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Tsvetkova V, Magro G, Broggi G, Luchini C, Cappello F, Caporalini C, Buccoliero AM, Santoro L. New insights in gastrointestinal "pediatric" neoplasms in adult patients: pancreatoblastoma, hepatoblastoma and embryonal sarcoma of the liver. A practical approach by GIPPI-GIPAD Groups. Pathologica 2022; 114:64-78. [PMID: 35212317 PMCID: PMC9040550 DOI: 10.32074/1591-951x-559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 12/11/2022] Open
Abstract
Pediatric solid neoplasms are rare and very different from those observed in adults. The majority of them are referred to as embryonal because they arise as a result of alterations in the processes of organogenesis or normal growth and are characterized by proliferation of primitive cells, reproducing the corresponding tissue at various stages of embryonic development. This review will focus on embryonal gastrointestinal pediatric neoplasms in adult patients, including pancreatoblastoma, hepatoblastoma, and embryonal sarcoma of the liver. Although they are classically considered pediatric neoplasms, they may (rarely) occur in adult patients. Hepatoblastoma represents the most frequent liver neoplasm in the pediatric population, followed by hepatocellular carcinoma and embryonal sarcoma of the liver; while pancreatoblastoma is the most common malignant pancreatic tumor in childhood. Both in children and adults, the mainstay of treatment is complete surgical resection, either up front or following neoadjuvant chemotherapy. Unresectable and/or metastatic neoplasms may be amenable to complete delayed surgery after neoadjuvant chemotherapy. However, these neoplasms display a more aggressive behavior and overall poorer prognosis in adults than in children, probably because they are diagnosed in later stages of diseases.
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Affiliation(s)
- Vassilena Tsvetkova
- Department of Diagnostics and Public Health, Section of Pathology, Verona University and Hospital Trust; Verona, Italy
| | - Gaetano Magro
- Department of Medical and Surgical Sciences and Advanced Technologies "G. F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Giuseppe Broggi
- Department of Medical and Surgical Sciences and Advanced Technologies "G. F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, Verona University and Hospital Trust; Verona, Italy
| | - Filippo Cappello
- Department of Pathology, Azienda Ospedaliera Universitaria di Padova, Padova, Italy
| | | | | | - Luisa Santoro
- Department of Pathology, Azienda Ospedaliera Universitaria di Padova, Padova, Italy
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Long non-coding RNA Linc00205 promotes hepatoblastoma progression through regulating microRNA-154-3p/Rho-associated coiled-coil Kinase 1 axis via mitogen-activated protein kinase signaling. Aging (Albany NY) 2022; 14:1782-1796. [PMID: 35179516 PMCID: PMC8908927 DOI: 10.18632/aging.203902] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 09/18/2021] [Indexed: 11/25/2022]
Abstract
Hepatoblastoma (HB) is the most common pediatric liver tumor. The significant tumor heterogeneity of HB leads to varied prognoses among children with the disease. Recent studies have suggested that long non-coding RNAs (lncRNAs) can serve as novel therapies for HB treatment. Thus, in this study, we aimed to reveal the function and mechanism of the lncRNA Linc00205 in HB. Our results exhibited that, in both HB tissues and cell lines, levels of Linc00205 were significantly increased. In addition, knockdown of Linc00205 led to suppression of HB development. Moreover, we identified that Linc00205 was able to directly bind to miR-154-3p, thus isolating miR-154-3p from its target Rho-associated coiled-coil Kinase 1 (ROCK1). Further cellular behavioral experiments elucidated that the miR-154-3p inhibitor and ROCK1 overexpression were able to reverse the effect of downregulated Linc00205 on proliferation, migration, invasion, and apoptosis of HB cells by rescue assays via mitogen-activated protein kinase (MAPK) signaling. Our results demonstrated that Linc00205 enhanced HB progression by regulating ROCK1 expression via sponging miR-154-3p through MAPK signaling, which suggests a novel potential therapeutic target for HB.
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Abstract
Teratoid hepatoblastoma (HB) is a variant of mixed HB described as having a mixture of heterologous components. A 3-year-old boy presented for a liver transplant evaluation due to persistent HB. His liver was biopsied as well as a perirenal mass. Histologic examination demonstrated elements of yolk sac tumor and review of original resection showed a neuroendocrine component. This unique combination of histology has not been reported before in HB. Also, this case presents a unique diagnostic challenge as it presented with a metastasis containing yolk sac elements. Recognition and awareness of this histologic variant are important to accurately identify metastatic lesions.
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Affiliation(s)
- Jacob A Smith
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sarangarajan Ranganathan
- Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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4
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Ranganathan S, Lopez-Terrada D, Alaggio R. Hepatoblastoma and Pediatric Hepatocellular Carcinoma: An Update. Pediatr Dev Pathol 2020; 23:79-95. [PMID: 31554479 DOI: 10.1177/1093526619875228] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hepatoblastomas (HBs) and pediatric hepatocellular carcinomas (HCCs) together account for almost 80% of primary malignant liver tumors in children and adolescents/young adults. Children's Hepatic International Collaboration (CHIC), Children's Oncology Group (COG), SociétéInternationale d'Oncologie Pédiatrique (SIOP), and International Childhood Liver Tumors Strategy Group trials have contributed to define prognostic factors and risk stratification in these tumors. The recently proposed histologic International Consensus classification of HB and HCC in children based on retrospective analysis from CHIC cases represents the base to define entities with homogeneous clinicopathologic and molecular features. This review will provide a morphologic guide for the upcoming International Liver Tumor treatment trial (Pediatric Hepatic International Tumour Trial) to be conducted through several continents. There will be an emphasis on molecular features and immunohistochemical markers for the definition of the individual histologic subtypes of HB and to better characterize the group of liver tumors in the provisional category of hepatocellular neoplasm-not otherwise specified. A brief overview of HCC in children will also be provided.
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Affiliation(s)
- Sarangarajan Ranganathan
- Department of Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pathology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Dolores Lopez-Terrada
- Department of Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pathology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Rita Alaggio
- Department of Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pathology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
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Heck JE, Lee PC, Wu CK, Tsai HY, Ritz B, Arah OA, Li CY. Gestational risk factors and childhood cancers: A cohort study in Taiwan. Int J Cancer 2020; 147:1343-1353. [PMID: 32020595 DOI: 10.1002/ijc.32905] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/05/2019] [Accepted: 01/13/2020] [Indexed: 12/18/2022]
Abstract
Gestational risk factors such as birth weight, gestational age and parity have been repeatedly found to be related to pediatric cancers, but few reports have emerged from Asian countries. Here we report on demographic and gestational factors in a Taiwanese cohort. Our study included all children born in Taiwan 2004-2014 for whom there was a birth record (n = 2,079,037), of which 1900 children had been diagnosed with cancer prior to age 12. We conducted multivariable hazard regression to examine associations between demographic and gestational factors with cancer. Greater parity (family with 2+ older children) was related to acute myeloid leukemia [Hazard ratio (HR) = 2.15, 95% confidence interval (CI): 1.31, 3.55), central nervous system tumors (HR = 1.67, CI: 1.13, 2.48) and neuroblastoma (HR = 1.67, CI: 1.07, 2.63). Hepatoblastoma cases had a higher risk of low birth weight (<2,500 g; HR = 3.01, CI: 1.85, 4.91), very preterm birth (<33 weeks gestation; HR = 13.71, CI: 7.45, 25.23), plural pregnancies (HR = 2.37, CI: 1.10, 5.14) and both small (HR = 2.13, CI: 1.23, 3.67) and large (HR = 1.83, CI: 1.01, 3.32) for gestational age. Germ cell tumors were more common among children born in rural areas (HR = 1.63, CI: 1.02, 2.60). Despite that Taiwan has lower rates of both high and low birthweight compared to other developed nations, we observed several similar associations to those reported in Western Countries. Further research should examine unique exposures in Taiwan that may be contributing to higher incidence of certain cancer types.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA.,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chia-Kai Wu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hsin-Yun Tsai
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA.,Department of Statistics, UCLA College of Letters and Science, Los Angeles, CA.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
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6
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Pruente JR, Deike DE, Lockart B, Gaebler-Spira D. The association of hepatoblastoma, prematurity and cerebral palsy: Case reports. J Pediatr Rehabil Med 2020; 13:185-188. [PMID: 32444576 DOI: 10.3233/prm-190662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Hepatoblastoma is the most common primary liver tumor in children and has a greater incidence in children with a history of prematurity and very low birth weight. To increase awareness of the association between prematurity and hepatoblastoma for health care providers who treat children with Cerebral Palsy (CP), we present two case reports. METHODS Two case reports of premature, very low birth weight infants with hepatoblastoma are described and a literature review of hepatoblastoma in the setting of prematurity and cerebral palsy is performed. RESULTS Each patient had a history of 26-28 week prematurity, very low birth weight, and CP. Both presented with worsening constipation and abdominal distension that did not respond to oral medications. Appropriate referrals to the ER were made which lead to a diagnosis of hepatoblastoma. Pediatric rehabilitation was a source of referral for diagnosis in one patient and aided in the rehabilitation course following treatment for both patients. CONCLUSIONS Hepatoblastoma is the most common primary liver tumor in children and has an increased incidence in children with a history of prematurity and very low birth weight. Providers who frequently care for the very low birth weight and premature children with CP should be aware of this correlation and include hepatoblastoma in the differential when managing patients with suddenly worsening constipation or abdominal distension. Pediatric physiatrists and other providers for these patients could be a source of referrals and diagnosis leading to timely treatment.
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Affiliation(s)
- Jessica R Pruente
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Dawn E Deike
- Department of Pediatric Physical Medicine and Rehabilitation, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Barbara Lockart
- Department of Hematology and Oncology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Department of Pediatric Physical Medicine and Rehabilitation, Shirley Ryan AbilityLab, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Loss of EGFR-ASAP1 signaling in metastatic and unresectable hepatoblastoma. Sci Rep 2016; 6:38347. [PMID: 27910913 PMCID: PMC5133573 DOI: 10.1038/srep38347] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 11/09/2016] [Indexed: 02/08/2023] Open
Abstract
Hepatoblastoma (HBL), the most common childhood liver cancer is cured with surgical resection after chemotherapy or with liver transplantation if local invasion and multifocality preclude resection. However, variable survival rates of 60–80% and debilitating chemotherapy sequelae argue for more informed treatment selection, which is not possible by grading the Wnt-β-catenin over activity present in most HBL tumors. A hypothesis-generating whole transcriptome analysis shows that HBL tumors removed at transplantation are enriched most for cancer signaling pathways which depend predominantly on epidermal growth factor (EGF) signaling, and to a lesser extent, on aberrant Wnt-β-catenin signaling. We therefore evaluated whether EGFR, ASAP1, ERBB2 and ERBB4, which signal downstream after ligation of EGF, and which show aberrant expression in several other invasive cancers, would also predict HBL tumor invasiveness. Immunohistochemistry of HBL tumors (n = 60), which are histologically heterogeneous, shows that compared with well-differentiated fetal cells, less differentiated embryonal and undifferentiated small cells (SCU) progressively lose EGFR and ASAP1 expression. This trend is exaggerated in unresectable, locally invasive or metastatic tumors, in which embryonal tumor cells are EGFR-negative, while SCU cells are EGFR-negative and ASAP1-negative. Loss of EGFR-ASAP1 signaling characterizes undifferentiated and invasive HBL. EGFR-expressing HBL tumors present novel therapeutic targeting opportunities.
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8
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Bissig-Choisat B, Kettlun-Leyton C, Legras XD, Zorman B, Barzi M, Chen LL, Amin MD, Huang YH, Pautler RG, Hampton OA, Prakash MM, Yang D, Borowiak M, Muzny D, Doddapaneni HV, Hu J, Shi Y, Gaber MW, Hicks MJ, Thompson PA, Lu Y, Mills GB, Finegold M, Goss JA, Parsons DW, Vasudevan SA, Sumazin P, López-Terrada D, Bissig KD. Novel patient-derived xenograft and cell line models for therapeutic testing of pediatric liver cancer. J Hepatol 2016; 65:325-33. [PMID: 27117591 PMCID: PMC5668139 DOI: 10.1016/j.jhep.2016.04.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 04/04/2016] [Accepted: 04/08/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Pediatric liver cancer is a rare but serious disease whose incidence is rising, and for which the therapeutic options are limited. Development of more targeted, less toxic therapies is hindered by the lack of an experimental animal model that captures the heterogeneity and metastatic capability of these tumors. METHODS Here we established an orthotopic engraftment technique to model a series of patient-derived tumor xenograft (PDTX) from pediatric liver cancers of all major histologic subtypes: hepatoblastoma, hepatocellular cancer and hepatocellular malignant neoplasm. We utilized standard (immuno) staining methods for histological characterization, RNA sequencing for gene expression profiling and genome sequencing for identification of druggable targets. We also adapted stem cell culturing techniques to derive two new pediatric cancer cell lines from the xenografted mice. RESULTS The patient-derived tumor xenografts recapitulated the histologic, genetic, and biological characteristics-including the metastatic behavior-of the corresponding primary tumors. Furthermore, the gene expression profiles of the two new liver cancer cell lines closely resemble those of the primary tumors. Targeted therapy of PDTX from an aggressive hepatocellular malignant neoplasm with the MEK1 inhibitor trametinib and pan-class I PI3 kinase inhibitor NVP-BKM120 resulted in significant growth inhibition, thus confirming this PDTX model as a valuable tool to study tumor biology and patient-specific therapeutic responses. CONCLUSIONS The novel metastatic xenograft model and the isogenic xenograft-derived cell lines described in this study provide reliable tools for developing mutation- and patient-specific therapies for pediatric liver cancer. LAY SUMMARY Pediatric liver cancer is a rare but serious disease and no experimental animal model currently captures the complexity and metastatic capability of these tumors. We have established a novel animal model using human tumor tissue that recapitulates the genetic and biological characteristics of this cancer. We demonstrate that our patient-derived animal model, as well as two new cell lines, are useful tools for experimental therapies.
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Affiliation(s)
- Beatrice Bissig-Choisat
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Claudia Kettlun-Leyton
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Xavier D. Legras
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Barry Zorman
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Mercedes Barzi
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Leon L. Chen
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Mansi D. Amin
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Yung-Hsin Huang
- Program in Developmental Biology, Baylor College of Medicine, Houston, TX, USA
| | - Robia G. Pautler
- Small Animal Imaging Facility, Texas Children’s Hospital, Houston, TX, USA,Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, USA
| | - Oliver A. Hampton
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Masand M. Prakash
- Department of Pediatric Radiology, Texas Children’s Hospital, Houston, TX, USA
| | - Diane Yang
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA,Graduate Program Department of Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Malgorzata Borowiak
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA,Program in Developmental Biology, Baylor College of Medicine, Houston, TX, USA,Graduate Program Department of Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX, USA,McNair Medical Institute, Houston, USA
| | - Donna Muzny
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | | | - Jianhong Hu
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Yan Shi
- Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation and Division of Hepatobiliary Surgery, Baylor College of Medicine, Houston, TX, USA,Department of Surgery, Texas Children’s Hospital, Houston, TX, USA
| | - M. Waleed Gaber
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA,Small Animal Imaging Facility, Texas Children’s Hospital, Houston, TX, USA,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - M. John Hicks
- Department of Pathology, Texas Children’s Hospital, Houston, TX, USA
| | | | - Yiling Lu
- Department of Systems Biology, MD Anderson Cancer Center, Houston, TX, USA
| | - Gordon B. Mills
- Department of Systems Biology, MD Anderson Cancer Center, Houston, TX, USA
| | - Milton Finegold
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA,Department of Pathology, Texas Children’s Hospital, Houston, TX, USA
| | - John A. Goss
- Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation and Division of Hepatobiliary Surgery, Baylor College of Medicine, Houston, TX, USA,Department of Surgery, Texas Children’s Hospital, Houston, TX, USA
| | - D. Williams Parsons
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA,Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Sanjeev A. Vasudevan
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA,Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation and Division of Hepatobiliary Surgery, Baylor College of Medicine, Houston, TX, USA,Department of Surgery, Texas Children’s Hospital, Houston, TX, USA
| | - Pavel Sumazin
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Dolores López-Terrada
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA,Department of Pathology, Texas Children’s Hospital, Houston, TX, USA
| | - Karl-Dimiter Bissig
- Center for Cell and Gene Therapy, Stem Cells and Regenerative Medicine Center, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA; Program in Developmental Biology, Baylor College of Medicine, Houston, TX, USA; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA; Graduate Program Department of Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX, USA.
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Deshpande G, Patel MD. Emergency hepatic resection a life saving procedure in ruptured hepatoblastoma: case report. Indian J Surg Oncol 2013; 4:169-71. [PMID: 24426723 PMCID: PMC3693135 DOI: 10.1007/s13193-013-0228-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Accepted: 02/05/2013] [Indexed: 11/25/2022] Open
Affiliation(s)
- Gururaj Deshpande
- Department of Surgical Oncology, Gujarat Cancer and Research Institute, New Civil Hospital Campus, Asarwa, Ahmedabad, 380016 India
| | - Mahesh D. Patel
- Department of Surgical Oncology, Gujarat Cancer and Research Institute, New Civil Hospital Campus, Asarwa, Ahmedabad, 380016 India
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10
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Puumala SE, Ross JA, Feusner JH, Tomlinson GE, Malogolowkin MH, Krailo MD, Spector LG. Parental infertility, infertility treatment and hepatoblastoma: a report from the Children's Oncology Group. Hum Reprod 2012; 27:1649-56. [PMID: 22473396 DOI: 10.1093/humrep/des109] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND A recent study suggested a markedly increased risk of hepatoblastoma (HB) among children conceived with treatment for infertility. However, it is not clear whether this finding is confounded by the association between HB and low birthweight (LBW). METHODS Associations between parental infertility and its treatment and HB were examined using data from a case-control study conducted through the Children's Oncology Group (COG). Telephone interviews were completed for 383 mothers of cases diagnosed with HB at US COG institutions between January 2000 and December 2008 and for 387 mothers of controls recruited through state birth registries. Logistic regression was used to examine possible associations. RESULTS After adjusting for birthweight and other potential confounders, no significant association was found for any of the measures of parental infertility or its treatment. In HB cases conceived through assisted reproductive technology (ART), 4 of 16 also had Beckwith-Wiedemann syndrome (BWS) compared with 9 of 365 in HB cases without ART. CONCLUSIONS Little evidence of an association between parental infertility or its treatment and HB was found. The relationship found in a previous study could be due to LBW and BWS which are risk factors for HB and also associated with parental infertility and its treatment.
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Affiliation(s)
- Susan E Puumala
- Department of Pediatrics, University of South Dakota, Sioux Falls, SD 57104, USA
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11
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Nutrition in early life, and risk of cancer and metabolic disease: alternative endings in an epigenetic tale? Br J Nutr 2008; 101:619-30. [PMID: 19079817 DOI: 10.1017/s0007114508145883] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
There is substantial evidence which shows that constraints in the early life environment are an important determinant of risk of metabolic disease and CVD. There is emerging evidence that higher birth weight, which reflects a more abundant prenatal environment, is associated with increased risk of cancer, in particular breast cancer and childhood leukaemia. Using specific examples from epidemiology and experimental studies, this review discusses the hypothesis that increased susceptibility to CVD, metabolic disease and cancer have a common origin in developmental changes induced in the developing fetus by aspects of the intra-uterine environment including nutrition which involve stable changes to the epigenetic regulation of specific genes. However, the induction of specific disease risk is dependent upon the nature of the environmental challenge and interactions between the susceptibility set by the altered epigenome and the environment throughout the life course.
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Abstract
We confirmed the strong association of hepatoblastoma with very low birth weight (relative risk <1000 g vs >or=2000 g=25.6; 95% confidence interval: 7.70-85.0) and demonstrated independent associations with congenital abnormalities and maternal Asian race in a population-based Minnesota study that included 36 cases and 7788 controls.
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13
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Strunk CJ, Alexander SW. Solid Tumors of Childhood. Oncology 2007. [DOI: 10.1007/0-387-31056-8_62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Trobaugh-Lotrario AD, Greffe B, Garza-Williams S, Haas JE, Odom LF. Erythropoietin receptor presence in hepatoblastoma: a possible link to increased incidence of hepatoblastoma in very low birthweight infants. Pediatr Blood Cancer 2007; 49:365-6. [PMID: 16937361 DOI: 10.1002/pbc.21010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Mellemkjaer L, Hasle H, Gridley G, Johansen C, Kjaer SK, Frederiksen K, Olsen JH. Risk of cancer in children with the diagnosis immaturity at birth. Paediatr Perinat Epidemiol 2006; 20:231-7. [PMID: 16629697 DOI: 10.1111/j.1365-3016.2006.00717.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cancer risk in children born before term has been assessed in a large number of case-control studies but very rarely in cohort studies. We carried out a cohort study of 35 178 children with the diagnosis immaturity at birth in the Hospital Discharge Register during 1977-89. The children were followed for cancer in the Danish Cancer Registry until 1994 and comparisons were made with incidence rates for all children in Denmark. The 64 observed cases of childhood cancer in the cohort corresponded closely to the expected number {standardised incidence ratio (SIR) = 1.03; [95% confidence interval (CI) 0.80, 1.32]}. The only cancer site with an observed number that deviated significantly from the expected number was central nervous system (CNS) tumours (26 cases observed; SIR = 1.57; [95% CI 1.02, 2.30]) in particular medulloblastoma (9 cases observed; SIR = 3.1; [95% CI 1.4, 5.9]). In a nested case-control study of the CNS tumours, we found that more cases than controls had been exposed to diagnostic X-rays, but the result was not significant. Surprisingly, for those born before term, the risk of CNS tumours increased with increasing gestational age in the nested case-control data. Our results are in line with previous evidence that children born before term are not at increased risk for childhood cancer in general. An explanation behind the excess of CNS tumours could not be identified, but the effect of diagnostic X-rays in newborns may deserve further attention.
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Affiliation(s)
- Lene Mellemkjaer
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
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Abstract
The association between hepatoblastoma and low birth weight documented recently in the literature has yet to be well explained, in particular the suggestion that these patients may have a more aggressive form of the disease. From 1989 to 2003, our institution treated four patients for hepatoblastoma who had birth weights of less than 1,500 g. Notable was 100% patient survival despite bilateral and, in one case, recurrent disease. Speculation regarding the etiology of this subset of hepatoblastoma has included damage to developing hepatocytes induced by oxygen free radicals. Our patients universally had pulmonary disease requiring prolonged supplemental oxygen and ventilatory support. However, our review supports no changes in the standard care of low birth weight infants or in managing those who develop hepatoblastoma.
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Affiliation(s)
- Stephanie A Kapfer
- Division of Pediatric Surgery, Department of Surgery, State University of New York at Buffalo, The Women and Children's Hospital of Buffalo, Buffalo, NY 14222, USA
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18
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Abstract
The epidemiology of primary hepatic malignancies in U.S. children is poorly characterized. We analyzed the incidence, mortality, and characteristics of primary hepatic malignancies in U.S. residents less than 20 years of age. Fatal primary hepatic malignancies in persons less than 20 years of age, between 1979 and 1996, were identified using the multiple-cause-of-death database (National Center for Health Statistics). Histologically confirmed primary hepatic malignancies occurring between 1973 and 1997 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Between 1979 and 1996, 918 primary hepatic malignancy deaths (average, 0.7/1,000,000/year) were reported nationally among persons less than 20 years of age; rates were higher among Asians and among foreign-born children. Between 1973 and 1997, 271 primary hepatic malignancy cases were reported to SEER among persons less than 20 years of age, of which 184 (67%) and 83 (31%) were hepatoblastoma and hepatocellular carcinoma, respectively. Among children less than 5 years of age, hepatoblastoma accounted for 91% of primary hepatic malignancy cases, whereas among those 15 to 19 years of age, hepatocellular carcinoma accounted for 87% of cases. Five-year survival for hepatoblastoma was 52%, compared with 18% for hepatocellular carcinoma. In the SEER sites, between 1973 and 1977 and 1993 and 1997, hepatoblastoma rates increased (0.6 to 1.2/1,000,000, respectively), while hepatocellular carcinoma rates decreased (0.45 to 0.29/1,000,000, respectively). In conclusion, histologically confirmed hepatocellular carcinoma was reported in children less than 5 years of age, also, where hepatoblastoma is the predominant primary hepatic malignancy. Hepatocellular carcinoma has worse survival rates than hepatoblastoma, and its incidence has not increased. Better maintenance of databases may provide information about associated factors behind this unexpected occurrence.
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Affiliation(s)
- Anil Darbari
- Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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19
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Oue T, Kubota A, Okuyama H, Kawahara H, Nara K, Kawa K, Kitajima H. Hepatoblastoma in children of extremely low birth weight: a report from a single perinatal center. J Pediatr Surg 2003; 38:134-7; discussion 134-7. [PMID: 12592636 DOI: 10.1053/jpsu.2003.50027] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE The incidence of hepatoblastoma (HB) in children of low birth weight is increasing. In the authors' institute, 5 infants of extremely low birth weight (ELBW) were found to have HB. The purpose of this study was to identify the characteristics of these infants to elucidate the pathogenesis of HB arising in ELBW infants. METHODS Birth weight (BW) ranged from 554 to 750 g (mean, 654 g) and gestational age from 23 to 29 weeks (mean, 25.8 weeks). Medical records of the 5 patients were reviewed, and perinatal treatments were compared with those of ELBW infants without HB. RESULTS One patient with intraabdominal hemorrhage had emergency operation, which was followed by early postoperative death. The parents of one child refused treatment because of associated severe anomalies. He died of the growing tumor 4 months after diagnosis. The remaining 3 patients had radical operation performed after intraarterial chemoembolization and systemic chemotherapy. One died of hepatic failure 7 months after operation. Two are alive 5 and 9 months after operation. The incidence of HB among ELBW infants was estimated to be about 0.5% in our institute. The mean durations of mechanical ventilation, oxygen inhalation, and hospitalization during the neonatal periods in cases of HB were significantly longer than those in BW matched control infants (P <.01). CONCLUSIONS ELBW children have a high risk for HB. In follow-up of ELBW infants, serum alpha-fetoprotein or abdominal ultrasonography may be useful to detect early HB. The children with HB received perinatal treatments for a significantly longer time, which suggests that perinatal intensive and long-term medical treatments may be involved in the tumorigenesis in the highly sensitive immature liver.
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Affiliation(s)
- Takaharu Oue
- Department of Pediatric Surgery, Pediatrics and Neonatology, Osaka Medical Center & Research Institute for Maternal & Child Health, Izumi, Osaka, Japan
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20
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Feusner J, Plaschkes J. Hepatoblastoma and low birth weight: a trend or chance observation? MEDICAL AND PEDIATRIC ONCOLOGY 2002; 39:508-9. [PMID: 12228908 DOI: 10.1002/mpo.10176] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Several reports have suggested an association between prematurity and hepatoblastoma (HB). PROCEDURE Data were collected by questionnaires from 105 children with HB enrolled in a Children's Cancer Group (CCG) study. RESULTS Observed over expected rates were increased about 2- and 15+-fold for prematurity (<37 weeks at birth) and low birth weight (<1,000 g) respectively. Similar data were derived from a later CCG study of 36 HB children. CONCLUSIONS Early reports of a possible association between prematurity and HB have been confirmed.
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Affiliation(s)
- James Feusner
- Oncology, Children's Hospital Oakland, Oakland, California 94609, USA.
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21
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Turusov VS, Torii M, Sills RC, Willson GA, Herbert RA, Hailey JR, Haseman JK, Boorman GA. Hepatoblastomas in mice in the US National Toxicology Program (NTP) studies. Toxicol Pathol 2002; 30:580-91. [PMID: 12371667 DOI: 10.1080/01926230290105802] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Over the last 8 years, a 5-fold increase in the incidence of mice with spontaneous hepatoblastomas and a moderate increase in the incidence of chemically induced hepatoblastomas in B6C3F1 mice occurred in 2-year NTP studies compared to the previous 7 years. There was a positive association between an increased incidence of mice with hepatoblastoma and an increased incidence of mice with hepatocellular tumors in the treated mice. The rate of pulmonary metastases for hepatoblastoma was similar to that of pulmonary metastasis for hepatocellular carcinomas. Although a variety of chemicals caused an increased incidence of mice with hepatoblastoma, there was no apparent association between a specific chemical structure or a biological class of compounds and their capacity to induce hepatoblastomas. Hepatoblastomas frequently arose within hepatocellular carcinomas or adenomas and were induced by the same compounds that induced hepatocellular neoplasms. Therefore, it seems reasonable to combine the incidence of mice with hepatoblastomas and the incidence of mice with hepatocellular carcinomas in hazard identification studies.
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22
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Abstract
The role of the pathologist in dealing with common problems of liver disease in children is likely to change dramatically as the molecular genetic revolution progresses. For example, microchip arrays for genes involved in bile salt synthesis and transport will pinpoint the specific mutations responsible for infantile cholestasis and similar methods will sort out infectious agents of acute and chronic hepatitis. But even as biochemistry, microbiology, and immunology laboratories already provide essential diagnostic information in such settings, informed histopathologic interpretation will continue to guide investigations of etiology and therapeutics and will remain an important medical necessity [95,96,100,102,104].
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Affiliation(s)
- Milton J Finegold
- Department of Pathology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA.
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23
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Abstract
Hepatoblastoma is the most common primary liver tumor in children, accounting for just over 1% of pediatric cancers. The etiology is unknown, but it has been associated with Beckwith-Weidemann syndrome, familial adenomatosis polypi, and low birth weight. The primary treatment is surgical resection, however, chemotherapy plays an important role by increasing the number of tumors that are resectable. The prognosis for patients with resectable tumors is fairly good, however, the outcome for those with nonresectable or recurrent disease is poor.
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Affiliation(s)
- C E Herzog
- University of Texas M.D. Anderson Cancer Center, University of Texas-Houston Medical School, Houston, Texas 77030, USA.
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24
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Maruyama K, Ikeda H, Koizumi T, Tsuchida Y, Tanimura M, Nishida H, Takahashi N, Fujimura M, Tokunaga Y. Case-control study of perinatal factors and hepatoblastoma in children with an extremely low birthweight. Pediatr Int 2000; 42:492-8. [PMID: 11059537 DOI: 10.1046/j.1442-200x.2000.01287.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is a significant association between hepatoblastoma and low birthweight. A case-control study was conducted to reveal risk factors for hepatoblastoma in children of extremely low birthweight (< 1,000 g). METHODS Prenatal and postnatal histories, including parental histories, of 12 hepatoblastoma cases and 75 birthweight-matched controls were compared. RESULTS The gestational age of the hepatoblastoma cases (23-32 weeks: median 25 weeks), tended to be lower than that of the controls (23-36 weeks; median, 27 weeks; P = 0.072). The time for an infant's bodyweight to return to the same level as the birthweight also tended to be longer in hepatoblastoma cases than in controls (P = 0.055). All hepatoblastoma cases received oxygen therapy for a period of 4-508 days (median 114 days), which was significantly longer than the 0-366 days (median 62 days) in the controls (P = 0.022). Furosemide was given to all hepatoblastoma cases and was used for a significantly longer period in these infants (6460 days; median 89 days) than in the controls (0-241 days; median 44 days P = 0.027). A univariate Cox regression demonstrated that the time taken to regain bodyweight at birth and the duration of both oxygen therapy and furosemide treatment were significantly associated with the development of hepatoblastoma (hazard ratio (HR)= 1.044, P= 0.013; HR = 1.006, P= 0.001; and HR = 1.007, P= 0.001, respectively). Although there were significant correlations between the factors, a multivariate Cox regression analysis identified the duration of oxygen therapy as a significant independent risk factor (HR = 1.006, P = 0.001). CONCLUSIONS Oxygen therapy and furosemide treatment, along with the rate of growth, are risk factors for the development of hepatoblastoma in children of extremely low birthweight, and the duration of oxygen therapy is the most important factor in predicting the development of hepatoblastoma. Further studies are necessary to determine the real reasons for the development of hepatoblastoma and to protect children of low birthweight from the development of cancer.
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Affiliation(s)
- K Maruyama
- Department of Neonatology, Gunma Children's Medical Center, Seta-gun, Japan.
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