Wide surgical margins improve prognosis for HCC with microvascular invasion.

OBJECTIVE: Hepatocellular carcinoma (HCC) is the sixth leading cause of malignant tumors worldwide. Liver resection is a pivotal treatment modality for HCC. Surgical margin plays an important role in decreasing recurrence and improving prognosis for HCC patients. MATERIALS AND METHODS: This paper aimed to perform a systematic review of the literature in regard to surgical margin in HCC patients with microvascular invasion (MVI). RESULTS: Residual MVI due to insufficient surgical margins is the main origin of postoperative recurrence and metastasis in HCC patients. A wide surgical margin (WSM) significantly improves oncological outcomes and long-term survival in HCC patients with MVI. Progress in the preoperative prediction of MVI may contribute to precise surgical decision-making in the future. CONCLUSIONS: WSM was associated with better outcomes in HCC patients with MVI. WSM is recommended for well-preserved liver function HCC patients who are predicted to have a high risk of MVI preoperatively.

[Inhibition of NLRP3 inflammasome activation on the inflammatory response of macrophage induced by silica dust].

Objective: To investigate the effect of inhibiting the activation of NLRP3 inflammatory bodies on the inflammatory response of macrophages induced by silica (SiO(2)) dust. Methods: Rat alveolar macrophages (NR8383) cells were used to establish the cell model, which was divided into four groups: blank control group, dust exposure group (50 mg/L silica dust suspension) , NLRP3 inhibitor group (50 mg/L silica dust suspension and 20 µmol/L NLRP3 inhibitor) , luteolin group (50 mg/L silica dust suspension and 20 µmol/L luteolin) . Samples were collected at 12, 24 and 48 hours after culture. The secretion of inflammatory factors IL and TGF-ß(1) were detected by ELISA. The levels of NLRP3 and Caspase-1 were detected by Western Blot. Results: Compared with the blank control group, the survival rates of NR8383 cells in the dust exposure group, NLRP3 inhibitor group and luteolin group were all decreased after 12, 24 and 48 hours of dust exposure, and the expression levels of IL-1ß, IL-18, TGF-ß1, NLRP3 and Caspase-1 were significantly increased (P<0.05) . Compared with the dust exposure group, NR8383 cells in NLRP3 inhibitor group and luteolin group had higher cell survival rates and lower levels of IL-1ß, IL-18, TGF-ß1, NLRP3 and Caspase-1 after 12, 24 and 48 hours of dust exposure (P<0.05) . Compared with the NLRP3 inhibitor group, the IL-1ß level of NR8383 cells in luteolin group decreased significantly at 12, 24 and 48 h, the IL-18 and TGF-ß1 levels decreased significantly at 48 h, the NLRP3 and Caspase-1 levels decreased significantly at 24 h (P<0.05) . Conclusion: Inhibition of NLRP3 inflammaasome activation can reduce the inflammatory response of macrophages induced by SiO(2) dust.

[Expression and significance of NLRP3/IL-1ß/TGF-ß(1) signal axis in rat model of silicosis pulmonary fibrosis].

Objective: To investigate the expression and significance of NLRP3/IL-1ß/TGF-ß(1) signal axis in a rat model of silicosis and pulmonary fibrosis. Methods: Eighty healthy Wistar male rats of SPF grade were randomly divided into 4 groups: high (100 mg/ml) , medium (50 mg/ml) , low (25 mg/ml) concentration SiO(2) dusting group and normal negative control. Group, 20 in each group. Five rats were sacrificed at 7 d, 14 d, 28 d and 56 d after SiO(2) dusting. The degree of alveolitis and the degree of pulmonary fibrosis were observed. The enzyme-linked immunosorbent assay (ELISA) was used to detect IL-1ß in lung tissue. The expressions of NLRP3 and Caspase-1 in lung tissue of rats were detected by Western Blot. Results: The alveolitis score and fibrosis degree of the rats in the dust-receiving group were significantly higher than those in the control group at 7 d, 14 d, 28 d and 56 d, and the difference was statistically significant (P<0.01) . The concentrations of IL-1ß, IL-18 and TGF-ß1 in 14 d, 28 d and 56 d were significantly higher than those in the control group (P<0.01) . The expressions of NLRP3 and Caspase-1 in lung tissue of rats exposed to dust were 7 d and 14 d, 28 d, 56d were higher than the control group (P<0.01) ; the expression levels of NLRP3, Caspase-1, IL-1ß, IL-18 and TGF-ß(1) in the low, medium and high concentration SiO(2) dusting group were 7 d, 14 d and The difference between the two groups was statistically significant (P<0.05) , and both showed a time-effect relationship with the increase of dusting time. Conclusion: NLRP3 and its downstream factors Caspase-1, IL-1ß, IL-18 and TGF-ß1 are highly expressed in the lung tissue of rats with silicosis and pulmonary fibrosis, suggesting that the NLRP3/IL-1ß/TGF-ß(1) signal axis may be associated with silicosis. Pulmonary fibrosis has a close relationship and plays a role in the formation of silicosis.

[Serum levels of periostin and their influencing factors in the beta-lactam antibiotic enterprise workers].

Objective: To observe serum levels of periostin, ECP, IgE in the antibiotic enterprise workers, and study the role of periostin, ECP, IgE in the development of allergic inflammation. Methods: 90 cases with asthma or rhinitis were enrolled as disease group, another 117 workers exposed to 7-ACA、6-APA dust without suffering from allergic illness, are chosen as group of dust exposed, and 192 healthy workers who didn't contact dust were chosen as control group. Questionnaires were used to learn their basic information.Lung function was determined with a portable spirometer.The expression levels of periostin、ECP and IgE in serum were measured by enzyme-linked immuno sorbent assay. Results: The exposure group and disease group had significantly lower forced vital capacity (FVC) , forced expiratory volume in 1 second (FEV(l.0)) , and FEV(l.0)/FVC ratio than the control group (P<0.05) . The disease group had significantly higher eosinophil than the control group (P<0.05) . Compared with the control group, the exposure group, the disease group, asthma subgroup, rhinitis subgroup of serum periostin and IgE increased, the differences are statistically significant (P<0.05) . Serum levels of ECP in the workers of asthma subgroup were significantly higher than that in control group (P<0.05) . Serum expression levels of periostin were positively correlated with IgE, ECP in workers (P<0.001) , serum levels of periostin were negatively correlated with FEV(1.0) in workers (P<0.05) . Multiple logistics regression analysis found that exposure to 7-ACA or 6-APA (OR=3.09, 95%CI: 1.83-5.21) , age>47years (OR=2.53, 95%CI: 1.22-5.26) , higher ECP (OR=1.04, 95%CI: 1.01-1.06) were risk factors for increased serum periostin level. Conclusion: Occupational exposure to 7-ACA or 6-APA can result in higher serum periostin level, exposure to 7-ACA or 6-APA, age>47 years, higher ECP are risk factors for increased serum periostin level.

Influence of surgical resection of hepatocellular carcinoma(HCC) for hematogenous dissemination of HCC cells and its effect on recurrence and metastasis: 3 years prospective study.

Aims was to study whether hepatal surgery leads to hematogenous dissemination of hepatocellular carcinoma (HCC) cells and determine period of its persistence by nested reverse transcription-polymerase chain reaction (RT-PCR). Peripheral vein blood (5ml) samples were obtained from 54 HCC patients of T1N0M0 and 6 HCC patients of T2N0M0 stage and 20 patients with liver cavernous hemangioma(LCH) before operation and 48h,72h and 1 week after surgical resection of hepatoma between Janurary 1st, 2007 and December 31th, 2010. We detected alpha-fetoprotein (AFP) messenger RNA(mRNA) by nested RT-PCR perioperatively.FPmRNA of all 60 cases of HCC patients and 20 cases of LCH were negative before hepatal surgery, 28 of 60 HCC cases became positve at 48h after surgery (46.7%), 16 of 60 HCC cases remained positive at 72h postoperatively(26.7%), none of 60 HCC patients AFPmRNA was detected at 1 week after hepatal surgery(0.0%). None of LCH patients were detected AFPmRNA after hepatal surgery(0.0%). For 28 HCC patients with AFPmRNA positive after hepatal surgery, 4 HCC patients developed intrahepatic tumor recurrences in 1st year (4/28, 14.3%),6 HCC patients relapsed in the second year(6/28,21.4%),10 HCC patients relapsed in the third year(10/28,35.7%). For 32 HCC patients with AFPmRNA negative group postoperation, 5 cases relapsed in 1st year (5/32, 15.6%),7 cases developed intrahepatic tumor recurrences in the second year (7/32, 21.9%),11 cases relasped in the third year (11/32, 34.4%,P>0.05),none of HCC patients occured distal metastasis after surgical resection of hepatoma. None of LCH patients relapsed postoperation within three years.Hepatal surgery may cause HCC cells spreading into peripheral blood shortly, but it may be not concerning with recurrence or metastasis of HCC.