RESUMO
Emerging hepatocellular carcinoma (HCC) has been sequentially reported in chronic hepatitis C virus (HCV) treated with direct-acting antivirals (DAAs). Homeobox transcript antisense RNA (HOTAIR), an oncogene, has been reported to be associated with cancer. We investigated the predictive value of lnc-HOTAIR for HCC surveillance in chronic HCV patients following DAAs therapy. The expression levels of lnc-HOTAIR and ATG-7 genes were measured in 220 with chronic HCV, following a DAAs based therapy for 12 weeks, the patients were followed-up for attentive surveillance of HCC for 12 months after starting DAAs. In terms of lnc-HOTAIR, patients with HCC and high viral load had significantly higher median expression levels of HOTAIR of (68 vs. 24; p = .001) and (94 vs. 52; p = .001), respectively. Moreover, the median expression level of ATG-7 was higher in those who developed HCC (114 vs. 51; p = .001). The expression of lnc-HOTAIR and ATG-7 are significant predictors of the development of HCC in HCV-4 infected patients treated with DAAs, with a cut-off value of 37 and 86, respectively. The increased expression levels of lnc-HOTAIR more than 68 in HCC patients following DAAs were correlated with poorer disease outcomes compared to those with lower expression levels; however, ATG-7 expression levels more than 114 were correlated with worse overall survival but not the progression-free one. We suggest that high expression levels of lnc-HOTAIR could serve as a risk assessment biomarker for HCC before and during DAAs course therapy in Chronic HCV-4 patients, and should be rigorously taken into consideration before DAAs.
Assuntos
Antivirais/administração & dosagem , Proteína 7 Relacionada à Autofagia/genética , Carcinoma Hepatocelular/virologia , Hepacivirus/genética , Hepatite C Crônica/tratamento farmacológico , Neoplasias Hepáticas/virologia , RNA Longo não Codificante/genética , Idoso , Antivirais/farmacologia , Proteína 7 Relacionada à Autofagia/metabolismo , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/metabolismo , Progressão da Doença , Feminino , Genótipo , Hepacivirus/efeitos dos fármacos , Hepacivirus/crescimento & desenvolvimento , Hepatite C Crônica/complicações , Hepatite C Crônica/genética , Hepatite C Crônica/metabolismo , Humanos , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/metabolismo , Masculino , Pessoa de Meia-Idade , Prognóstico , Análise de Sobrevida , Resultado do Tratamento , Regulação para Cima , Carga Viral/efeitos dos fármacosRESUMO
Objectives: To establish a novel transcranial color-coded sonography (TCCS) grading system for collateral circulation in cases of symptomatic chronic total carotid occlusion (TCO), and to correlate this new grading system with cerebrovascular reserve capacity (CVR) measured by SPECT. Methods: Thirty-four patients with symptomatic chronic TCO recruited from the neurovascular ultrasound laboratory of the department of Neurology at Cairo University Hospital during 3 years' time period and diagnosed by color-coded duplex were subjected to: clinical assessment, grading of cerebral collaterals using a proposed TCCS criteria, Brain SPECT studies at rest and with dipyridamole stress. Results: The new grading system for cerebral collateral circulation showed a significant positive correlation with CVR (P < 0.001 and Spearman correlation coefficient 0.686). Conclusion: The current study showed that this new TCCS grading system for cerebral collaterals is a reliable indicator for cerebral perfusion and reserve capacity in cases of chronic symptomatic TCO.