Altered expression in liver cancer with various hepatic blood flow occlusions: A pilot RNA sequencing study

Background and aims:Hepatocellular carcinoma is one of the most common cancers worldwide.Previous studies have reported he influence of various hepatic blood flow occlusions on tumor behavior,which is mainly mediated by liver ischemia-reperfusion.Although some genes and pathways have been determined,the whole transcriptome after various hepatic blood flow occlusions is lacking.Methods:We systematically explored transcriptome changes after various hepatic blood flow occlusions,including sham operation(SO;n=10),occlusion of the portal triad(OPT;n=10),and occlusion of the portal vein(OPV;n=10),by RNA-sequencing.Results:HE sections and TUNEL assays showed different liver injury among groups.We identified the top altered genes and pathways.Compared with the SO group,96 genes were altered in OPV,with 81 upregulated and 15 downregulated genes.The top 5 upregulated genes were Pdk4,Serpina12,Depp1,Igfbp1,and Mup22.The top 5 downregulated genes were Sprr1a,Serpinb2,Tnc,Cdkn3,and Cenpu.Compared with the SO group,there were 20 differentially expressed genes in OPT,with 18 upregulated and 2 downregulated genes.The top 5 upregulated genes wereC7,Zbtb16,Gabrp,Pdk4,and Mmrn1.The top 2 downregulated genes were Krt20 and Sis.Compared with the OPV group,72 differentially expressed genes were in OPT,with 39 upregulated and 33 downregulated genes.The top 5 upregulated genes wereHspa1b,Hbb-bs,Phf19,Ddias,and Rad54b.The top 5 downregulated genes were Cish,Socs2,Slc25a30,Rgs3,and Hsd3b5.Conclusion:Various surgical methods have an obvious influence on the transcriptome of tumors.

Correlation of effective hepatic blood flow with liver pathology in patients with hepatitis B virus

Background and aims:Effective hepatic blood flow(EHBF)decreases with liver disease progression,and identifying liver pathology is critical for patients with liver disease.This study was designed to elucidate the correlation between EHBF and liver pathology and explore the potential of EHBF for predicting the degree of liver pathology.Methods:In this study,207 patients with hepatitis B virus(HBV)who underwent liver biopsy and indocyanine green(ICG)clearance tests were enrolled.EHBF was measured using the ICG clearance test,and liver tissue was histologically analyzed to determine the pathological stage according to the Scheuer scoring system.Demographic data,biochemical indexes,and FibroScan data were collected for statistical analysis.Results:EHBF levels decreased as the liver histological stages of inflammation and fibrosis increased(P<0.01).EHBF was significantly negatively associated with the levels of alanine aminotransferase,aspartate aminotransferase,gamma-glutamyl transpeptidase,alkaline phosphatase,aspartate aminotransferase-to-platelet ratio index,fibrosis index based on the four factors,and liver stiffness measurement(P<0.05).The EHBF levels of patients without liver inflammation(G0)were significantly higher than those of patients with liver inflammation(G1e4)(P<0.001).The area under the receiver operating characteristic curve(AUROC)value for discriminating patients without liver inflammation was 0.827,and the optimal cutoff value was 0.936 L/min.The EHBF levels of patients with severe liver inflammation(G4)were significantly lower than those of patients with G0e3 liver inflammation(P<0.001).The AUROC value for discriminating patients with severe liver inflammation was 0.792,and the optimal cutoff value was 0.552 L/min.The EHBF levels of patients without liver fibrosis(S0)were significantly higher than those of patients with liver fibrosis(S1e4)(P<0.001).The AUROC value for discriminating patients without liver fibrosis was 0.633,and the optimal cutoff value was 1.173 L/min.The EHBF levels of patients with liver cirrhosis(S4)were significantly lower than those of patients with S0e3 liver fibrosis(P<0.001).The AUROC value for discriminating patients with liver cirrhosis(S4)was 0.630,and the optimal cutoff value was 0.562 L/min.Conclusions:EHBF levels and liver pathology are significantly correlated.EHBF could effectively reflect liver inflammation and fibrosis in patients infected with HBV,especially for patients without liver inflammation or liver fibrosis.

Primary animal experiment to test the feasibility of a novel Y-Z magnetic hepatic portal blocking band

BACKGROUND Hepatic portal blood flow occlusion is a common technique for reducing hepatic hemorrhage during hepatectomy.We designed a novel Y-Z magnetic hepatic portal blocking band(Y-Z MHPBB)based on the principle of magnetic compression technique.AIM To introduce the Y-Z MHPBB device and verify the feasibility of this device for hepatic portal blood flow occlusion in dogs.METHODS Ten beagles were randomly divided into the experimental group and control group.The operation time,intraoperative blood loss,the number of portal blood flow occlusions,the total time spent on adjusting the blocking band,and the average time spent on adjusting the blocking band were recorded.The surgeons evaluated the feasibility and flexibility of the two portal occlusion devices.RESULTS Laparoscopic hepatectomy was successfully performed in both the experimental group and control group.There was no statistical difference between the two groups in the operation time,intraoperative blood loss,and the number of hepatic portal blood flow occlusions.With respect to the total time spent on adjusting the blocking band and the average time spent on adjusting the blocking band,the experimental group showed significantly better outcomes than the control group,with a statistical difference(P<0.05).The operators found that the Y-Z MHPBB was superior to the modified T-tube in terms of operational flexibility.CONCLUSION The Y-Z MHPBB seems to be an ingenious design,accurate blood flow occlusion effect,and good flexibility;and it can be used for hepatic portal blood flow occlusion during laparoscopic hepatectomy.

Hepatic pseudolesions caused by alterations in intrahepatic hemodynamics

Hepatic pseudolesion may occur in contrast-enhanced computed tomography and magnetic resonance imaging due to the unique haemodynamic characteristics of the liver.The concept of hepatic arterial buffer response(HABR)has become mainstream for the understanding of the mechanism of the reciprocal effect between hepatic arterial and portal venous flow.And HABR is thought to be significantly related to the occurrence of the abnormal imaging findings on arterial phase of contrast enhanced images,such as hepatic arterial-portal vein shunt and transient hepatic attenuation difference,which mimic hypervascular tumor and may cause clinical problems.Third inflow to the liver also cause hepatic pseudolesion,and some of the cases may show histopathologic change such as focal hyperplasia,focal fatty liver,and focal sparing of fatty liver,and called pseudotumor.To understand these phenomena might be valuable for interpreting the liver imaging findings.