HCC patients.展开更多
AIM: To investigate the relationship between low immediate postoperative platelet count and perioperative outcome after liver resection in patients with hepatocellular carcinoma(HCC).METHODS: In a cohort of 565 consec...AIM: To investigate the relationship between low immediate postoperative platelet count and perioperative outcome after liver resection in patients with hepatocellular carcinoma(HCC).METHODS: In a cohort of 565 consecutive hepatitis B-related HCC patients who underwent major liver resection, the characteristics and clinical outcomes after liver resection were compared between patients with immediate postoperative platelet count < 100 × 109/L and patients with platelet count ≥ 100 × 109/L. Risk factors for postoperative hepatic insufficiency were evaluated by multivariate analysis.RESULTS: Patients with a low immediate postoperative platelet count(< 100 × 109/L) had more grade Ⅲ-Ⅴ complications(20.5% vs 12.4%, P = 0.016), and higher rates of postoperative liver failure(6.8% vs 2.6%,P = 0.02), hepatic insufficiency(31.5% vs 21.2%, P < 0.001) and mortality(6.8% vs 0.5%, P < 0.001), compared to patients with a platelet count ≥ 100 × 109/L. The alanine aminotransferase levels on postoperative days 3 and 5, and bilirubin on postoperative days 1, 3 and 5 were higher in patients with immediate postoperative low platelet count. Multivariate analysis revealed that immediate postoperative low platelet count, rather than preoperative low platelet count, was a significant independent risk factor for hepatic insufficiency.CONCLUSION: A low immediate postoperative platelet count is an independent risk factor for hepatic insufficiency. Platelets can mediate liver regeneration in the cirrhotic liver.展开更多
Hepatitis B virus(HBV)infection is a global health problem and more than 350 million people worldwide are chronic carriers of the virus.Despite the recent dramatic decline in HBV chronic patients through successful pr...Hepatitis B virus(HBV)infection is a global health problem and more than 350 million people worldwide are chronic carriers of the virus.Despite the recent dramatic decline in HBV chronic patients through successful programs of hepatitis B surface antigen vaccination,South Korea is still recognized as an endemic area of HBV infection.HBV infections in South Korea exhibit several distinct features in epidemiologic and clinical aspects.In this review paper,we summarize the distinct HBV mutation patterns related to clinical severity and the molecular epidemiologic traits in Korean chronic patients based on previous reports.Generally,several lines of evidence,including our previous results,have led to the conclusion that a combination of the exclusive predominance of genotype C2,which is prone to mutations,the high prevalence of basal core promoter double mutations,and the presence of distinct immune responses against HBV proteins in the Korean population may generate the distinct HBV variants rarely or not encountered in other areas,which results in distinct clinical manifestations in Korean chronic patients.This may provide a novel insight into the relationships between clinical severity,HBV genotype distribution,and HBV naturally occurring variants.展开更多
文摘Hepatocellular carcinoma(HCC) is one of the most commonly diagnosed and deadly cancers worldwide; its incidence has been rising in the United States due to the increase in hepatitis C associated cirrhosis and the growing epidemic of obesity. There have been no effective therapeutic options in the advanced disease setting beyond sorafenib, a multi-targeted tyrosine kinase inhibitor that showed significant survival benefit. Because of this, there is an urgent need to search for novel pathways in sorafenib experienced patients. This review will focus on the role of hypoxia and hypoxiainducible factor alpha(HIF-1α) in cancer development, specifically in HCC. We will discuss the biology of HIF-1α, the pathways with which it interacts, and the function of HIF-1α in HCC. Furthermore, we will review studies highlighting the relevance of HIF-1α in the clinical setting, as well as the pre-clinical data supporting its further investigation. Finally, we will conclude with a discussion of the potential role of a HIF-1α m RNA antagonist for the treatment of HCC, and hypothesize the ways in which such an inhibitor may be best utilized in the management of advanced HCC. Hypoxia plays a significant role in the development of HCC. HIF-1α is a key transcription factor involved in the hypoxic response of cancer cells. It activates transcription of genes responsible for angiogenesis, glucose metabolism, proliferation, invasion and metastasis in HCC. Its involvement in multiple, essential tumor pathways makes it an attractive potential therapeutic target in HCC.
基金Supported by Grants from National Natural Science Foundation of China,No.81201549 and No.81272644the Project of Innovative Research Team for Key Science and Technology in Xi’an Jiaotong University,No.2003KCJ-23
文摘AIM: To investigate the effects of single nucleotide polymorphisms(SNPs) in glutathione S-transferase(GST) genes on survival of hepatocellular carcinoma(HCC) patients.METHODS: Twelve tagging SNPs in GST genes(including GSTA1, GSTA4, GSTM2, GSTM3, GSTO1, GSTO2 and GSTP1) were genotyped using Sequenom Mass ARRAY i PLEX genotyping method in a cohort of 214 Chinese patients with resected HCC.The Cox proportional hazards model and log-rank test were performed to determine the SNPs related to outcome.Additionally, stratified analysis was performed at each level of the demographic and clinical variables.An SNP-gene expression association model was further established to investigate the correlation between SNP and gene expression.RESULTS: Two SNPs(GSTO2 : rs7085725 and GSTP1 : rs4147581) were significantly associated with overall survival in HCC patients(P = 0.035 and 0.042, respectively).In stratified analysis, they were more significantly associated with overall survival in patients with younger age, male gender and cirrhosis.We further investigated cumulative effects of these two SNPs on overall survival in HCC patients.Compared with the patients carrying no unfavorable genotypes, those carrying 2 unfavorable genotypes had a 1.70-fold increased risk of death(P < 0.001).The cumulative effects were more significant in those patients with younger age, male gender and cirrhosis(HR = 2.00, 1.94 and 1.97, respectively; all P < 0.001).Additionally, we found that heavy smoking resulted in a significantly worse overall survival in those patients carrying variantalleles of rs7085725(HR = 2.07, 95%CI: 1.13-3.76, P = 0.018).The distributions of GSTO2 : rs7085725 and GSTP1 : rs4147581 genotypes were associated with altered gene expression and contributed to influences on overall survival.CONCLUSION: Our study provides the first evidence that GSTO2 and GSTP1 gene polymorphisms may serve as independent prognostic markers for HCC patients.
基金Supported by Grants from the National Science and Technology Major Project of China,No.2012ZX10002-016 and No.2012ZX10002-017
文摘AIM: To investigate the relationship between low immediate postoperative platelet count and perioperative outcome after liver resection in patients with hepatocellular carcinoma(HCC).METHODS: In a cohort of 565 consecutive hepatitis B-related HCC patients who underwent major liver resection, the characteristics and clinical outcomes after liver resection were compared between patients with immediate postoperative platelet count < 100 × 109/L and patients with platelet count ≥ 100 × 109/L. Risk factors for postoperative hepatic insufficiency were evaluated by multivariate analysis.RESULTS: Patients with a low immediate postoperative platelet count(< 100 × 109/L) had more grade Ⅲ-Ⅴ complications(20.5% vs 12.4%, P = 0.016), and higher rates of postoperative liver failure(6.8% vs 2.6%,P = 0.02), hepatic insufficiency(31.5% vs 21.2%, P < 0.001) and mortality(6.8% vs 0.5%, P < 0.001), compared to patients with a platelet count ≥ 100 × 109/L. The alanine aminotransferase levels on postoperative days 3 and 5, and bilirubin on postoperative days 1, 3 and 5 were higher in patients with immediate postoperative low platelet count. Multivariate analysis revealed that immediate postoperative low platelet count, rather than preoperative low platelet count, was a significant independent risk factor for hepatic insufficiency.CONCLUSION: A low immediate postoperative platelet count is an independent risk factor for hepatic insufficiency. Platelets can mediate liver regeneration in the cirrhotic liver.
基金Supported by A National Research Foundation of Korea grant funded by the Korean government(MEST)No.2013005810
文摘Hepatitis B virus(HBV)infection is a global health problem and more than 350 million people worldwide are chronic carriers of the virus.Despite the recent dramatic decline in HBV chronic patients through successful programs of hepatitis B surface antigen vaccination,South Korea is still recognized as an endemic area of HBV infection.HBV infections in South Korea exhibit several distinct features in epidemiologic and clinical aspects.In this review paper,we summarize the distinct HBV mutation patterns related to clinical severity and the molecular epidemiologic traits in Korean chronic patients based on previous reports.Generally,several lines of evidence,including our previous results,have led to the conclusion that a combination of the exclusive predominance of genotype C2,which is prone to mutations,the high prevalence of basal core promoter double mutations,and the presence of distinct immune responses against HBV proteins in the Korean population may generate the distinct HBV variants rarely or not encountered in other areas,which results in distinct clinical manifestations in Korean chronic patients.This may provide a novel insight into the relationships between clinical severity,HBV genotype distribution,and HBV naturally occurring variants.
