Huaier granule prolongs overall survival after curative resection of hepatocarcinoma carcinoma: A propensity score analysis.

BACKGROUND: The effectiveness and safety of huaier granules in reducing recurrence after curative resection of HCC have been confirmed, but it is unclear whether huaier granules can significantly prolong overall survival. AIM: To demonstrate the effectiveness of huaier granule for HCC after curative resection over a 5-year follow-up. METHOD: A total of 1265 HCC patients who underwent curative resection from January 2008 to January 2020 were enrolled, 1111 patients were finally enrolled according to the exclusion criteria, and the oncology outcome of Huaier granule was analyzed by propensity score matching method (PSM). RESULT: Before propensity score matching, huaier granule resulted in better 5- year overall survival (61.49% vs 54.92%, p = 0.0099) and recurrence-free survival (45.64% vs 38.42%, p = 0.0042) for HCC patients. For solitary HCC ≤30 mm, huaier granule resulted in similar 5- year recurrence-free survival (54.55% vs 50.13%, p = 0.4403), but better 5- year overall survival (82.42% vs70.08%, p = 0.0189). Similar to overall patients, huaier granule resulted in better 5- year overall survival (54.77% vs 51.37%, p = 0.1530) and recurrence-free survival (42.61% vs 35.62%, p = 0.0082) for solitary HCC >30 mm. After propensity score matching, we did confirm that huaier granules can significantly prolong overall survival by more than 5 years, the exception was recurrence-free survival in the HCC <30 mm cohort.

Therapeutic Effect of Catgut Implantation at Acupoint in a Mouse Model of Hepatocellular Carcinoma by Suppressing Immune Escape.

BACKGROUND: The occurrence and development of hepatocellular carcinoma (HCC) are closely related to immune function, as is the capacity of hepatoma cells to escape. Immunosurveillance is a key mechanism. Catgut implantation at acupoint (CIAA) is a promising acupuncture improvement method that can regulate immunity and has been widely used in the clinical treatment of a variety of diseases. The aim of this study is to observe the therapeutic effect of CIAA on HCC and to investigate the potential mechanism of immune escape. MATERIALS AND METHODS: A total of 40 mice were randomly divided into three groups: the HCC model group (n = 15), the CIAA treatment group (n = 15), and the control group (n = 10). HCC was chemically induced in 30 mice by the combination of DEN, carbon tetrachloride, and ethanol for 150 days. Among them, 15 were selected for CIAA treatment to ascertain the therapeutic effect. The mRNA expression levels of AFP, IL-10, PD-1, and CTLA-4 in three groups were examined by using RT-PCR. AFP and AKT expressions were measured by using western blotting. PD1, CTLA-4, IL-10, CD4+, and CD8+ protein expression levels were evaluated by using IHC. The mortality rate, body weight, and psychological conditions of three groups were also compared. RESULTS: The mRNA and protein expression levels of AFP, PD-1, CTLA-4, and IL-10 were significantly downregulated in the CIAA-treated mice in comparison with HCC mice. IHC assay shows that CD4+ and CD8+ expression levels were notably upregulated after CIAA treatment. Western blotting assay shows that AKT pathway was deactivated in CIAA-treated mice. CIAA notably reduced the mortality rate and inhibited weight loss caused by HCC and improved the overall psychological condition of the mice. CONCLUSIONS: Taken together, our data corroborate the effective potency of CIAA in the treatment of HCC by and inhibiting immune escape and deactivating the AKT pathway.