C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.

Transcription factor glucocorticoid modulatory element-binding protein 1 promotes hepatocellular carcinoma progression by activating Yes-associate protein 1

BACKGROUND Glucocorticoid modulatory element-binding protein 1(GMEB1),which has been identified as a transcription factor,is a protein widely expressed in various tissues.Reportedly,the dysregulation of GMEB1 is linked to the genesis and development of multiple cancers.AIM To explore GMEB1’s biological functions in hepatocellular carcinoma(HCC)and figuring out the molecular mechanism.METHODS GMEB1 expression in HCC tissues was analyzed employing the StarBase database.Immunohistochemical staining,Western blotting and quantitative realtime PCR were conducted to examine GMEB1 and Yes-associate protein 1(YAP1)expression in HCC cells and tissues.Cell counting kit-8 assay,Transwell assay and flow cytometry were utilized to examine HCC cell proliferation,migration,invasion and apoptosis,respectively.The JASPAR database was employed for predicting the binding site of GMEB1 with YAP1 promoter.Dual-luciferase reporter gene assay and chromatin immunoprecipitation-qPCR were conducted to verify the binding relationship of GMEB1 with YAP1 promoter region.RESULTS GMEB1 was up-regulated in HCC cells and tissues,and GMEB1 expression was correlated to the tumor size and TNM stage of HCC patients.GMEB1 overexpression facilitated HCC cell multiplication,migration,and invasion,and suppressed the apoptosis,whereas GMEB1 knockdown had the opposite effects.GMEB1 bound to YAP1 promoter region and positively regulated YAP1 expression in HCC cells.CONCLUSION GMEB1 facilitates HCC malignant proliferation and metastasis by promoting the transcription of the YAP1 promoter region.

Long non-coding RNA CDKN2B-AS1 promotes hepatocellular carcinoma progression via E2F transcription factor 1/G protein subunit alpha Z axis

BACKGROUND A series of long non-coding RNAs(lncRNAs)have been reported to play a crucial role in cancer biology.Some previous studies report that lncRNA CDKN2B-AS1 is involved in some human malignancies.However,its role in hepatocellular carcinoma(HCC)has not been fully deciphered.AIM To decipher the role of CDKN2B-AS1 in the progression of HCC.METHODS CDKN2B-AS1 expression in HCC was detected by quantitative real-time polymerase chain reaction.The malignant phenotypes of Li-7 and SNU-182 cells were detected by the CCK-8 method,EdU method,and flow cytometry,respectively.RNA immunoprecipitation was executed to confirm the interaction between CDKN2B-AS1 and E2F transcription factor 1(E2F1).Luciferase reporter assay and chromatin immunoprecipitation were performed to verify the binding of E2F1 to the promoter of G protein subunit alpha Z(GNAZ).E2F1 and GNAZ were detected by western blot in HCC cells.RESULTS In HCC tissues,CDKN2B-AS1 was upregulated.Depletion of CDKN2B-AS1 inhibited the proliferation of HCC cells,and the depletion of CDKN2B-AS1 also induced cell cycle arrest and apoptosis.CDKN2B-AS1 could interact with E2F1.Depletion of CDKN2B-AS1 inhibited the binding of E2F1 to the GNAZ promoter region.Overexpression of E2F1 reversed the biological effects of depletion of CDKN2B-AS1 on the malignant behaviors of HCC cells.CONCLUSION CDKN2B-AS1 recruits E2F1 to facilitate GNAZ transcription to promote HCC progression.

Regulatory mechanism of RAD51-associated protein 1 and its upstream molecules in hepatocellular carcinoma

Background:The DNA damage repair mechanism plays a crucial role in the occurrence and development of hepatocellular carcinoma(HCC),and RAD51-associated protein 1(RAD51AP1)has received increasing attention as an important protein in the homologous recombination repair pathway.However,the role of RAD51AP1 and its molecular regulatory mechanism in HCC still need further investigation.Methods:We first analysed RAD51AP1 expression,functional enrichment and prognostic value in HCC.Then,the miRWalk,miRDB,and Encyclopedia of RNA Interactomes databases were used to predict the corresponding microRNAs and long noncoding RNAs of RAD51AP1,and their expression levels and prognostic value were analysed.Results:RAD51AP1 was upregulated in the majority of cancers include HCC.The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses revealed that RAD51AP1 was mainly involved in pathways related to the cell cycle and repair in HCC.Moreover,the expression level of RAD51AP1 was significantly correlated with T stage,pathologic stage,histologic grade and the level of alpha-fetoprotein.In addition,RAD51AP1 was an independent risk factor significantly and had a high predictive value in HCC.Based on ceRNA network,RAD51AP1 may be regulated by upstream MSC-AS1 and hsa-miR-23c to affect the HCC occurrence and development.Conclusions:High expression of RAD51AP1 plays an important biological role in the cell cycle and repair pathways,and has important diagnostic and prognostic value in HCC.Based on the regulatory mechanism of ceRNA network,we speculate that lncRNA MSC-AS1 acts on hsa-miR-23c and regulates DNA damage repair of HCC through RAD51AP1.It provides a new perspective for further study of DNA damage repair mechanism and potential related treatment of HCC.

BAP1在肝细胞肝癌中的表达及其与预后的关系

目的探讨BRCA1相关蛋白1(BAP1)在肝细胞肝癌(LIHC)中的表达变化及其与预后的关系。方法从UALCA获得癌症基因组图谱(TCGA)中LIHC的BAP1 m RNA表达水平及临床数据并进行数据分组和处理。采用R3.2.2软件进行分析。比较BAP1在癌组织与正常组织中的表达差异,并分析LIHC患者各亚组临床指标的BAP1表达水平与正常组织的差异。采用寿命表法计算生存率,采用Kaplan-Meier法比较BAP1高表达组和中低表达组患者的生存率,并绘制患者的生存曲线。结果LIHC组织中BAP1 mRNA表达中位数为37.748 TPM,明显高于正常组织中的18.444 TPM,差异有显著统计学意义(P<0.01);患者的性别、年龄、种族、体质量、组织学类型、组织学分级、淋巴结、TNM分期Ⅰ~Ⅲ期、TP53突变的各组癌组织中BAP1表达水平与正常组织表达水平比较差异均有统计学意义(P<0.05),而Ⅳ期组癌组织中BAP1表达水平与正常组织表达水平比较差异无统计学意义(P>0.05);患者的中位生存时间为27.18个月,1年、2年、3年、4年、5年生存率分别为0.57%、0.31%、0.20%、0.13%、0.08%;BAP1 m RNA高表达的整体生存率较BAP1mRNA中低表达者短,差异均有统计学意义(P<0.05)。结论BAP1 m RNA在LIHC中呈高表达,高表达组生存率较低,提示预后不良。

肝细胞癌患者血清ECM1、MMP-9和VEGF水平的变化及其意义

目的 探究肝细胞癌患者血清细胞外基质蛋白-1(ECM1)、基质金属蛋白酶-9(MMP-9和血管内皮生长因子(VEGF)水平的变化及其意义。方法 对60例肝细胞癌患者进行回顾性分析,患者主要使用甲磺酸阿帕替尼进行治疗,必要时也可联合GEMOX方案肝动脉化疗栓塞术进行治疗。采用酶联免疫吸附法测定患者治疗前后的血清ECM1、VEGF、MMP-9水平。比较患者治疗前后ECM1、MMP-9和VEGF水平;比较不同临床病理特征(年龄、性别、血管侵犯、淋巴结转移、TNM分期、Edmondson分期和肿瘤直径)患者ECM1、MMP-9和VEGF水平。结果 治疗后,患者ECM1、MMP-9以及VEGF水平分别为(135.23±44.58)pg/ml、(421.25±87.56)μg/L和(657.56±54.56)pg/ml,均低于治疗前的(215.56±30.80)pg/ml、(499.56±30.56)μg/L、(798.02±50.79)pg/ml(P<0.05)。不同年龄、性别患者ECM1、MMP-9、VEGF水平比较差异无统计学意义(P>0.05);不同血管侵犯、淋巴结转移、TNM分期、Edmondson分期和肿瘤直径患者ECM1、MMP-9、VEGF水平比较差异具有统计学意义(P<0.05)。结论 ECM1、MMP-9、VEGF三者相互作用可促进肝癌细胞的转移,可根据其水平情况,了解患者肝细胞、肝功能健康状况。

Long interspersed nuclear element ORF-1 protein promotes proliferation and resistance to chemotherapy in hepatocellular carcinoma

AIM:To clarify the specific roles and mechanisms of long interspersed nuclear element-1 ORF-1 protein [human long interspersed nuclear element-1(LINE-1),ORF-1p] in chemotherapeutic drug resistance and cell proliferation regulation in hepatocellular carcinoma(HCC) cells.METHODS:MTT assays were performed to identify the effect of the chemotherapeutic drug toxicity on HepG2 cells.Cell proliferation inhibition and the IC 50 were calculated by the Origin 8.0 software.Western blotting assays were performed to investigate whether LINE-1 ORF-1p modulates the expression of some important genes,including p53,p27,p15,Bcl-2,mdr,and p-gp.To corroborate the proliferation and anchor-independent growth results,the HepG2 cells were analyzed by flow cytometry to investigate the effect of LINE-1 ORF1p on the apoptosis regulation.RESULTS:LINE-1 ORF-1p contributed to the resistance to several chemotherapeutic drugs(cisplatin and epirubicin) in HepG2 cells.The IC 50 of the epirubicin and cisplatin increased from 36.04 nmol/L to 59.11 nmol/L or from 37.94 nmol/L to 119.32 nmol/L.Repression of LINE-1 ORF-1p expression by the siRNA could markedly enhance the response of HepG2 cells to the epirubicin and cisplatin.The IC 50 correspondingly decreased from 28.06 nmol/L to 3.83 nmol/L or from 32.04 nmol/L to 2.89 nmol/L.Interestingly,down-regulation of LINE-1 ORF-1p level by siRNA could promote the response of HepG2 cells to the paclitaxel.The IC 50 decreased from 35.90 nmol/L to 7.36 nmol/L.However,overexpression of LINE-1 ORF-1p did not modulate the paclitaxel toxicity in HepG2 cells.Further Western blotting revealed that LINE-1 ORF-1p enhanced mdr and p-gp gene expression.As a protein arrested in the nucleus,LINE-1 ORF-1p may function through modulating transcriptional activity of some important transcription factors.Indeed,LINE-1 ORF-1p promoted HepG2 cell proliferation,anchor-independent growth and protected the cells against apoptosis through modulating the expression of p15,p21,p53,and Bcl-2 genes.CONCLUSION:LINE-1 ORF-1p promotes HepG2 cell proliferation and plays an important role in the resistance of chemotherapeutic drugs.By establishing novel roles and defining the mechanisms of LINE-1 ORF1p in HCC chemotherapeutic drug resistance and cell proliferation regulation,this study indicates that LINE-1 ORF-1p is a potential target for overcoming HCC chemotherapeutic resistance.

肝癌组织中miR-1470 PATZ1表达水平与患者5年内预后的关系

目的:探讨肝癌组织中微小RNA-1470(miR-1470)、POZ结构域和AT结合基序锌指蛋白1(PATZ1)表达水平与患者5年内预后的关系。方法:选取2015年9月至2018年8月在邯郸市中心医院接受根治术治疗的肝癌患者135例,术中留取肝癌组织及相应癌旁正常组织(距肿瘤边缘2cm以上的正常肝脏组织)。采用免疫组织化学法检测PATZ1蛋白表达;采用实时荧光定量PCR法检测miR-1470、PATZ1 mRNA表达;术后进行5年的随访,统计5年总生存率。比较肝癌组织和癌旁正常组织中miR-1470、PATZ1 mRNA和蛋白表达情况;分析肝癌组织中miR-1470、PATZ1 mRNA表达与临床病理参数的关系,二者表达的相关性及与预后的关系,影响预后的危险因素;双荧光素酶报告基因实验验证miR-1470与PATZ1的靶向关系。结果:肝癌组织PATZ1蛋白阳性表达率明显低于癌旁正常组织(P<0.05)。与癌旁正常组织比较,肝癌组织中miR-1470表达水平明显升高,PATZ1 mRNA表达水平明显降低(P<0.05)。肝癌组织中miR-1470、PATZ1 mRNA低表达、高表达患者在血清甲胎蛋白(AFP)水平、中国肝癌分期方案(CNLC)分期及有无脉管癌栓方面,差异均有统计学意义(P<0.05)。肝癌组织中miR-1470与PATZ1 mRNA表达呈负相关(P<0.05)。miR-1470低表达患者、PATZ1 mRNA高表达患者5年总生存率分别明显高于miR-1470高表达患者、PATZ1 mRNA低表达患者(P<0.05)。CNLC分期Ⅲ期、脉管癌栓、miR-1470高表达及PATZ1 mRNA低表达是影响肝癌患者预后不良的独立危险因素(P<0.05)。miR-1470可负向调控PATZ1表达。结论:肝癌组织中miR-1470表达上调,PATZ1表达下调,两者呈负相关,均可作为评估肝癌患者预后的生物标记物,且miR-1470可负向调控PATZ1表达。

SIRT5、CRIP1在肝细胞肝癌组织中的表达及临床意义

目的探讨沉默调节蛋白5(SIRT5)、富含半胱氨酸肠蛋白1(CRIP1)在肝细胞肝癌(HCC)组织中的表达及临床意义。方法选取2018年1月—2020年5月长治医学院附属和平医院肝胆外科手术切除HCC患者150例,采用免疫组化法检测HCC组织及癌旁组织中SIRT5、CRIP1表达;分析SIRT5、CRIP1表达与HCC患者临床病理参数的关系;根据HCC组织中SIRT5、CRIP1表达水平将HCC患者分为SIRT5、CRIP1阳性/阴性表达组,采用Kaplan-Meier法绘制SIRT5、CRIP1阳性/阴性表达HCC患者生存曲线;采用Cox回归分析影响HCC患者预后的因素。结果与癌旁组织比较,HCC组织SIRT5阳性表达率降低,CRIP1阳性表达率升高(χ^(2)=40.991、42.946,P均<0.001)。肿瘤单发、肿瘤直径小、中高分化程度、无脉管侵犯、TNM分期Ⅰ~Ⅱ期的HCC组织较肿瘤多发、肿瘤直径大、低分化、有脉管侵犯、TNM分期Ⅲ期的患者SIRT5阳性表达率升高、CRIP1阳性表达率降低,差异均有统计学意义(SIRT5:χ^(2)/P=5.179/0.023、6.459/0.011、5.899/0.015、7.402/0.007、5.930/0.015;CRIP1:χ^(2)/P=4.275/0.039、5.442/0.002、6.459/0.011、6.394/0.011、5.655/0.017);随访3年,150例HCC患者失访11例,3年总生存率为56.83%(79/139)。Kaplan-Meier生存曲线分析显示,SIRT5阳性表达组3年总生存率高于SIRT5阴性表达组,CRIP1阳性表达组3年总生存率低于CRIP1阴性表达组(Log-rankχ^(2)=7.552、20.942,P=0.006、<0.001)。多因素Cox回归分析显示,肿瘤数目多发、肿瘤直径≥5 cm、低分化、脉管侵犯、TNM分期Ⅲ期、CRIP1阳性为HCC患者死亡的独立危险因素[OR(95%CI)=2.685(1.031~6.999)、2.252(1.143~4.439)、4.181(1.735~10.076)、3.945(1.653~9.419)、3.485(1.492~8.141)、4.540(1.641~12.562),P均<0.05],SIRT5阳性为独立保护因素[OR(95%CI)=0.207(0.085~0.506),P<0.01]。结论HCC组织SIRT5低表达和CRIP1高表达,与肿瘤数目、肿瘤直径、分化程度、脉管侵犯、TNM分期和预后有关。

Y-box binding protein 1 augments sorafenib resistance via the PI3K/Akt signaling pathway in hepatocellular carcinoma

BACKGROUND Sorafenib is the first-line treatment for patients with advanced hepatocellular carcinoma(HCC).Y-box binding protein 1(YB-1)is closely correlated with tumors and drug resistance.However,the relationship between YB-1 and sorafenib resistance and the underlying mechanism in HCC remain unknown.AIM To explore the role and related mechanisms of YB-1 in mediating sorafenib resistance in HCC.METHODS The protein expression levels of YB-1 were assessed in human HCC tissues and adjacent nontumor tissues.Next,we constructed YB-1 overexpression and knockdown hepatocarcinoma cell lines with lentiviruses and stimulated these cell lines with different concentrations of sorafenib.Then,we detected the proliferation and apoptosis in these cells by terminal deoxynucleotidyl transferase dUTP nick end labeling,flow cytometry and Western blotting assays.We also constructed a xenograft tumor model to explore the effect of YB-1 on the efficacy of sorafenib in vivo.Moreover,we studied and verified the specific molecular mechanism of YB-1 mediating sorafenib resistance in hepatoma cells by digital gene expression sequencing(DGE-seq).RESULTS YB-1 protein levels were found to be higher in HCC tissues than in corresponding nontumor tissues.YB-1 suppressed the effect of sorafenib on cell proliferation and apoptosis.Consistently,the efficacy of sorafenib in vivo was enhanced after YB-1 was knocked down.Furthermore,KEGG pathway enrichment analysis of DGEseq demonstrated that the phosphoinositide-3-kinase(PI3K)/protein kinase B(Akt)signaling pathway was essential for the sorafenib resistance induced by YB-1.Subsequently,YB-1 interacted with two key proteins of the PI3K/Akt signaling pathway(Akt1 and PIK3R1)as shown by searching the BioGRID and HitPredict websites.Finally,YB-1 suppressed the inactivation of the PI3K/Akt signaling pathway induced by sorafenib,and the blockade of the PI3K/Akt signaling pathway by LY294002 mitigated YB-1-induced sorafenib resistance.CONCLUSION Overall,we concluded that YB-1 augments sorafenib resistance through the PI3K/Akt signaling pathway in HCC and suggest that YB-1 is a key drug resistance-related gene,which is of great significance for the application of sorafenib in advanced-stage HCC.

Hepatic arterial infusion chemotherapy with anti-angiogenesis agents and immune checkpoint inhibitors for unresectable hepatocellular carcinoma and meta-analysis

BACKGROUND Hepatic arterial infusion chemotherapy(HAIC)has been proven to be an ideal choice for treating unresectable hepatocellular carcinoma(uHCC).HAIC-based treatment showed great potential for treating uHCC.However,large-scale studies on HAIC-based treatments and meta-analyses of first-line treatments for uHCC are lacking.AIM To investigate better first-line treatment options for uHCC and to assess the safety and efficacy of HAIC combined with angiogenesis inhibitors,programmed cell death of protein 1(PD-1)and its ligand(PD-L1)blockers(triple therapy)under real-world conditions.METHODS Several electronic databases were searched to identify eligible randomized controlled trials for this meta-analysis.Study-level pooled analyses of hazard ratios(HRs)and odds ratios(ORs)were performed.This was a retrospective single-center study involving 442 patients with uHCC who received triple therapy or angiogenesis inhibitors plus PD-1/PD-L1 blockades(AIPB)at Sun Yat-sen University Cancer Center from January 2018 to April 2023.Propensity score matching(PSM)was performed to balance the bias between the groups.The Kaplan-Meier method and cox regression were used to analyse the survival data,and the log-rank test was used to compare the suvival time between the groups.RESULTS A total of 13 randomized controlled trials were included.HAIC alone and in combination with sorafenib were found to be effective treatments(P values for ORs:HAIC,0.95;for HRs:HAIC+sorafenib,0.04).After PSM,176 HCC patients were included in the analysis.The triple therapy group(n=88)had a longer median overall survival than the AIPB group(n=88)(31.6 months vs 14.6 months,P<0.001)and a greater incidence of adverse events(94.3%vs 75.4%,P<0.001).CONCLUSION This meta-analysis suggests that HAIC-based treatments are likely to be the best choice for uHCC.Our findings confirm that triple therapy is more effective for uHCC patients than AIPB.

肝癌患者血清IGFBP1的表达及其临床意义

目的探究肝癌患者血清胰岛素生长因子结合蛋白1(insulin growth factor binding protein 1,IGFBP1)的表达变化及其临床意义。方法回顾性选取于武汉大学中南医院就诊的体检正常对照个体(CTL组,n=32)、慢性乙型肝炎患者(CHB组,n=32)和肝癌患者(HCC组,n=64)。采用-80℃冻存上述研究对象的血清标本,酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测血清中IGFBP1的水平,3组间差异比较采用单因素方差分析,事后两两比较采用LSD-t检验;不符合正态分布的计量资料多组间差异比较采用Kruskal-Wallis H检验,并一步两两比较;计数资料组间差异比较采用Fisher确切概率法;相关性分析采用Spearman法,受试者工作特征(receiver operating characteristic,ROC)曲线用于评价血清IGFBP1的诊断效能,二元Logistic回归分析用于血清IGFBP1水平对肝癌的风险评估。结果HCC组患者的血清IGFBP1表达水平明显高于CTL组和CHB组,差异有统计学意义(H=29.427,P<0.001);乙型肝炎病毒(hepatitis B virus,HBV)感染不影响血清IGFBP1水平。血清IGFBP1水平与经典的肝癌血清蛋白标志物甲胎蛋白(alpha fetoprotein,AFP)存在较强的正相关关系(r=0.484,P<0.001),其诊断效能为(AUC=0.773,95%CI:0.693~0.852,P<0.001)。二元Logistic回归分析结果显示,血清IGFBP1升高是肝癌的风险因子(OR=1.049,95%CI:1.014~1.084,P=0.005)。结论肝癌患者血清中IGFBP1水平升高是肝癌的风险因素,对肝癌的诊断具有一定的临床价值。

Effects of signal regulatory proteinα1 on proliferation of hepatocellular carcinoma: a preliminary study

BACKGROUND: Signal regulatory protein alpha1 (Sirpα1) is a negative regulatory factor, and inhibits receptor tyro- sine kinase-dependent cell proliferating signal. This study was undertaken to observe the effect of signal regulatory proteinα1 ( Sirpα1) on gankyrin, cyclin D1, CDK4 and Fas expression in Sk-hep1 mouse hepatoma carcinoma cell line. METHODS: BOSC 23 packed cells were respectively trans- fected by means of recombinated retrovirus including pLX- SN, pLXSN-Sirpα1 and pLXSN-Sirpα1Δ4Y2 with lipofec- tin, and various plasmid virus media (viral titer 2.1 × 106 CFU/ml) were collected and infected respectively in 80% confluent Sk-hepl cells. Transfected Sk-hep1 cells were se- lectively screened with G418 (1200 μg/ml), and Sk-hep1 cell lines transfected with various plasmids were obtained. The protein expressions of gankyrin, cyclin D1, CDK4 and Fas in various Sk-hep1 lines were determined by Western blotting. Various Sk-hep1 lines were recovered to culture with 10% fetal bovine serum at 12 hours and 24 hours after starving culture with free serum for 72 hours, and cells were collected to determine the percentage of S phase cells of proliferating cycle by flow cytometry. RESULTS: Sirpα1 transfection remarkably downregulated gankyrin and cyclin D1 expression. Sirpα1Δ4Y2 downregu- lation of gankyrin expression was greater than that of Sirpα1(P <0.05), but no significant effect of Sirpα1 and Sirpα1Δ4Y2 on CDK4 and Fas protein expression was ob- served in transfected Sk-hep1 lines (P >0.05). The per- centage of S phase cells significantly decreased in Sk-hep1 cells transfected with Sirpα1 and Sirpα1Δ4Y2 plasmids (vs pLXSN Sk-hep1, P <0.05). The percentage of S phase cells in various Sk-hep1 cells increased when recovering to culture with 10% fetal bovine serum at 12 hours, but the percentage of S phase cells in Sk-hep1 cells transfected with Sirpα1 was the lowest ( vs pLXSN and Sirpα1Δ4Y2 Sk- hepl, P<0.05). The percentage of S phase cells in trans- fected pLSXN Sk-hep1 cells was the largest (vs Sirpα1 and Sirpα1Δ4Y2 Sk-hepl, P <0. 05). There was no significant difference between the transfected Sirpα1 Sk-hepl cells and Sirpα1Δ4Y2 Sk-hep1 cells (P>0.05). CONCLUSIONS: Sirpα1 decreases gankyrin and cyclin D1 expression, and inhibits proliferation of liver carcinoma cells. It may be one of the forms for an Sirpα1 negative regulation of carcinogenesis and development of hepatocel- lular carcinoma.

PABPC1在肝细胞癌患者癌组织中的表达及其与预后的关系

目的 分析多聚腺苷酸结合蛋白胞质1(PABPC1)在肝细胞癌(HCC)患者癌组织中的表达情况及其对患者预后的影响。方法 采用癌症基因组图谱计划(TCGA)中的数据分析369例HCC患者癌组织及50例正常肝组织的PABPC1 mRNA表达水平。回顾性分析、比较2018年1月至2019年2月在该院就诊的166例HCC患者癌组织和癌旁正常组织PABPC1 mRNA表达水平及不同临床病理特征的HCC患者癌组织中PABPC蛋白表达情况。绘制受试者工作特征(ROC)曲线分析采用PABPC1 mRNA表达水平区分癌组织和癌旁正常组织的效能,根据随访结果采用多因素COX回归模型分析影响HCC患者预后的因素。结果 TCGA数据结果显示,369例HCC患者癌组织中PABPC1 mRNA表达量显著高于50例正常肝组织中的表达量(P<0.05)。在临床病例分析中,166例HCC患者癌组织中PABPC1 mRNA表达水平及PABPC1蛋白阳性率均显著高于癌旁组织(P<0.05),且PABPC1蛋白阳性表达患者PABPC1 mRNA表达水平为2.76±0.79,显著高于阴性表达患者的1.52±0.84(P<0.001)。ROC曲线结果显示,PABPC1 mRNA区分癌组织和癌旁正常组织的曲线下面积为0.913。UICC分期Ⅲ~Ⅳ期、伴有淋巴结转移以及多发肿瘤灶HCC患者的PABPC1蛋白阳性表达率分别高于UICC分期Ⅰ~Ⅱ期、无淋巴结转移及单发肿瘤灶的患者,差异均有统计学意义(P<0.05)。随访期间,50例(30.12%)患者在术后1年内死亡,95例(57.23%)患者在术后3年内死亡,101例(60.84%)患者在术后5年内死亡;多因素COX回归分析结果显示,癌组织PABPC1蛋白表达情况是影响HCC患者1年、3年、5年生存情况的独立因素(P<0.05)。癌组织PABPC1蛋白阳性表达及阴性表达HCC患者的1年、3年和5年总生存期比较,差异均有统计学意义(P<0.001)。结论 PABPC1 mRNA和蛋白在HCC患者癌组织中均呈高表达,且PABPC1蛋白高表达预示HCC患者生存预后不良。

Combined TIM-3 and PD-1 blockade restrains hepatocellular carcinoma development by facilitating CD4+ and CD8+T cellmediated antitumor immune responses

BACKGROUND Immune checkpoint inhibitors(ICIs)targeting programmed cell death protein 1(PD-1)and T cell immunoglobulin and mucin domain-containing protein 3(TIM-3)are beneficial to the resumption of anti-tumor immunity response and hold extreme potential as efficient therapies for certain malignancies.However,ICIs with a single target exhibit poor overall response rate in hepatocellular carcinoma(HCC)patients due to the complex pathological mechanisms of HCC.AIM To investigate the effects of combined TIM-3 and PD-1 blockade on tumor development in an HCC mouse model,aiming to identify more effective immunotherapies and provide more treatment options for HCC patients.METHODS The levels of PD-1 and TIM-3 on CD4+and CD8+T cells from tumor tissues,ascites,and matched adjacent tissues from HCC patients were determined with flow cytometry.An HCC xenograft mouse model was established and treated with anti-TIM-3 monoclonal antibody(mAb)and/or anti-PD-1 mAb.Tumor growth in each group was measured.Hematoxylin and eosin staining and immunohistochemical staining were used to evaluate T cell infiltration in tumors.The percentage of CD4+and CD8+T cells in tissue samples from mice was tested with flow cytometry.The percentages of PD-1+CD8+,TIM-3+CD8+,and PD-1+TIM-3+CD8+T cells was accessed by flow cytometry.The levels of the cytokines including tumor necrosis factor alpha(TNF-α),interferon-γ(IFN-γ),interleukin(IL)-6,and IL-10 in tumor tissues were gauged with enzyme-linked immunosorbent assay kits.RESULTS We confirmed that PD-1 and TIM-3 expression was substantially upregulated in CD4+and CD8+T cells isolated from tumor tissues and ascites of HCC patients.TIM-3 mAb and PD-1 mAb treatment both reduced tumor volume and weight,while combined blockade had more substantial anti-tumor effects than individual treatment.Then we showed that combined therapy increased T cell infiltration into tumor tissues,and downregulated PD-1 and TIM-3 expression on CD8+T cells in tumor tissues.Moreover,combined treatment facilitated the production of T cell effector cytokines TNF-α and IFN-γ,and reduced the production of immunosuppressive cytokines IL-10 and IL-6 in tumor tissues.Thus,we implicated that combined blockade could ameliorate T cell exhaustion in HCC mouse model.CONCLUSION Combined TIM-3 and PD-1 blockade restrains HCC development by facilitating CD4+ and CD8+T cell-mediated antitumor immune responses.

Reactive oxygen species-induced activation of Yes-associated protein-1 through the c-Myc pathway is a therapeutic target in hepatocellular carcinoma

BACKGROUND The Hippo signaling pathway regulates organ size by regulating cell proliferation and apoptosis with terminal effectors including Yes-associated protein-1(YAP-1).Dysregulation in Hippo pathway has been proposed as one of the therapeutic targets in hepatocarcinogenesis.The levels of reactive oxygen species(ROS)increase during the progression from early to advanced hepatocellular carcinoma(HCC).AIM To study the activation of YAP-1 by ROS-induced damage in HCC and the involved signaling pathway.METHODS The expression of YAP-1 in HCC cells(Huh-7,HepG2,and SNU-761)was quantified using real-time polymerase chain reaction and immunoblotting.Human HCC cells were treated with H2O2,which is a major component of ROS in living organisms,and with either YAP-1 small interfering RNA(siRNA)or control siRNA.To investigate the role of YAP-1 in HCC cells under oxidative stress,MTS assays were performed.Immunoblotting was performed to evaluate the signaling pathway responsible for the activation of YAP-1.Eighty-eight surgically resected frozen HCC tissue samples and 88 nontumor liver tissue samples were used for gene expression analyses.RESULTS H2O2 treatment increased the mRNA and protein expression of YAP-1 in HCC cells(Huh-7,HepG2,and SNU-761).Suppression of YAP-1 using siRNA transfection resulted in a significant decrease in tumor proliferation during H2O2 treatment both in vitro and in vivo(both P<0.05).The oncogenic action of YAP-1 occurred via the activation of the c-Myc pathway,leading to the upregulation of components of the unfolded protein response(UPR),including 78-kDa glucoseregulated protein and activating transcription factor-6(ATF-6).The YAP-1 mRNA levels in human HCC tissues were upregulated by 2.6-fold compared with those in nontumor tissues(P<0.05)and were positively correlated with the ATF-6 Levels(Pearson’s coefficient=0.299;P<0.05).CONCLUSION This study shows a novel connection between YAP-1 and the UPR through the c-Myc pathway during oxidative stress in HCC.The ROS-induced activation of YAP-1 via the c-Myc pathway,which leads to the activation of the UPR pathway,might be a therapeutic target in HCC.

肝细胞癌患者癌组织中CRIP1、STUB1表达及临床预后意义

目的探讨肝细胞癌患者癌组织中富含半胱氨酸肠蛋白1(CRIP1)、STIP1同源性和包含U-box蛋白1(STUB1)表达及临床预后意义。方法选取2018年2月至2020年2月该院诊治的112例肝细胞癌患者作为研究对象。免疫组化法检测肝细胞癌患者癌组织和癌旁组织中CRIP1、STUB1表达。分析肝细胞癌患者癌组织CRIP1、STUB1表达与其临床病理特征的关系。Kaplan-Meier生存分析癌组织CRIP1、STUB1表达对肝细胞癌患者预后的影响。COX回归分析影响肝细胞癌预后的因素。结果肝细胞癌患者癌组织中CRIP1阳性率为62.50%(70/112),明显高于癌旁组织[7.14%(8/112)],差异有统计学意义(χ^(2)=76.652,P<0.05)。肝细胞癌患者癌组织中STUB1阳性率为26.23%(32/112),明显低于癌旁组织[82.14%(92/112)],差异有统计学意义(χ^(2)=73.284,P<0.05)。癌组织中CRIP1与STUB1表达呈负相关(r=-0.678,P<0.001)。不同肿瘤TNM分期、组织学分级及肿瘤最大径的肝细胞癌患者癌组织中CRIP1、STUB1阳性率比较,差异有统计学意义(P<0.05)。CRIP1阳性组3年累积生存率明显低于CRIP1阴性组,差异有统计学意义(Log-rankχ^(2)=29.601,P<0.001)。STUB1阴性组3年累积生存率明显低于STUB1阳性组,差异有统计学意义(Log-rankχ^(2)=13.590,P<0.001)。肿瘤TNM分期Ⅱ~Ⅲ期、组织学分级Ⅲ级、肿瘤最大径>5 cm、CRIP1阳性、STUB1阴性是影响肝细胞癌患者预后的独立危险因素。结论肝细胞癌患者癌组织中CRIP1表达上调,STUB1表达下调,临床上可根据肝细胞癌患者癌组织中CRIP1、STUB1表达情况对患者预后进行评估。

lncRNA LUCAT1通过miR-199b-5p/AKAP1信号轴促进肝癌进展的机制

目的探究长链非编码RNA(long non-coding RNA,lncRNA)肺癌相关转录物1(lung cancer associated transcript 1,LUCAT1)通过miR-199b-5p/A激酶锚定蛋白1(A-kinase anchoring protein 1,AKAP1)信号轴促进肝癌转移的机制。方法收集2020年1月至2021年10月在成都市新都区人民医院进行手术治疗的80例肝细胞癌(hepatocellular carcinoma,HCC)患者的肝癌及癌旁组织标本,采用RT-qPCR检测LUCAT1、miR-199b-5p、AKAP1 mRNA水平。将Huh7、HepG2细胞进行不同转染,pHRi-si-NC、pHRi-si-LUCAT1分别转染至Huh7、HepG2细胞,pHRi-si-LUCAT1和pHRi-anti-miR-NC、pHRi-si-LUCAT1和pHRi-anti-miR-199b-5p、pHRi-si-LUCAT1和pHRi-NC、pHRi-si-LUCAT1和pHRi-AKAP1分别共转染至Huh7、HepG2细胞。双荧光素酶报告验证LUCAT1对miR-199b-5p、miR-199b-5p对AKAP1的调控关系;EdU染色、划痕实验和Transwell实验检测细胞增殖、迁移和侵袭能力;RT-qPCR检测细胞LUCAT1、miR-199b-5p和AKAP1 mRNA水平;Western blot检测细胞Ki67、基质金属蛋白酶(matrix metalloproteinase,MMP)-2、MMP-9水平。向20只裸鼠皮下注射已转染pHRi-si-LUCAT1的Huh7细胞悬液,30 d后测定移植瘤体积、质量、LUCAT1、miR-199b-5p、AKAP1 mRNA、Ki67、MMP-2、MMP-9水平。结果①与癌旁组织相比,HCC组织LUCAT1(1.51±0.53比1.13±0.72;t=3.802,P<0.001)、AKAP1 mRNA(3.73±0.97比1.28±0.76;t=17.783,P<0.001)水平显著升高,miR-199b-5p(1.21±0.53比3.56±1.02;t=18.286,P<0.001)水平显著降低。②转染pHRi-si-LUCAT1后,miR-199b-5p水平显著升高(Huh7:3.71±0.28比1.00±0.10,t=15.787,P=0.004;HepG2:3.49±0.25比1.00±0.11,t=15.790,P=0.004),LUCAT1(Huh7:0.34±0.05比1.00±0.06,t=14.637,P=0.005;HepG2:0.41±0.06比1.00±0.07,t=11.084,P=0.008)和AKAP1 mRNA水平显著降低(Huh7:0.52±0.05比1.00±0.09,t=8.075,P=0.015;HepG2:0.55±0.06比1.00±0.13,t=5.444,P=0.032);细胞EdU阳性率、划痕愈合率和细胞侵袭数均显著降低(P均<0.05);Ki67(Huh7:0.24±0.03比0.92±0.06,t=17.558,P=0.003;HepG2:0.10±0.03比0.51±0.03,t=16.738,P=0.004)、MMP-2(Huh7:0.20±0.03比0.90±0.05,t=20.793,P=0.002;HepG2:0.05±0.02比0.21±0.02,t=9.798,P=0.010)、MMP-9(Huh7:0.25±0.04比0.75±0.05,t=13.525,P=0.005;HepG2:0.15±0.03比0.59±0.04,t=15.242,P=0.004)表达水平显著降低;共转染pHRi-si-LUCAT1和pHRi-anti-miR-199b-5p后,miR-199b-5p水平显著降低(Huh7:1.42±0.11比3.65±0.25,t=14.142,P=0.005;HepG2:1.30±0.05比3.71±0.20,t=20.248,P=0.002),LUCAT1(Huh7:0.85±0.10比0.40±0.06,t=6.683,P=0.022;HepG2:0.90±0.08比0.45±0.04,t=8.714,P=0.013)和AKAP1 mRNA水平显著升高(Huh7:0.80±0.07比0.55±0.04,t=5.371,P=0.033;HepG2:0.85±0.08比0.51±0.04,t=6.584,P=0.022);细胞EdU阳性率、划痕愈合率和细胞侵袭数均显著升高(P均<0.05);Ki67(Huh7:0.91±0.06比0.25±0.04,t=15.853,P=0.004;HepG2:0.92±0.07比0.18±0.03,t=16.830,P=0.004)、MMP-2(Huh7:0.62±0.05比0.22±0.03,t=11.882,P=0.007;HepG2:0.75±0.05比0.39±0.05,t=8.818,P=0.013)、MMP-9(Huh7:0.51±0.05比0.18±0.02,t=10.614,P=0.009;HepG2:0.89±0.06比0.34±0.04,t=13.211,P=0.006)表达水平显著升高;共转染pHRi-si-LUCAT1和pHRi-AKAP1后,miR-199b-5p水平显著降低(Huh7:1.82±0.12比3.55±0.30,t=9.274,P=0.011;HepG2:1.70±0.14比3.62±0.25,t=11.606,P=0.007),LUCAT1(Huh7:0.71±0.03比0.30±0.03,t=16.738,P=0.004;HepG2:0.75±0.05比0.35±0.04,t=10.820,P=0.008)和AKAP1 mRNA水平显著升高(Huh7:0.87±0.05比0.51±0.03,t=10.694,P=0.009;HepG2:0.90±0.09比0.54±0.04,t=6.331,P=0.024);细胞EdU阳性率、划痕愈合率和细胞侵袭数均显著升高(P均<0.05);Ki67(Huh7:0.64±0.06比0.30±0.03,t=8.779,P=0.013;HepG2:0.75±0.06比0.25±0.03,t=12.910,P=0.006)、MMP-2(Huh7:0.80±0.05比0.34±0.04,t=12.443,P=0.002;HepG2:0.84±0.08比0.40±0.03,t=8.920,P=0.012)、MMP-9(Huh7:0.76±0.05比0.23±0.04,t=14.337,P=0.005;HepG2:0.76±0.05比0.31±0.04,t=12.173,P=0.007)表达水平显著升高;③转染pHRi-si-LUCAT1后,肿瘤体积[(523.67±64.33)mm^(3)比(1542.21±201.51)mm^(3),t=8.340,P=0.014)]和质量[(0.67±0.15)g比(1.87±0.22)g,t=7.806,P=0.016)]均显著减小,LUCAT1(0.47±0.10比1.00±0.14,t=5.336,P=0.033)、AKAP1(0.12±0.03比0.51±0.05,t=11.585,P=0.007)、Ki67(2.45±0.28比5.93±0.55,t=9.766,P=0.010)、MMP-2(2.35±0.25比5.74±0.51,t=10.338,P=0.009)、MMP-9(3.55±0.34比6.42±0.84,t=5.486,P=0.032)蛋白水平均显著降低,miR-199b-5p(1.68±0.17比1.00±0.16,t=5.045,P=0.037)水平显著升高。结论LncRNA LUCAT1通过miR-199b-5p/AKAP1信号轴促进HCC细胞增殖、迁移和侵袭。

GTSE1在肝癌中的表达及其对预后和免疫浸润的影响

目的研究G_(2)/S期应答相关蛋白1(G_(2) and S phase-expressed protein 1,GTSE1)在肝细胞癌(hepatocellular carcinoma,HCC)中的表达、免疫学作用和预后分析,及其潜在作用机制。方法使用公共数据库癌症基因组图谱(The Cancer Genome Atlas,TCGA)提供的数据,用Kaplan-Meier、肿瘤免疫评估资源(Tumor Immune Estimation Resource,TIMER)数据库和基因表达谱交互分析(Gene Expression Profiling Interactive Analysis,GEPIA)数据库进行GTSE1基因表达、免疫学作用及预后分析,通过免疫组化实验验证GTSE1在临床样本中的表达,应用R软件对GTSE1相关差异基因进行基因本体(gene ontology,GO)和京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)富集分析。结果GTSE1在人类癌组织中显著高表达,且与肝细胞癌预后不良显著相关(P<0.05);GTSE1基因表达与HCC中浸润性免疫细胞的丰度显著相关(P<0.001)。GTSE1相关的差异表达基因主要富集于核分裂、细胞器裂变、离子通道活性等基因模块;其参与的信号通路主要包括神经活性配体-受体的相互作用、细胞周期等。结论GTSE1在HCC中的表达显著上调并与患者预后不良显著相关,且在免疫细胞浸润中发挥重要作用,可作为HCC的预后标志物和免疫治疗靶点。

PD-1抑制剂预防肝细胞癌消融术后复发的临床研究

目的探讨程序性细胞死亡受体-1(PD-1)抑制剂用于肝细胞癌(HCC)消融术后预防复发的有效性和安全性。方法前瞻性选择2021年1月至2023年3月在首都医科大学附属北京佑安医院行肝动脉栓塞(TAE)序贯局部消融术(微波消融或射频消融)治疗后达到完全消融的HCC患者63例,根据患者意愿将患者非随机分配至试验组(n=31)或对照组(n=32),试验组术后接受PD-1抑制剂辅助治疗(卡瑞利珠单抗治疗200 mg,每3周1次),对照组无辅助治疗。Kaplan-Meier法绘制累计复发率曲线,Log-rank检验比较两组生存率差异;Cox回归分析得出影响HCC患者局部消融术后无复发生存期(RFS)的独立危险因素。结果两组治疗后随访2~15个月,中位随访8个月。试验组复发率明显低于对照组(41.94%vs 68.75%,χ^(2)=4.59,P=0.03)。试验组中1~2级免疫相关不良事件发生率为92.59%(25/27),≥3级为7.41%。肿瘤最大径(HR=0.49,95%CI 0.25-0.98,P<0.05)与抗PD-1辅助治疗(HR=0.41,95%CI 0.20-0.85,P<0.05)是HCC患者消融术后RFS的独立影响因素(P<0.05)。结论本研究的短期结果表明,PD-1抑制剂用于HCC根治性消融术后的肿瘤预防复发安全、有效。