Assessment of water enema PET/CT: an effective imaging technique for the diagnosis of incidental colorectal 18F-FDG uptake.

BACKGROUND: To validate the feasibility of water enema PET/CT (WE-PET/CT) in incidental colorectal 18F-FDG uptake and improve the accuracy of diagnosing colorectal neoplastic lesions. METHODS: We retrospectively analysed the electronic records of 338 patients undergoing common PET/CT and WE-PET/CT at our hospital. PET/CT results were correlated with colonoscopy pathology and follow-up results. The ROC contrast curve was plotted to evaluate the accuracy of SUVmax on common PET/CT and WE-PET/CT for detecting neoplastic lesions. SUVmax and the median retention indexes (RIs) of cancerous, precancerous, and benign lesions and physiologic uptake were compared. RESULTS: The sensitivity, specificity and accuracy of diagnosing neoplastic lesions with common PET/CT were 84.0%, 78.3% and 80.2%, respectively. The corresponding results with WE-PET/CT were 95.8%, 96.5% and 96.2%. The AUC of SUVmax on WE-PET/CT was significantly higher than that on common PET/CT (0.935 vs. 0.524, p < 0.001). The median SUVmax on WE-PET/CT was significantly higher than that on common PET/CT in cancerous and precancerous lesions, and significantly decreased in benign lesions and physiologic uptake (p < 0.001). The RI was significantly different between cancerous lesions and physiologic uptake, between precancerous lesions and physiologic uptake, between benign lesions and physiologic uptake, and between cancerous and benign lesions (p < 0.05). CONCLUSIONS: WE-PET/CT is a noninvasive, well-tolerated and effective technique for diagnosing incidental colorectal 18F-FDG uptake. It is helpful for a timely colonoscopy and can effectively avoid an unnecessary colonoscopy for incidental colorectal 18F-FDG uptake.

Diagnostic performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT in preoperative parathyroid gland localization in secondary hyperparathyroidism.

BACKGROUND: Secondary hyperparathyroidism (SHPT) usually requires parathyroidectomy when drug regimens fail. However, obtaining an exact preoperative map of the locations of the parathyroid glands is a challenge. The purpose of this study was to compare the diagnostic performance of US, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT in patients with SHPT. METHODS: Sixty patients with SHPT who were undergoing dialysis were evaluated preoperatively by US, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT. Postoperative pathology served as the gold standard. The sensitivity, specificity, and accuracy were determined for each method. Spearman correlation analysis was used to analyse the correlation of hyperplastic parathyroid calcification with serum alkaline phosphatase (ALP) and parathyroid hormone (PTH). RESULTS: A total of 229 lesions in 60 patients were pathologically confirmed to be parathyroid hyperplasia, with 209 lesions in typical sites, 15 lesions in the upper mediastinum and 5 lesions in the thyroid. A total of 88.33% (53/60) of patients had four lesions. US, early and delayed 99mTc-MIBI SPECT/CT had significantly higher sensitivity and accuracy than dual-phase 99mTc-MIBI scintigraphy (P < 0.001). Furthermore, early 99mTc-MIBI SPECT/CT had significantly higher sensitivity (P < 0.001) and accuracy (P = 0.001 and P < 0.001) than US and delayed 99mTc-MIBI SPECT/CT. In patients with ectopic hyperplastic parathyroid glands, the sensitivity of early 99mTc-MIBI SPECT/CT (90%) was significantly higher than that of US (55%) and dual-phase 99mTc-MIBI scintigraphy (50%) (P < 0.05). The Spearman correlation results showed a significant albeit weak association between calcification and both serum PTH and ALP (P = 0.002). CONCLUSION: The ability of early 99mTc-MIBI SPECT/CT to detect hyperplastic parathyroid glands in patients with SHPT is superior to that of US, dual-phase 99mTc-MIBI scintigraphy and delayed 99mTc-MIBI SPECT/CT; furthermore, dual-phase 99mTc-MIBI SPECT/CT is not essential.

Hepatitis B virus X protein related lncRNA WEE2-AS1 promotes hepatocellular carcinoma proliferation and invasion.

Hepatitis B virus X protein (HBx) is involved in the initiation and progression of hepatocellular carcinoma (HCC) by regulating the host protein-coding genes. In this study, we showed that HBx altered the expression of lncRNAs to promote the progression of HCC. lncRNA microarray and quantitative reverse-transcription polymerase chain reactions (qRT-PCRs) were performed to identify lncRNAs that were differentially regulated by HBx in HCC cells and tissues. Protein, mRNA, and lncRNA expression analyses; cell cycle and apoptosis analyses; loss/gain-of-function analysis were performed to delineate the consequences of WEE2-AS1 upregulation in HCC cells. WEE2-AS1 over-expressed in HCC and was positively correlated to hepatitis B virus (HBV) infection, hepatic vascular invasion, poor tumor differentiation and poor patient prognosis. WEE2-AS1 also accelerated the proliferation, migration, invasion and cell cycle progression of HCC cells. Fermitin family member 3 (FERMT3) was a downstream target of WEE2-AS1. In conclusion, there is a preliminary HBx-WEE2-AS1- FERMT3 pathway which may serve as a therapeutic target for HBV-associated HCC.

Ropivacaine via nuclear factor kappa B signalling modulates CD62E expression and diminishes tumour cell arrest.

BACKGROUND: The issue whether anaesthesia has an impact on the prognosis of carcinoma has been widely discussed and remains debated. Ropivacaine has been widely used in perioperative period as a long acting local anesthetic. An early event during recurrence or metastasis of carcinoma is the adhesion of circulating tumour cells (CTCs) to endothelial cells (ECs) through binding adhesion molecules that are up-regulated on inflamed endothelium during the perioperative period or other periods. This study was to explore the impact of ropivacaine on the adhesion of tumour cells, providing evidences of its influence on the prognosis of carcinoma. MATERIALS AND METHODS: Human umbilical vein endothelial cells (HUVECs) were pre-treated with ropivacaine (10-7-10-5 M; 30 min) prior to treatment with tumour necrosis factor alpha (TNFα) (10 ng ml-1; 1, 4 and 8 h). Intercellular adhesion molecule-1 (ICAM-1), endothelial-selectin (CD62E) and vascular cell adhesion molecule-1 (VCAM-1) mRNA levels were detected via quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR). To clarify the underlying action mechanism, p65, p-p65, IκBα, p-IκBα, IKKα/ß and p-IKKα/ß protein levels were evaluated via western blotting. Cell viability and tumour cell adhesion assays were also assessed. RESULTS: The clinically usage concentration of ropivacaine (10-6 M) produced a significant decrease in CD62E expression compared with that produced by TNFα only (p < 0.001). Moreover, adhesion assays showed that ropivacaine effectively inhibited the adhesion of hepatoma cells (p < 0.01), human colon cancer cells (p < 0.01) and human leukemic monocyte (p < 0.01). Western blot results showed that pre-treatment with ropivacaine inhibited the phosphorylation of p65 (p < 0.05), IκBα (p < 0.001) and IKKα/ß (p < 0.01). CONCLUSIONS: Ropivacaine decreased the adhesion of tumour cells. Ropivacaine modulated CD62E expression by inhibiting the activation of NF-κB. These results might provide new insight into the issue whether anaesthesia has an impact on the prognosis of carcinoma.

Theoretical analysis of obliquely excited surface plasmon self-interference.

We present the theoretical analysis of surface plasmon polaritons induced by a tightly focused light beam at oblique incidence. Firstly, we propose a geometrical model to explain the evolution of SPPs effect as light deviating from normal incidence, and introduce a concept of critical oblique angle (θ(co)) which is one of the key factors affecting the stability, efficiency and lateral resolution of SPPs. Secondly, the integral expressions for the transmitted SPP field excited by a linearly polarized vortex beam are derived, using angular spectrum representation and rotation matrix trans-formation, for the oblique directions as parallel and perpendicular to polarization plane. An interesting finding is that the system completely goes out of SPP self-interference resonance at an incident angle smaller than θ(co) at parallel obliquity, while larger than θ(co) at perpendicular obliquity.

SMYD3 promotes hepatocellular carcinoma progression by methylating S1PR1 promoters.

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. SET and MYND domain-containing protein 3 (SMYD3) has been shown to promote the progression of various types of human cancers, including liver cancer; however, the detailed molecular mechanism is still largely unknown. Here, we report that SMYD3 expression in HCC is an independent prognostic factor for survival and promotes the proliferation and migration of HCC cells. We observed that SMYD3 upregulated sphingosine-1-phosphate receptor 1 (S1PR1) promoter activity by methylating histone 3 (H3K4me3). S1PR1 was expressed at high levels in HCC samples, and high S1PR1 expression was associated with shorter survival. S1PR1 expression was also positively correlated with SMYD3 expression in HCC samples. We confirmed that SMYD3 promotes HCC cell growth and migration in vitro and in vivo by upregulating S1PR1 expression. Further investigations revealed that SMYD3 affects critical signaling pathways associated with the progression of HCC through S1PR1. These findings strongly suggest that SMYD3 has a crucial function in HCC progression that is partially mediated by histone methylation at the downstream gene S1PR1, which affects key signaling pathways associated with carcinogenesis and the progression of HCC.

Anti-oncogene PTPN13 inactivation by hepatitis B virus X protein counteracts IGF2BP1 to promote hepatocellular carcinoma progression.

Hepatitis B x protein (HBx) affects cellular protein expression and participates in the tumorigenesis and progression of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Metabolic reprogramming contributed to the HCC development, but its role in HBV-related HCC remains largely unclear. Tyrosine-protein phosphatase nonreceptor type 13 (PTPN13) is a significant regulator in tumor development, however, its specific role in hepatocarcinogenesis remains to be explored. Here, we found that decreased PTPN13 expression was associated with HBV/HBx. Patients with low PTPN13 expression showed a poor prognosis. Functional assays revealed that PTPN13 inhibited proliferation and tumorigenesis in vitro and in vivo. Further mechanistic studies indicated that HBx inhibited PTPN13 expression by upregulating the expression of DNMT3A and interacting with DNMT3A. Furthermore, we found that DNMT3A bound to the PTPN13 promoter (-343 to -313 bp) in an epigenetically controlled manner associated with elevated DNA methylation and then inhibited PTPN13 transcription. In addition, we identified IGF2BP1 as a novel PTPN13-interacting gene and demonstrated that PTPN13 influences c-Myc expression by directly and competitively binding to IGF2BP1 to decrease the intracellular concentration of functional IGF2BP1. Overexpressing PTPN13 promoted c-Myc mRNA degradation independent of the protein tyrosine phosphatase (PTP) activity of PTPN13. Importantly, we discovered that the PTPN13-IGF2BP1-c-Myc axis was important for cancer cell growth through promoting metabolic reprogramming. We verified the significant negative correlations between PTPN13 expression and c-Myc, PSPH, and SLC7A1 expression in clinical HCC tissue samples. In summary, our findings demonstrate that PTPN13 is a novel regulator of HBV-related hepatocarcinogenesis and may play an important role in HCC. PTPN13 may serve as a prognostic marker and therapeutic target in HBV-related HCC patients.

HBx/ERα complex-mediated LINC01352 downregulation promotes HBV-related hepatocellular carcinoma via the miR-135b-APC axis.

Hepatitis B virus (HBV) infection plays an important role in hepatocarcinogenesis, especially in hepatocellular carcinoma (HCC). Long non-coding RNAs (lncRNAs) have emerged as crucial biomarkers and regulators in many cancers. Novel lncRNAs involved in the initiation and progression of HBV-related hepatocellular carcinoma (HCC) need to be investigated. Here, we report that the long non-coding RNA LINC01352 is markedly downregulated by HBV/HBx (HBV X protein) in HCC cells and clinical samples. The LINC01352 expression level in HCC is an independent prognostic factor for survival. We found that HBx suppresses LINC01352 promoter activity by forming a complex with the estrogen receptor (ERα). Furthermore, using a combination of in vitro and in vivo studies, we confirmed that HBx promotes HCC cell growth and metastasis by inhibiting LINC01352 expression. Further investigation revealed that the downregulation of LINC01352, which acts as an endogenous sponge, increases the expression of miR-135b, leading to the reduced production of adenomatous polyposis coli (APC), consequently activating Wnt/ß-catenin signalling to facilitate tumour progression. These findings strongly suggest that the LINC01352-miR-135b-APC axis regulated by the HBx/ERα complex acts as an important pathogenic factor for tumour progression, which may help provide a theoretical basis for the identification of new therapeutic targets for HBV-related HCC.

Development and external validation of prognostic nomograms in hepatocellular carcinoma patients: a population based study.

Background: We attempted to construct and validate novel nomograms to predict overall survival (OS) and cancer-specific survival (CSS) in patients with hepatocellular carcinoma (HCC). Methods: Models were established using a discovery set (n=10,262) obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Based on univariate and multivariate Cox regression analyses, we identified independent risk factors for OS and CSS. Concordance indexes (c-indexes) and calibration plots were used to evaluate model discrimination. The predictive accuracy and clinical values of the nomograms were measured by decision curve analysis (DCA). Results: Our OS nomogram with a c-index of 0.753 (95% confidence interval (CI), 0.745-0.761) was based on age, sex, race, marital status, histological grade, TNM stage, tumor size, and surgery performed, and it performed better than TNM stage. Our CSS nomogram had a c-index of 0.748 (95% CI, 0.740-0.756). The calibration curves fit well. DCA showed that the two nomograms provided substantial clinical value. Internal validation produced c-indexes of 0.758 and 0.752 for OS and CSS, respectively, while external validation in the Sun Yat-sen Memorial Hospital (SYMH) cohort produced a c-indexes of 0.702 and 0.686 for OS and CSS, respectively. Conclusions: We have developed nomograms that enable more accurate individualized predictions of OS and CSS to help doctors better formulate individual treatment and follow-up management strategies.

ANKHD1 is required for SMYD3 to promote tumor metastasis in hepatocellular carcinoma.

ABSRACT: BACKGROUND: Tumor metastasis is the major reason for poor prognosis of hepatocellular carcinoma (HCC) patients after hepatic resection. SMYD3 has been demonstrated to promote liver tumor metastasis in mice. However, the detailed molecular mechanism is still largely unknown. METHODS: The effect of SMYD3 on invasiveness and metastasis of HCC was analyzed by immunohistochemistry, migration assay, invasion assay, wound healing assay and in vivo lung metastasis assay. Mass spectrometry analysis was conducted using proteins pulled down by H3K4me3 antibody in SMYD3-overexpressing cells. Luciferase reporter, chromatin immunoprecipitation, Electrophoretic mobility shift assay were used to measure the regulation of SLUG transcription by SMYD3-ANKHD1. In addition, the role of SMYD3-ANKHD1 in determining clinical outcomes for HCC patients was investigated by immunohistochemistry in 243 HCC tissues. RESULTS: SMYD3 was an independent prognostic factor of HCC and promoted migration and invasion of human HCC cells. ANKHD1 was identified by mass spectrometry as a co-regulator with SMYD3. ANKHD1 interacted with H3K4me3 when cells were overexpressing SMYD3. The pro-migratory and pro-invasive effects of SMYD3 were attenuated when ANKHD1 was knocked down by siRNA. Furthermore, we found that SMYD3 bound and activated the SLUG gene promoter in a manner associated with elevating H3K4me3, H3K9Ac and H3K14Ac. Knockdown of ANKHD1 could attenuate the SMYD3-dependent activation of Slug expression. We further detected the expression of SMYD3 and ANKHD1 in 243 HCC patients and found that patients with positive coexpression of SMYD3 and ANKHD1 (SMYD3+ANKHD1+) had the shortest overall and recurrence-free survival. CONCLUSION: Our findings provide a novel molecular mechanism for the SMYD3-regulated HCC migration and metastasis, and indicates that SMYD3-ANKHD1 may be a potential target for treating HCC.

The diagnostic value of five serum tumor markers for patients with cholangiocarcinoma.

OBJECTIVE: To assess the clinical significance and diagnostic value of the single and combined detection of five tumor markers in patients with cholangiocarcinoma. METHODS: In total, 296 patients with biliary tract disease who were diagnosed and received treatment at Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University (17113011) during April 2011 to Dec 2017 were chosen for this study. Patients were divided into a cholangiocarcinoma group and a benign biliary tract disease group. Serum was collected from the patients, and the concentrations of AFP, CEA, CA125, CA19-9, CA72-4 and total bilirubin (TBIL) were tested. BM SPSS Statistics 22.0 was used to analyze the data. Receiver-operating characteristic (ROC) curves for the single and combined detection of five tumor markers were generated, and the sensitivity, specificity, and area under ROC curve (AUC) were calculated. RESULTS: The concentrations of serum tumor markers in the cholangiocarcinoma group were higher than those in the benign biliary tract disease group. The AUCs for the single detections of the AFP, CEA, CA125, CA19-9, CA72-4 were 0.654, 0.808, 0.772, 0.833, and 0.743, and the optimal cutoffs were 2.58 ng/mL, 2.85 ng/mL, 23.85 U/mL, 46.75 U/mL, and 2.46 U/mL respectively. The combined detection of CEA, CA125 and CA19-9 had great diagnostic value. Its AUC was 0.888, its sensitivity was 85.1%, and its specificity was 83.1%. CONCLUSIONS: The levels of CEA, CA125, CA19-9 and CA72-4 had a different diagnostic value for cholangiocarcinoma, and combined serum CEA, CA125 and CA19-9 would have the best clinical diagnostic effect of cholangiocarcinoma.

Uridine-cytidine kinase 2 promotes metastasis of hepatocellular carcinoma cells via the Stat3 pathway.

INTRODUCTION: Uridine-cytidine kinase 2 (Uck2) has been demonstrated to activate antitumor prodrugs and regulate chemosensitivity in cancer cells. However, the expression and function of Uck2 in hepatocellular carcinoma (HCC) remain unknown. In this study, we were the first to systematically elucidate the role of Uck2 in HCC. PATIENTS AND METHODS: Uck2 gene expression was queried between normal liver tissues and HCC in a web-based data mining platform (www.oncomine.org). Uck2 gene expression in tissue microarray was determined by immunohistochemical staining. The clinical and prognostic significance of Uck2 expression was statistically analyzed. Stable cell lines with increased Uck2 expression were established using lentivirus-based vectors, and RNAi technology was used to transiently downregulate Uck2 expression. Cell migration and invasion were assessed by using wound-healing and transwell assays, respectively. mRNA and protein expression levels were determined using quantitative real-time PCR and Western blotting, respectively. RESULTS: We report the upregulation of Uck2 expression in HCC tissues. We explored the relationship between Uck2 levels and the clinicopathological features of HCC patients. High Uck2 notably correlated with early recurrence and poor prognosis in HCC patients. Uck2 expression in HCC cell lines regulated the cell migration and invasion capacities in vitro. The stable overexpression of Uck2 in Bel-7402 cells promoted their metastasis ability in vivo. Furthermore, the Uck2 upregulation increased the MMP2/9 expression and activated the Stat3 signaling pathway. In addition, WP1066, a Stat3 inhibitor, neutralized the effects of Uck2 on the MMP2/9 expression and the migration and invasion capacities of HCC cells. CONCLUSION: Our data suggest that Uck2 promotes HCC cell migration and invasion via the Stat3 signaling pathway and might be a novel potential target in HCC therapy.

A Novel Inflammation-Based Prognostic Score: The Fibrinogen/Albumin Ratio Predicts Prognoses of Patients after Curative Resection for Hepatocellular Carcinoma.

BACKGROUND: Inflammation is an important hallmark of cancer. Fibrinogen and albumin are both vital factors in systemic inflammation. This study investigated the prognostic value of the fibrinogen/albumin ratio in HCC patients who underwent curative resection. METHODS: HCC patients (n = 151) who underwent curative resection were evaluated retrospectively. The optimal cutoff value for the fibrinogen/albumin ratio was selected by receiver operating characteristic (ROC) curve analysis. Correlations between preoperative fibrinogen/albumin ratios and clinicopathologic characteristics were analyzed by χ2 test. The area under the receiver operating characteristic curve (AUC) was calculated to compare the prognostic value of the fibrinogen/albumin ratio with other prognostic scores (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and albumin-bilirubin (ALBI) score). The overall survival (OS) and time to recurrence (TTR) were assessed by the log-rank test and the Cox proportional hazard regression model. RESULTS: An optimal cutoff value of the preoperative fibrinogen/albumin ratio (0.062) was determined for 151 patients who underwent curative resection for HCC via a ROC curve analysis. Fibrinogen/albumin ratio > 0.062 was significantly associated with microvascular invasion, an advanced BCLC stage, and ALBI grade. Multivariate analyses revealed that fibrinogen/albumin ratio was an independent predictor for OS (P = 0.003) and TTR (P = 0.035). The prognostic ability of fibrinogen/albumin ratio was comparable to other prognostic scores (NLR, PLR, and ALBI score) by AUC analysis. Patients with a fibrinogen/albumin ratio > 0.062 had lower 1-, 3-, and 5-year OS rates (66.0%, 41.8%, and 28.2% versus 81.9%, 69.3%, and 56.1%, resp., P < 0.001) and higher 1-, 3-, and 5-year recurrence rates (60.9%, 79.2%, and 90.5% versus 49.5%, 69.1%, and 77.1%, resp., P = 0.008) compared with patients with fibrinogen/albumin ratio ≤ 0.062. CONCLUSION: The preoperative fibrinogen/albumin ratio is an effective prognostic factor for HCC patients who underwent curative resection. An elevated fibrinogen/albumin ratio significantly correlates with poorer survival and a higher risk of recurrence in HCC patients.

Therapeutic significance and indications of pulmonary metastasectomy for hepatocellular carcinoma following liver resection.

BACKGROUND: To explore the therapeutic significance and indications of pulmonary metastasectomy (PMT) in hepatocellular carcinoma (HCC) patients with pulmonary metastasis (PM) following liver resection (LR). PATIENTS AND METHODS: PM-HCC patients who underwent LR were retrospectively enrolled, and survival outcomes and prognostic factors were analyzed. Patients were divided into PMT and non-PMT group, and propensity score matching (PSM) analysis was used for survival comparison. Prognostic analysis and survival comparisons were performed specifically in PMT patients. RESULTS: Ninety-seven patients were enrolled, among which twenty-six underwent PMT while seventy-one did not. Survival outcome was superior in PMT group compared to non-PMT group (33.5 vs. 10.5 months) (p = 0.003), while no statistical difference was found after PSM analysis (33.5 vs. 11.2 months) (p = 0.138). Synchronous PM-HCC, serum alpha fetal protein≥400 ng/ml at PM diagnosis, no intrahepatic treatments (LR, ablation or transarterial chemoembolization) after LR, intrahepatic recurrence or metastasis at repeated PM diagnosis were inferior independent prognostic factors in PMT patients (p < 0.05). Superior survival outcomes were seen in candidate PMT patients when corresponding indications were satisfied (p = 0.014, p = 0.005). CONCLUSION: PMT might provide potential survival benefits in well selected PM-HCC patients who underwent LR. Well designed, multi-institutional studies with larger patient number were still to be required.

Epithelial-Mesenchymal Transition is Superior to Vessels-Encapsulate Tumor Cluster in Promoting Metastasis of Hepatocellular Carcinoma: a Morphological Evidence.

Purpose Vessels-encapsulate tumor cluster (VETC) is a vascular pattern distinct from classical capillary-like pattern. It is reported that VETC structure is common in hepatocellular carcinoma (HCC) and can promote HCC metastasis in an epithelial-mesenchymal transition (EMT)-independent but VETC-dependent manner. However, the main metastatic manner of HCC containing both VETC and classical vascular structure (we called VETC±) is unknown. Methods Vascular pattern types and E-cadherin expression were evaluated by immunohistochemical staining in 168 HCC tissues, 50 pairs of primary HCC tissues and intrahepatic metastatic lesions, as well as 12 pairs of primary HCC tissues and major portal vein tumor thrombus. Survival and recurrence rates were evaluated using Kaplan-Meier analysis. The multivariate Cox proportional hazards model was used to determine the independent prognostic factors of HCC. Results VETC± cases were more common than VETC+ cases (HCC tissues with a VETC pattern fully distributed in the HCC section) in HCC. Statistical analysis showed that VETC± was an independent predictor of survival and recurrence. Furthermore, E-cadherin was positively correlated with the presence of VETC structure. In the case of HCCs with VETC±, their metastases (both intrahepatic and major vascular) were more likely to be VETC negative. Conclusions Our findings suggest that EMT may be superior to VETC in promoting HCC metastasis. Thus, both anti-EMT and anti-VETC agents should be considered in the case of HCC with VETC±.

Genomic and Epigenomic Heterogeneity of Hepatocellular Carcinoma.

Understanding the intratumoral heterogeneity of hepatocellular carcinoma is instructive for developing personalized therapy and identifying molecular biomarkers. Here we applied whole-exome sequencing to 69 samples from 11 patients to resolve the genetic architecture of subclonal diversification. Spatial genomic diversity was found in all 11 hepatocellular carcinoma cases, with 29% of driver mutations being heterogeneous, including TERT, ARID1A, NOTCH2, and STAG2. Similar with other cancer types, TP53 mutations were always shared between all tumor regions, that is, located on the "trunk" of the evolutionary tree. In addition, we found that variants within several drug targets such as KIT, SYK, and PIK3CA were mutated in a fully clonal manner, indicating their therapeutic potentials for hepatocellular carcinoma. Temporal dissection of mutational signatures suggested that mutagenic processes associated with exposure to aristolochic acid and aflatoxin might play a more important role in early, as opposed to late, stages of hepatocellular carcinoma development. Moreover, we observed extensive intratumoral epigenetic heterogeneity in hepatocellular carcinoma based on multiple independent analytical methods and showed that intratumoral methylation heterogeneity might play important roles in the biology of hepatocellular carcinoma cells. Our results also demonstrated prominent heterogeneity of intratumoral methylation even in a stable hepatocellular carcinoma genome. Together, these findings highlight widespread intratumoral heterogeneity at both the genomic and epigenomic levels in hepatocellular carcinoma and provide an important molecular foundation for better understanding the pathogenesis of this malignancy. Cancer Res; 77(9); 2255-65. ©2017 AACR.

Advanced glycosylation end product promotes forkhead box O1 and inhibits Wnt pathway to suppress capacities of epidermal stem cells.

Diabetes mellitus is frequently accompanied by chronic complications like delayed wound healing, which is consider to be attributed to the accumulation of advanced glycosylation end product (AGE). However, the impacts of AGE on epidermal stem cells (ESCs) are largely unknown. This study aims to address the influence and mechanism of AGE on ESCs. ESCs isolated from rats were cultured in AGE-modified bovine serum albumin and transfected with small interfering RNA to knock down AGE-specific receptor (AGER). Expression of stem cell markers integrin ß1 (ITGB1) and keratin 19 (KRT19), cell viability, apoptosis and reactive oxygen species (ROS) were examined. Wnt pathway-related factors Wnt family member 1 (WNT1), WNT3A, ß-catenin, v-myc avian myelocytomatosis viral oncogene homolog (MYC), cyclin D1 (CCND1) and matrix metallopeptidase 7 (MMP7) were quantified. The interaction between forkhead box O1 (FOXO1) and ß-catenin was assessed by co-immunoprecipitation. Results indicated that AGE down-regulated ITGB1 and KRT19 expression, suppressed ESC viability and promoted apoptosis, and ROS level (P < 0.01), implying decreased capacities of ESCs. AGE also promoted AGER and FOXO1, while AGER knockdown had the opposite effects. Moreover, AGER knockdown elevated the level of WNT1, WNT3A, MYC, CCND1 and MMP7 that were suppressed by AGE (P < 0.01). Immunoprecipitation analysis showed that FOXO1 could compete with lymphoid enhancer binding factor 1 to interact with ß-catenin, which might help to elucidate the mechanism of AGE repressing ESCs. This study helps to understand the mechanism of accumulated AGE in affecting ESC capacities, and provides potential therapeutic targets to meliorate diabetic wound healing.

Lin28B over-expression mediates the repression of let-7 by hepatitis B virus X protein in hepatoma cells.

The Let-7 microRNA (miRNA) family is frequently downregulated in multiple human tumors, including hepatocellular carcinoma (HCC). Our previous report demonstrated that hepatitis B virus X protein (HBx) suppressed the expression of let-7 in HepG2 hepatoma cells. However, the underlying mechanisms were not elucidated. Lin28B is known to negatively regulate the maturation of let-7, and this prompted us to determine whether HBx acts through Lin28B to suppress let-7. Real-time reverse-transcription polymerase chain reaction (qRT-PCR) was performed to examine let-7 expression before and after treatment with c-Myc-and Lin28B-specific siRNAs in HepG2 cells stably/transiently transfected with HBx. mRNA and protein analyses were employed to determine the correlation of HBx, c-Myc and Lin28B in HCC tissues and cells. Cell cycle and proliferation assays were performed to delineate the consequences of Lin28B repression in HepG2 cells expressing HBx. Lin28B was overexpressed in HBx-transfected cells and HBV-infected liver tissues. HBx-c-Myc-Lin28B axis mediated the repression of let-7 in HepG2 cells. Reduced expression of Lin28B inhibited the growth and cell cycle progression of HepG2 cells by derepressing let-7 and repressing c-Myc. There was not only a preliminary HBx-c-Myc-Lin28B-let-7 pathway but also another possible double-negative feedback loop between c-Myc/Lin28B and let-7 in HepG2 cells transfected with HBx, which together induced the deregulation of let-7. Lin28B has the potential to be a novel molecular target in the treatment of HBV(+) HCC.