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Ho CT, Tan ECH, Lee PC, Chu CJ, Huang YH, Huo TI, Su YH, Hou MC, Wu JC, Su CW. Conventional and machine-learning based risk score for patients with early-stage hepatocellular carcinoma. Clin Mol Hepatol 2024:cmh.2024.0103. [PMID: 38600872 DOI: 10.3350/cmh.2024.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/10/2024] [Indexed: 04/12/2024] Open
Abstract
Background/Aims The performance of machine-learning (ML) in predicting the outcomes of patients with hepatocellular carcinoma (HCC) remains uncertain. We aimed to develop risk scores using conventional methods and ML to categorize early-stage HCC patients into distinct prognostic groups. Methods The study retrospectively enrolled 1411 consecutive treatment-naïve patients with the Barcelona Clinic Liver Cancer (BCLC) stage 0 to A HCC from 2012 to 2021. The patients were randomly divided into a training cohort (n=988) and validation cohort (n=423). Two risk scores (CATS-IF and CATS-INF) were developed to predict overall survival (OS) in the training cohort using the conventional methods (Cox proportional hazards model) and ML-based methods (LASSO Cox regression), respectively. They were then validated and compared in the validation cohort. Results In the training cohort, factors for the CATS-IF score were selected by the conventional method, including age, curative treatment, single large HCC, serum creatinine and alpha-fetoprotein levels, fibrosis-4 score, lymphocyte-to-monocyte ratio, and albumin bilirubin grade. The CATS-INF score, determined by ML-based methods, included the above factors and two additional ones (aspartate aminotransferase and prognostic nutritional index). In the validation cohort, both CATS-IF score and CATS-INF score outperformed other modern prognostic scores in predicting OS, with the CATS-INF score having the lowest Akaike information criterion value. A calibration plot exhibited good correlation between predicted and observed outcomes for both scores. Conclusions Both the conventional Cox-based CATS-IF score and ML-based CATS-INF score effectively stratified patients with early-stage HCC into distinct prognostic groups, with the CATS-INF score showing slightly superior performance.
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Affiliation(s)
- Chun-Ting Ho
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Elise Chia-Hui Tan
- Department of Health Service Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Pei-Chang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chi-Jen Chu
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Hsiang Huang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Teh-Ia Huo
- Division of Basic Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Hui Su
- Department of Accounting, Soochow University, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Ho CT, Chia-Hui Tan E, Lee PC, Chu CJ, Huang YH, Huo TI, Hou MC, Wu JC, Su CW. Prognostic Nutritional Index as a Prognostic Factor for Very Early-Stage Hepatocellular Carcinoma. Clin Transl Gastroenterol 2024; 15:e00678. [PMID: 38240325 DOI: 10.14309/ctg.0000000000000678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/10/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Field factors play more important roles in predicting the outcomes of patients compared with tumor factors in early-stage hepatocellular carcinoma (HCC). However, the prognostic ability of noninvasive serum marker scores for hepatic fibrosis and liver functional reserve on very early-stage HCC is still not yet determined. We aimed to investigate the performance of these serum marker scores in predicting the prognoses of patients with very early-stage HCC. METHODS A total of 446 patients with very early-stage HCC from 2012 to 2022 were retrospectively enrolled. Serum biomarkers and prognostic scores determining overall survival (OS) were analyzed by Cox proportional hazards model. We compared the Akaike information criterion among the prognostic nutritional index (PNI), aspartate aminotransferase-to-platelet ratio index, albumin-bilirubin (ALBI) score, EZ (easy)-ALBI score, modified ALBI score, fibrosis-4 score, and lymphocyte-to-monocyte ratio to determine the predictability on the OS. RESULTS After a median follow-up of 41.0 months (interquartile range 36.9-45.1 months), 81 patients died, with a 5-year OS rate of 71.0%. Among the noninvasive serum marker scores, PNI had the best performance in predicting the OS with the lowest Akaike information criterion (846.407) compared with other scores. Moreover, we stratified the patients into high-risk (PNI <45) and low-risk (PNI ≥45) groups. It showed that the 5-year OS rates were 83.4% and 60.8% in the low-risk and high-risk PNI groups, respectively ( P < 0.001). DISCUSSION PNI had the best performance in predicting the OS for patients with very early-stage HCC.
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Grants
- MOST 111-2314-B-075-056, MSTC 112-2314-B-075-043-MY2 National Science and Technology Council of Taiwan
- (V112C-039, Center of Excellence for Cancer Research MOHW112-TDU-B-221-124007, and Big Data Center), Y.L. Lin Hung Tai Education Foundation, and Yin Shu-Tien Foundation Taipei Veterans General Hospital-National Yang Ming Chiao Tung University Excellent Physician Scientists Cultivation Program, No. 112-V-B-073). Taipei Veterans General Hospital
- (V112C-039, Center of Excellence for Cancer Research MOHW112-TDU-B-221-124007, and Big Data Center), Y.L. Lin Hung Tai Education Foundation, and Yin Shu-Tien Foundation Taipei Veterans General Hospital-National Yang Ming Chiao Tung University Excellent Physician Scientists Cultivation Program, No. 112-V-B-073) Taipei Veterans General Hospital
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Affiliation(s)
- Chun-Ting Ho
- Department of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Elise Chia-Hui Tan
- Department of Health Service Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Pei-Chang Lee
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chi-Jen Chu
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Hsiang Huang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Healthcare and Services Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Teh-Ia Huo
- Division of Basic Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chien-Wei Su
- Department of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Su CW, Ochirkhuree B, Namdag B, Badamnachin B, Ganbold S, Gidaagaya S, Ganbold A, Yang SS, Duger D, Wu JC. Risk factors associated with hepatitis D virus infection and preventive strategies in Mongolia. J Chin Med Assoc 2024:02118582-990000000-00357. [PMID: 38417133 DOI: 10.1097/jcma.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Hepatitis D virus (HDV) infection is highly prevalent in Mongolia. We aimed to identify the risk factors associated with HDV infection, propose preventive strategies, and evaluate the outcomes of a three-year collaborative project between Taiwan and Mongolia. METHODS In 2016 and 2018, we conducted onsite visits to Mongolia. Mongolian investigators collected questionnaires focusing on risk factors, demographic characteristics, and serum samples for acute HDV infections. Furthermore, 19 Mongolian seed teachers participated in a one-week workshop on infection control in Taiwan. Subsequently, these seed teachers trained more than 400 medical personnel in Mongolia. To assess secular changes in acute HDV infection, we reviewed the registration data from the National Center for Communicable Disease (NCCD) in Mongolia between 2011 and 2021. RESULTS Among the 194 Mongolian patients, 108 had dual infection with hepatitis B virus (HBV) and HDV, while 86 had acute hepatitis B (AHB). Patients with HBV/HDV dual infections were older (28.6 years vs. 25.5 years, p=0.030) and had lower rates of positive hepatitis B e antigen in their sera, lower rates of serum HBV DNA exceeding 2000 IU/mL, and higher rates of having received dental treatment (59.4% vs. 40.5%, p=0.014) and injection therapy (64.2% vs. 44.0%, p=0.009) compared to those with AHB. Analysis of NCCD data revealed that new HDV infection cases were more prevalent between 2011 and 2015 (111.20 ± 29.79 cases/year) and decreased to 54.67 ± 27.34 cases/year between 2016 and 2021 (p=0.010). CONCLUSION Dental treatment and injections were associated with a higher risk of acute HDV infections in Mongolia. Through collaborative efforts, the incidence rate of HDV infection has declined in recent years.
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Affiliation(s)
- Chien-Wei Su
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Holistic and Multidisciplinary Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Gastroenterology Center, First Central Hospital of Mongolia, Ulaanbaatar, Mongolia
- Department of Gastroenterology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- Emergency Department, National Center for Communicable Disease, Mongolia
- Hepatology Laboratory, National Center for Communicable Diseases, Mongolia
- Liver Unit, Cathay General Hospital, Taipei, Taiwan, ROC
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Translational Division, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Bayarmaa Ochirkhuree
- Gastroenterology Center, First Central Hospital of Mongolia, Ulaanbaatar, Mongolia
| | - Bira Namdag
- Department of Gastroenterology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | | | - Sarangua Ganbold
- Hepatology Laboratory, National Center for Communicable Diseases, Mongolia
| | - Sarantuya Gidaagaya
- Department of Gastroenterology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Anar Ganbold
- Gastroenterology Center, First Central Hospital of Mongolia, Ulaanbaatar, Mongolia
| | - Sien-Sing Yang
- Liver Unit, Cathay General Hospital, Taipei, Taiwan, ROC
| | - Davaadorj Duger
- Department of Gastroenterology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Translational Division, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Teng W, Chang TT, Yang HI, Peng CY, Su CW, Su TH, Hu TH, Yu ML, Yang HC, Wu JC. Correction to: Risk scores to predict HCC and the benefits of antiviral therapy for CHB patients in gray zone of treatment guidelines. Hepatol Int 2024:10.1007/s12072-023-10634-6. [PMID: 38252366 DOI: 10.1007/s12072-023-10634-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Wei Teng
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Republic of China
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
| | - Ting-Tsung Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
| | - Hwai-I Yang
- Genomics Research Center, Academia Sinica, Taipei, Taiwan, Republic of China
| | - Cheng-Yuan Peng
- Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Tung-Hung Su
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Tsung-Hui Hu
- Department of Gastroenterology and Hepatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
| | - Hung-Chih Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Republic of China.
- Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Republic of China.
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Liang YJ, Chiou YW, Chiu APT, Shiao MS, Teng W, Lin CW, Cheng ML, Huang YH, Liang KH, Su CW, Lai CY, Chen CL, Wu JC. Antiviral therapy reduces hepatocellular carcinoma through suppressing hepatitis B virus replication may improve ER stress, mitochondrial and metabolic dysfunctions and decrease p62 in hybridized mice with single HBV transgene and miR-122. J Med Virol 2023; 95:e29325. [PMID: 38108211 DOI: 10.1002/jmv.29325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
Hepatitis B virus (HBV) hijacks autophagy for its replication. Nucleos(t)ide analogs (NUCs) treatment suppressed HBV replication and reduced hepatocellular carcinoma (HCC) incidence. However, the use of NUCs in chronic hepatitis B (CHB) patients with normal or minimally elevated serum alanine aminotransferase (ALT) levels is still debated. Animal models are crucial for studying the unanswered issue and evaluating new therapies. MicroRNA-122 (miR-122), which regulates fatty acid and cholesterol metabolism, is downregulated during hepatitis and HCC progression. The reciprocal inhibition of miR-122 with HBV highlights its role in HCC development as a tumor suppressor. By crossbreeding HBV-transgenic mice with miR-122 knockout mice, we generated a hybrid mouse model with a high incidence of HCC up to 89% and normal ALT levels before HCC. The model exhibited early-onset hepatic steatosis, progressive liver fibrosis, and impaired late-phase autophagy. Metabolomics and microarray analysis identified metabolic signatures, including dysregulation of lipid metabolism, inflammation, genomic instability, the Warburg effect, reduced TCA cycle flux, energy deficiency, and impaired free radical scavenging. Antiviral treatment reduced HCC incidence in hybrid mice by approximately 30-35% compared to untreated mice. This effect was linked to the activation of ER stress-responsive transcription factor ATF4, clearance of autophagosome cargo p62, and suppression of the CHOP-mediated apoptosis pathway. In summary, this study suggests that despite minimal ALT elevation, HBV replication can lead to liver injury. Endoplasmic reticulum stress, reduced miR-122 levels, mitochondrial and metabolic dysfunctions, blocking protective autophagy resulting in p62 accumulation, apoptosis, fibrosis, and HCC. Antiviral may improve the above-mentioned pathogenesis through HBV suppression.
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Affiliation(s)
- Yuh-Jin Liang
- Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yu-Wei Chiou
- Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Abby Pei-Ting Chiu
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, USA
- Department of Biology, University of Washington, Seattle, Washington, USA
| | - Ming-Shi Shiao
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Wei Teng
- Department of Gastroenterology & Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC
| | - Chin-Wei Lin
- Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Mei-Ling Cheng
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, ROC
| | - Yen-Hua Huang
- Center for Systems and Synthetic Biology and Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Kung-Hao Liang
- Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chien-Wei Su
- Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Division of Holistic and Multidisciplinary Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chi-Yu Lai
- Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chih-Li Chen
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Jaw-Ching Wu
- Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Zhao YX, Song JY, Bao XW, Zhang JL, Wu JC, Wang LY, He C, Shao W, Bai XL, Liang TB, Sheng JP. Single-cell RNA sequencing-guided fate-mapping toolkit delineates the contribution of yolk sac erythro-myeloid progenitors. Cell Rep 2023; 42:113364. [PMID: 37922312 DOI: 10.1016/j.celrep.2023.113364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/16/2023] [Accepted: 10/16/2023] [Indexed: 11/05/2023] Open
Abstract
Erythro-myeloid progenitors of the yolk sac that originates during early embryo development has been suggested to generate tissue-resident macrophage, mast cell, and even endothelial cell populations from fetal to adult stages. However, the heterogeneity of erythro-myeloid progenitors (EMPs) is not well characterized. Here, we adapt single-cell RNA sequencing to dissect the heterogeneity of EMPs and establish several fate-mapping tools for each EMP subset to trace the contributions of different EMP subsets. We identify two primitive and one definitive EMP subsets from the yolk sac. In addition, we find that primitive EMPs are decoupled from definitive EMPs. Furthermore, we confirm that primitive and definitive EMPs give rise to microglia and other tissue-resident macrophages, respectively. In contrast, only Kit+ Csf1r- primitive EMPs generate endothelial cells transiently during early embryo development. Overall, our results delineate the contribution of yolk sac EMPs more clearly based on the single-cell RNA sequencing (scRNA-seq)-guided fate-mapping toolkit.
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Affiliation(s)
- Y X Zhao
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China
| | - J Y Song
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China
| | - X W Bao
- Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China
| | - J L Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China
| | - J C Wu
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China
| | - L Y Wang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang, China
| | - C He
- Infinity Scope Biotechnology Co., Ltd., Hangzhou 311200, China
| | - W Shao
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210000, China.
| | - X L Bai
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China.
| | - T B Liang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China.
| | - J P Sheng
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China.
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7
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Yan S, Tu CY, Du CY, Luo J, Liu JF, Liu TQ, Liu Q, Liu J, Li XH, Wang LC, Fang ZP, Yi WM, Chen YJ, Li QL, Ni Y, Wu JC, Qin CJ, Gu YL, Lu Z, Lun ZJ, Du LX, Chen G, Zheng QC, Sun KJ, Han WQ, Yu J. [Effect of recombinant human thrombin for hemostasis in liver resection: a randomized controlled phase Ⅲ clinical trial]. Zhonghua Yi Xue Za Zhi 2023; 103:3416-3423. [PMID: 37963740 DOI: 10.3760/cma.j.cn112137-20230911-00438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Objective: To evaluate the hemostatic efficacy, safety and immunogenicity of recombinant human thrombin in the treatment of liver wounds that still ooze after conventional surgical hemostasis. Methods: A multicenter, stratified randomized, double-blind, placebo-controlled phase Ⅲ trial with a planned enrollment of 510 subjects at 33 centers, with a 2∶1 randomization to the thrombin group versus the placebo group. An interim analysis will be conducted after approximately 70% of the subjects have completed the observation period. The primary efficacy endpoint was the rate of hemostasis within 6 minutes at the point of bleeding that could be evaluated. Safety analysis was performed one month after surgery, and the positive rates of anti-drug antibody (ADA) and neutralizing antibody were evaluated. Results: At the interim analysis, a total of 348 subjects had been randomized and received the study drug (215 were male and 133 were female). They were aged 19-69 (52.9±10.9)years. Among them, 232 were in the thrombin group and 116 were in the placebo group, with balanced and comparable demographics and baseline characteristics between the two groups. The hemostasis rate at 6 minutes was 71.6% (95%CI:65.75%-77.36%) in the thrombin group and 44.0% (95%CI: 34.93%-53.00%) in the placebo group, respectively (P<0.001). No grade≥3 drug-related adverse events and no drug-related deaths were reported from the study.No recombinant human thrombin-induced immunologically-enhanced ADA or immunologically-induced ADA was detected after topical use in subjects. Conclusion: Recombinant human thrombin has shown significant hemostatic efficacy and good safety in controlling bleeding during liver resection surgery, while also demonstrating low immunogenicity characteristics.
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Affiliation(s)
- S Yan
- Department of Hepatobiliary and Pancreatic Surgery, the Second Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
| | - C Y Tu
- Department of General Surgery, Lishui Central Hospital, Lishui 323020, China
| | - C Y Du
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
| | - J Luo
- Department of Hepatobiliary and Intestinal Surgery, Hunan Cancer Hospital, Changsha 410031, China
| | - J F Liu
- Department of Hepatobiliary and Pancreatic Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, China
| | - T Q Liu
- Department of General Surgery, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Q Liu
- Department of Hepatobiliary Surgery, Liuzhou People's Hospital, Liuzhou 545006, China
| | - J Liu
- Department of Hepatobiliary Surgery, Guizhou Provicial People's Hospital, Guiyang 550002, China
| | - X H Li
- Department of Hepatobiliary Surgery, Liaocheng People's Hospital, Liaocheng 252000, China
| | - L C Wang
- Department of General Surgery, the Third People's Hospital of Hainan Province, Sanya 572000, China
| | - Z P Fang
- Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Linhai 317099, China
| | - W M Yi
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, Changsha 410005, China
| | - Y J Chen
- Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, China
| | - Q L Li
- Department of Hepatobiliary and Pancreatic Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Y Ni
- Department of Hepatobiliary and Pancreatic Surgery, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - J C Wu
- Department of Hepatobiliary Surgery, Hainan Provincial People's Hospital, Haikou 570311, China
| | - C J Qin
- Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng 475000, China
| | - Y L Gu
- Department of Hepatobiliary Surgery, Affiliated Hospital of Jiangnan Univeisity, Wuxi 214122, China
| | - Z Lu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
| | - Z J Lun
- Department of Hepatobiliary Vascular Surgery, Zaozhuang Municipal Hospital, Zaozhuang 277101, China
| | - L X Du
- Department of Hepatobiliary Surgery, Shanxi Provincial People's Hospital, Xi'an 710068, China
| | - G Chen
- Department of Hepatobiliary and Pancreatic Surgery, the First People's Hospital of Kunming, Kunming 650034, China
| | - Q C Zheng
- Department of Hepatobiliary Surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China
| | - K J Sun
- Department of Hepatobiliary Surgery, Zibo Central Hospital, Zibo 255036, China
| | - W Q Han
- Department of Urinary Surgery, Hunan Cancer Hospital, Changsha 410031, China
| | - J Yu
- Department of Hepatobiliary and Pancreatic Surgery, the First Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
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Yu YY, Song CJ, Sun WL, Wu JC, Lei LH. [Management of soft and hard tissue defects in aesthetic zone in severe periodontitis with periodontal-orthodontic treatment: a case report]. Zhonghua Kou Qiang Yi Xue Za Zhi 2023; 58:1067-1072. [PMID: 37818542 DOI: 10.3760/cma.j.cn112144-20230815-00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Affiliation(s)
- Y Y Yu
- Department of Periodontics, The Second Affiliated Hospital of Zhejiang University School of Medicine, School of Stomatology, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310009, China
| | - C J Song
- Department of Periodontics, The Second Affiliated Hospital of Zhejiang University School of Medicine, School of Stomatology, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310009, China
| | - W L Sun
- Department of Periodontics, The Second Affiliated Hospital of Zhejiang University School of Medicine, School of Stomatology, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310009, China
| | - J C Wu
- Department of Orthopedics, Hangzhou Mingzhou Hospital, Hangzhou 310009, China
| | - L H Lei
- Department of Periodontics, The Second Affiliated Hospital of Zhejiang University School of Medicine, School of Stomatology, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310009, China
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Razavi-Shearer D, Gamkrelidze I, Pan C, Jia J, Berg T, Gray R, Lim YS, Chen CJ, Ocama P, Desalegn H, Abbas Z, Abdallah A, Aghemo A, Ahmadbekova S, Ahn SH, Aho I, Akarca U, Al Masri N, Alalwan A, Alavian S, Al-Busafi S, Aleman S, Alfaleh F, Alghamdi A, Al-Hamoudi W, Aljumah A, Al-Naamani K, Al-Rifai A, Alserkal Y, Altraif I, Amarsanaa J, Anderson M, Andersson M, Armstrong P, Asselah T, Athanasakis K, Baatarkhuu O, Ben-Ari Z, Bensalem A, Bessone F, Biondi M, Bizri AR, Blach S, Braga W, Brandão-Mello C, Brosgart C, Brown K, Brown, Jr R, Bruggmann P, Brunetto M, Buti M, Cabezas J, Casanovas T, Chae C, Chan HLY, Cheinquer H, Chen PJ, Cheng KJ, Cheon ME, Chien CH, Choudhuri G, Christensen PB, Chuang WL, Chulanov V, Cisneros L, Coffin C, Contreras F, Coppola N, Cornberg M, Cowie B, Cramp M, Craxi A, Crespo J, Cui F, Cunningham C, Dalgard O, De Knegt R, De Ledinghen V, Dore G, Drazilova S, Duberg AS, Egeonu S, Elbadri M, El-Kassas M, El-Sayed M, Estes C, Etzion O, Farag E, Ferradini L, Ferreira P, Flisiak R, Forns X, Frankova S, Fung J, Gane E, Garcia V, García-Samaniego J, Gemilyan M, Genov J, Gheorghe L, Gholam P, Gish R, Goleij P, Gottfredsson M, Grebely J, Gschwantler M, Guingane NA, Hajarizadeh B, Hamid S, Hamoudi W, Harris A, Hasan I, Hatzakis A, Hellard M, Hercun J, Hernandez J, Hockicková I, Hsu YC, Hu CC, Husa P, Janicko M, Janjua N, Jarcuska P, Jaroszewicz J, Jelev D, Jeruma A, Johannessen A, Kåberg M, Kaita K, Kaliaskarova K, Kao JH, Kelly-Hanku A, Khamis F, Khan A, Kheir O, Khoudri I, Kondili L, Konysbekova A, Kristian P, Kwon J, Lagging M, Laleman W, Lampertico P, Lavanchy D, Lázaro P, Lazarus JV, Lee A, Lee MH, Liakina V, Lukšić B, Malekzadeh R, Malu A, Marinho R, Mendes-Correa MC, Merat S, Meshesha BR, Midgard H, Mohamed R, Mokhbat J, Mooneyhan E, Moreno C, Mortgat L, Müllhaupt B, Musabaev E, Muyldermans G, Naveira M, Negro F, Nersesov A, Nguyen VTT, Ning Q, Njouom R, Ntagirabiri R, Nurmatov Z, Oguche S, Omuemu C, Ong J, Opare-Sem O, Örmeci N, Orrego M, Osiowy C, Papatheodoridis G, Peck-Radosavljevic M, Pessoa M, Pham T, Phillips R, Pimenov N, Pincay-Rodríguez L, Plaseska-Karanfilska D, Pop C, Poustchi H, Prabdial-Sing N, Qureshi H, Ramji A, Rautiainen H, Razavi-Shearer K, Remak W, Ribeiro S, Ridruejo E, Ríos-Hincapié C, Robalino M, Roberts L, Roberts S, Rodríguez M, Roulot D, Rwegasha J, Ryder S, Sadirova S, Saeed U, Safadi R, Sagalova O, Said S, Salupere R, Sanai F, Sanchez-Avila JF, Saraswat V, Sargsyants N, Sarrazin C, Sarybayeva G, Schréter I, Seguin-Devaux C, Seto WK, Shah S, Sharara A, Sheikh M, Shouval D, Sievert W, Simojoki K, Simonova M, Sinn DH, Sonderup M, Sonneveld M, Spearman CW, Sperl J, Stauber R, Stedman C, Sypsa V, Tacke F, Tan SS, Tanaka J, Tergast T, Terrault N, Thompson A, Thompson P, Tolmane I, Tomasiewicz K, Tsang TY, Uzochukwu B, Van Welzen B, Vanwolleghem T, Vince A, Voeller A, Waheed Y, Waked I, Wallace J, Wang C, Weis N, Wong G, Wong V, Wu JC, Yaghi C, Yesmembetov K, Yip T, Yosry A, Yu ML, Yuen MF, Yurdaydin C, Zeuzem S, Zuckerman E, Razavi H. Global prevalence, cascade of care, and prophylaxis coverage of hepatitis B in 2022: a modelling study. Lancet Gastroenterol Hepatol 2023; 8:879-907. [PMID: 37517414 DOI: 10.1016/s2468-1253(23)00197-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND The 2016 World Health Assembly endorsed the elimination of hepatitis B virus (HBV) infection as a public health threat by 2030; existing therapies and prophylaxis measures make such elimination feasible, even in the absence of a virological cure. We aimed to estimate the national, regional, and global prevalence of HBV in the general population and among children aged 5 years and younger, as well as the rates of diagnosis, treatment, prophylaxis, and the future burden globally. METHODS In this modelling study, we used a Delphi process with data from literature reviews and interviews with country experts to quantify the prevalence, diagnosis, treatment, and prevention measures for HBV infection. The PRoGReSs Model, a dynamic Markov model, was used to estimate the country, regional, and global prevalence of HBV infection in 2022, and the effects of treatment and prevention on disease burden. The future incidence of morbidity and mortality in the absence of additional interventions was also estimated at the global level. FINDINGS We developed models for 170 countries which resulted in an estimated global prevalence of HBV infection in 2022 of 3·2% (95% uncertainty interval 2·7-4·0), corresponding to 257·5 million (216·6-316·4) individuals positive for HBsAg. Of these individuals, 36·0 million were diagnosed, and only 6·8 million of the estimated 83·3 million eligible for treatment were on treatment. The prevalence among children aged 5 years or younger was estimated to be 0·7% (0·6-1·0), corresponding to 5·6 million (4·5-7·8) children with HBV infection. Based on the most recent data, 85% of infants received three-dose HBV vaccination before 1 year of age, 46% had received a timely birth dose of vaccine, and 14% received hepatitis B immunoglobulin along with the full vaccination regimen. 3% of mothers with a high HBV viral load received antiviral treatment to reduce mother-to-child transmission. INTERPRETATION As 2030 approaches, the elimination targets remain out of reach for many countries under the current frameworks. Although prevention measures have had the most success, there is a need to increase these efforts and to increase diagnosis and treatment to work towards the elimination goals. FUNDING John C Martin Foundation, Gilead Sciences, and EndHep2030.
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10
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Fu CC, Chen YJ, Su CW, Wei CY, Chu CJ, Lee PC, Huo TI, Huang YH, Huang HC, Wu JC, Hou MC. The outcomes and prognostic factors of patients with hepatocellular carcinoma and Child-Turcotte-Pugh class B. J Chin Med Assoc 2023; 86:876-884. [PMID: 37537726 DOI: 10.1097/jcma.0000000000000975] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The Child-Turcotte-Pugh (CTP) score is widely used for assessing the liver's functional reserve in patients with advanced chronic liver disease (ACLD) and hepatocellular carcinoma (HCC). This study aims to explore the outcomes of patients with HCC and CTP class B and to investigate the prognostic accuracy of prediction models for ACLD in these patients. METHODS We retrospectively enrolled 1143 patients with HCC and CTP class B between 2007 and 2022. We divided the patients into three subgroups based on their CTP scores: CTP-B7, CTP-B8, and CTP-B9. We compared the corrected Akaike information criterion among each mortality prediction model, including the CTP score, albumin-bilirubin (ALBI) score, modified ALBI score, the model for end-stage liver disease (MELD), and MELD 3.0. RESULTS Among the enrolled patients, 576 (50.3%) were in the CTP-B7 group, 363 (31.8%) were in the CTP-B8 group, and 204 (17.9%) were in the CTP-B9 group. After a median follow-up of 4.6 months (interquartile range IQR 1.8-17.2 months), 963 patients died, and the 5-year overall survival (OS) rate was 11.4%. The 5-year OS rates were 11.6%, 13.6%, and 8.3% in the CTP-B7, CTP-B8, and CTP-B9 groups, respectively. Patients in the CTP-B7 group and CTP-B8 group had comparable OS ( p = 0.089), both of which were better than those in the CTP-B9 group ( p < 0.001). Furthermore, the MELD 3.0 score had the lowest corrected akaike information criteria value and provided a more accurate mortality prediction than the MELD score, ALBI grade, modified ALBI grade, and CTP score. CONCLUSION Patients in the CTP-B7 and CTP-B8 groups had comparable OS, both of which were better than those in the CTP-B9 group. Moreover, MELD 3.0 provided the most accurate mortality prediction in patients with HCC and CTP class B.
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Affiliation(s)
- Chia-Chu Fu
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yu-Jen Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Cheng-Yi Wei
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chi-Jen Chu
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Pei-Chang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Teh-Ia Huo
- Division of Basic Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Pharmacology, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, ROC
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Hui-Chun Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Blank TGH, Grishunin KA, Zvezdin KA, Hai NT, Wu JC, Su SH, Huang JCA, Zvezdin AK, Kimel AV. Two-Dimensional Terahertz Spectroscopy of Nonlinear Phononics in the Topological Insulator MnBi_{2}Te_{4}. Phys Rev Lett 2023; 131:026902. [PMID: 37505956 DOI: 10.1103/physrevlett.131.026902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 03/08/2023] [Accepted: 06/05/2023] [Indexed: 07/30/2023]
Abstract
The interaction of a single-cycle terahertz electric field with the topological insulator MnBi_{2}Te_{4} triggers strongly anharmonic lattice dynamics, promoting fully coherent energy transfer between the otherwise noninteracting Raman-active E_{g} and infrared (IR)-active E_{u} phononic modes. Two-dimensional terahertz spectroscopy combined with modeling based on the classical equations of motion and symmetry analysis reveals the multistage process underlying the excitation of the Raman-active E_{g} phonon. In this nonlinear combined photophononic process, the terahertz electric field first prepares a coherent IR-active E_{u} phononic state and subsequently interacts with this state to efficiently excite the E_{g} phonon.
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Affiliation(s)
- T G H Blank
- Institute for Molecules and Materials, Radboud University, 6525 AJ Nijmegen, Netherlands
| | - K A Grishunin
- Institute for Molecules and Materials, Radboud University, 6525 AJ Nijmegen, Netherlands
| | - K A Zvezdin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 119991 Moscow, Russia
- HSE University, 101000 Moscow, Russia
| | - N T Hai
- Department of Physics, National Changhua University of Education, Changhua 500, Taiwan
| | - J C Wu
- Department of Physics, National Changhua University of Education, Changhua 500, Taiwan
| | - S-H Su
- Department of Physics, National Cheng Kung University, Tainan 701, Taiwan
| | - J-C A Huang
- Department of Physics, National Cheng Kung University, Tainan 701, Taiwan
| | - A K Zvezdin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 119991 Moscow, Russia
- New Spintonic Technologies LLC, 121205 Moscow, Russia
| | - A V Kimel
- Institute for Molecules and Materials, Radboud University, 6525 AJ Nijmegen, Netherlands
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12
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Fu CC, Wei CY, Chu CJ, Lee PC, Huo TI, Huang YH, Chao Y, Hou MC, Wu JC, Su CW. The outcomes and prognostic factors of patients with hepatocellular carcinoma and normal serum alpha fetoprotein levels. J Formos Med Assoc 2023; 122:593-602. [PMID: 36456455 DOI: 10.1016/j.jfma.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/24/2022] [Accepted: 11/13/2022] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Alpha fetoprotein (AFP) is the most widely used tumor marker for hepatocellular carcinoma (HCC). Nevertheless, few studies have investigated the prognostic factors of HCC patients with normal serum AFP levels. METHODS We retrospectively enrolled 2198 patients with HCC and normal serum AFP levels (<20 ng/mL) from 2007 to 2020. Overall survival (OS) rates were calculated by the Kaplan-Meier method, and analyses of the prognostic factors were performed using a Cox proportional hazard model. RESULTS Among the enrolled patients, 1385 (63%) patients were in the low-normal AFP group (serum AFP levels ≤7 ng/mL), and 813 (37%) patients were in the high-normal AFP group (serum AFP levels between 7 and 20 ng/mL). The high-normal AFP group had poorer liver functional reserve, more multiple tumors, and smaller tumor size compared to those in the low-normal AFP group. After a median follow-up of 32.4 months, 942 patients died, and the 5-year OS rate was 54.4%. The 5-year OS rates were 57.4% and 49.8% in the low-normal AFP group and high-normal AFP group, respectively (p = 0.001). A multivariate analysis showed the independent prognostic factors of poor OS were no anti-viral therapy, advanced albumin-bilirubin grades, the presence of vascular invasion, tumor size ≥5 cm, and non-curative treatment modalities. Serum AFP levels were not associated with OS according to the multivariate analysis. CONCLUSION Liver functional reserve, anti-viral therapy, tumor size, vascular invasion, and treatment modalities, determined the outcomes of HCC patients with normal serum AFP levels, but serum AFP levels did not.
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Affiliation(s)
- Chia-Chu Fu
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Cheng-Yi Wei
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chi-Jen Chu
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Pei-Chang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Teh-Ia Huo
- Division of Basic Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Pharmacology, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Clinical medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yee Chao
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Jaw-Ching Wu
- Institute of Clinical medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Clinical medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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13
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Kao WY, Tan ECH, Lee HL, Huang YH, Huo TI, Chang CC, Chiou JF, Hou MC, Wu JC, Su CW. Entecavir versus tenofovir on prognosis of hepatitis B virus-related hepatocellular carcinoma after curative hepatectomy. Aliment Pharmacol Ther 2023; 57:1299-1312. [PMID: 36914943 DOI: 10.1111/apt.17438] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND There is still controversy about whether tenofovir disoproxil fumarate (TDF) and entecavir (ETV) have different effects on the outcomes of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). AIMS The aim of this study was to compare the prognoses between ETV and TDF treatment among patients with HBV-related HCC after hepatectomy. METHODS An analysis was done on data from the Taiwan Cancer Registry, which was linked to Taiwan National Health Insurance Research Database, for the years 2011-2016. We identified 7107 patients with HBV-related HCC after curative hepatectomy, and 25.3% of them used ETV or TDF after surgery. After propensity score overlap weighting, 1797 patients treated with ETV (n = 1365) or TDF (n = 432) were included for analyses. Cox proportional hazards models were used to compare the efficacy of ETV and TDF for recurrence and overall survival (OS). RESULTS After hepatectomy, the recurrence rate per 100 person-years was 14.87 for the ETV group and 9.25 for the TDF group. The risk of recurrence was similar in the TDF group and the ETV group (HR [95% CI]: 0.91 [0.69-1.19; p = 0.479]), as was the risk of all-cause mortality (HR [95% CI]: 0.67 [0.42-1.07]; p = 0.091). When considering early recurrence (<2 years) and late recurrence (≧2 years), the TDF and ETV groups showed no significant differences. Subgroup analyses and sensitivity analyses demonstrated consistent results. CONCLUSION Both TDF and ETV showed similar health benefits in terms of recurrence and OS in patients with HBV-related HCC patients after hepatectomy.
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Affiliation(s)
- Wei-Yu Kao
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
| | - Elise Chia-Hui Tan
- Department of Health Service Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Hsin-Lun Lee
- Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Teh-Ia Huo
- Division of Basic Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Pharmacology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Chao Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jeng-Fong Chiou
- Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Division of Holistic and Multidisciplinary Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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14
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Wang SY, Huang YH, Liang YJ, Wu JC. Gene coexpression network analysis identifies hubs in hepatitis B virus-associated hepatocellular carcinoma. J Chin Med Assoc 2022; 85:972-980. [PMID: 35801949 DOI: 10.1097/jcma.0000000000000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is among the leading causes of cancer-related death worldwide. The molecular pathogenesis of HCC involves multiple signaling pathways. This study utilizes systems and bioinformatic approaches to investigate the pathogenesis of HCC. METHODS Gene expression microarray data were obtained from 50 patients with chronic hepatitis B and HCC. There were 1649 differentially expressed genes inferred from tumorous and nontumorous datasets. Weighted gene coexpression network analysis (WGCNA) was performed to construct clustered coexpressed gene modules. Statistical analysis was used to study the correlation between gene coexpression networks and demographic features of patients. Functional annotation and pathway inference were explored for each coexpression network. Network analysis identified hub genes of the prognostic gene coexpression network. The hub genes were further validated with a public database. RESULT Five distinct gene coexpression networks were identified by WGCNA. A distinct coexpressed gene network was significantly correlated with HCC prognosis. Pathway analysis of this network revealed extensive integration with cell cycle regulation. Ten hub genes of this gene network were inferred from protein-protein interaction network analysis and further validated in an external validation dataset. Survival analysis showed that lower expression of the 10-gene signature had better overall survival and recurrence-free survival. CONCLUSION This study identified a crucial gene coexpression network associated with the prognosis of hepatitis B virus-related HCC. The identified hub genes may provide insights for HCC pathogenesis and may be potential prognostic markers or therapeutic targets.
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Affiliation(s)
- Shen-Yung Wang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Gastroenterology and Hepatology, Department of Medicine, MacKay Memorial Hospital, Taipei, Taiwan, ROC
| | - Yen-Hua Huang
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Center for Systems and Synthetic Biology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yuh-Jin Liang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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15
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Chen YJ, Su CW, Wei CY, Chau GY, Chen PH, Chao Y, Huang YH, Wu JC, Yang TC, Lee PC, Hou MC. Comparison of prognoses between cirrhotic and noncirrhotic patients with hepatocellular carcinoma and esophageal varices undergoing surgical resection. J Chin Med Assoc 2022; 85:679-686. [PMID: 35507056 DOI: 10.1097/jcma.0000000000000739] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Esophageal varices (EV) is common and is a poor prognostic factor for patients with hepatocellular carcinoma (HCC). However, the outcomes between cirrhotic and noncirrhotic HCC patients with EV is not well studied. The present study aimed to investigate the clinical manifestations and prognoses of HCC patients after surgical resection stratified by the cirrhosis status. METHODS A total of 111 patients with HCC and EV, who underwent surgical resection, were retrospectively enrolled between July 2003 and July 2019. The diagnosis of liver cirrhosis was established using the Ishak fibrosis score F5 or F6 in the nontumor part of liver specimens. Prognostic factors were analyzed using the Cox proportional hazards model. RESULTS There were 85 (76.6%) and 26 (23.4%) patients with and without cirrhosis, respectively. Compared with those without cirrhosis, there were more females, less seropositive rate of hepatitis B surface antigen (HBsAg), more seropositive rate of antibody against to hepatitis C virus (HCV), less albumin-bilirubin (ALBI) grade 1, lower platelet count, and more had tumor burden within the Milan criteria in cirrhotic patients. Cirrhotic patients had a higher risk of posthepatectomy decompensation compared to noncirrhotic patients (hazard ratio 9.577, p = 0.017). No difference was observed in overall survival and recurrence-free survival between patients with or without cirrhosis. CONCLUSION Compared with patients without cirrhosis, cirrhotic patients with HCC and EV are vulnerable to posthepatectomy decompensation. However, cirrhosis is not a poor prognostic factor of overall survival and recurrence for HCC patients after surgical resection.
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Affiliation(s)
- Yu-Jen Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Biomedical Science and Engineering Center, National Tsing Hua University, Hsinchu, Taiwan, ROC
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Cheng-Yi Wei
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Gar-Yang Chau
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ping-Hsien Chen
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Divsion of Gastroenterology and Hepatology, Department of Medicine, West Garden Hospital, Taipei, Taiwan, ROC
| | - Yee Chao
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Tsung-Chieh Yang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Pei-Chang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Lee CY, Chau GY, Wei CY, Chao Y, Huang YH, Huo TI, Hou MC, Su YH, Wu JC, Su CW. Surgical resection could provide better outcomes for patients with hepatocellular carcinoma and tumor rupture. Sci Rep 2022; 12:8343. [PMID: 35585167 PMCID: PMC9117281 DOI: 10.1038/s41598-022-12350-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/10/2022] [Indexed: 12/24/2022] Open
Abstract
We investigated the outcomes of patients with ruptured hepatocellular carcinoma (HCC) and identified the optimal treatment modality for such patients. We retrospectively enrolled 91 patients with treatment-naive HCC and tumor rupture at diagnosis, including 38 patients who underwent surgical resection (SR) alone, 28 patients who were treated with transarterial chemoembolization (TACE) only, 20 patients who had a sequential combination therapy of TACE and SR, and 5 patients who received best supportive care. After a median follow-up of 13.1 months, 54 patients died. The cumulative 5 years overall survival (OS) rates were 55.1% and 0% in the SR group and non-SR group, respectively (p < 0.001). Non-SR therapy was associated with poorer OS according to a multivariate analysis with a hazard ratio of 6.649 (95% confidence interval 3.581–12.344, p < 0.001). Moreover, whether patients received TACE or not did not impact the OS in both the SR group and the non-SR group. In conclusion, for patients with HCC and tumor rupture at the time of diagnosis, SR could lead to better prognoses than non-surgery treatment modalities. Moreover, a sequential combination of TACE and SR had similar clinical outcomes when compared to SR alone.
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Affiliation(s)
- Chun-Yang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Peitou District, Taipei, 11217, Taiwan
| | - Gar-Yang Chau
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Yi Wei
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Peitou District, Taipei, 11217, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yee Chao
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Peitou District, Taipei, 11217, Taiwan.,Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Teh-Ia Huo
- Division of Basic Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Pharmacology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Peitou District, Taipei, 11217, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Hui Su
- Department of Accounting, School of Business, Soochow University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Peitou District, Taipei, 11217, Taiwan. .,Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. .,Biomedical Science and Engineering Center, National Tsing Hua University, Hsinchu, Taiwan.
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17
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Abstract
BACKGROUND The incidence of hepatocellular carcinoma (HCC) is significantly higher in men than women. Nonetheless, the impact of sex disparities on HCC outcomes remains unclear. We aimed to compare the clinical manifestations and prognoses between male and female patients with HCC. METHODS This retrospective study enrolled 5337 consecutive patients (3976 men, 1361 women) who were diagnosed with HCC from 2007 to 2020. The prognostic factors were identified by the Cox proportional hazards model. RESULTS Male patients were younger upon HCC diagnosis (median age 64 vs 69 years; p < 0.001) with more favorable hepatic functional reserves (39.0% vs 35.1% albumin-bilirubin grade 1; p = 0.025) but had greater tumor burdens than the female patients. Furthermore, fewer male patients underwent curative therapies for HCC compared with the female patients (49.0% vs 57.0%; p < 0.001). After a median follow-up of 20.1 months (interquartile range, 5.8-47.3 months), 3133 patients died. The cumulative 5-year overall survival rates were 37.1% and 41.9% for male and female patients, respectively (p < 0.001). From the multivariate analysis, male sex was not an independent factor predictive of poor overall survival in all patients and in the subgroup analysis stratified by treatment modalities. When stratified by age, the female sex was an independent factor associated with lower mortality in younger (≤50 years) patients but not in older patients with HCC. CONCLUSION Sex was not an independent predictor of the outcome of patients with HCC, especially for those aged more than 50 years.
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Affiliation(s)
- Cheng-Yen Liao
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chun-Yang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Cheng-Yi Wei
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yee Chao
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yu-Hui Su
- Department of Accounting, School of Business, Soochow University, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Biomedical Science and Engineering Center, National Tsing Hua University, Hsinchu, Taiwan, ROC
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18
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Chang YS, Su CW, Chen SC, Chen YY, Liang YJ, Wu JC. Upregulation of USP22 and ABCC1 during Sorafenib Treatment of Hepatocellular Carcinoma Contribute to Development of Resistance. Cells 2022; 11:cells11040634. [PMID: 35203285 PMCID: PMC8870465 DOI: 10.3390/cells11040634] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 12/10/2022] Open
Abstract
Sorafenib is a small molecule that blocks tumor proliferation by targeting the activity of multi-kinases for the treatment of advanced hepatocellular carcinoma (HCC). Increasing sorafenib resistance following long-term treatment is frequently encountered. Mechanisms underlying sorafenib resistance remain not completely clear. To further understand the mechanism of sorafenib resistance in HCC, we established sorafenib-resistant cell lines by slowly increasing sorafenib concentration in cell culture medium. Upregulation of USP22 and ABCC1 were found in Sorafenib-resistant cells. Sorafenib-resistant cells treated with USP22 siRNA showed significant reduction in endogenous mRNA and protein levels of ABCC1. During sorafenib treatment, upregulation of USP22 increases ABCC1 expression and subsequently contributes to sorafenib resistance in HCC cells. Immunohistochemical analysis revealed a positive correlation between USP22 and ABCC1 expression in tissue samples from sorafenib-resistant patients (Pearson’s correlation = 0.59, p = 0.03). Our findings indicate that upregulation of USP22 and ABCC1 expression during treatment contribute to sorafenib resistance in HCC cells and that USP22 has strong potential as a therapeutic target for overcoming sorafenib resistance in HCC patients.
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Affiliation(s)
- Yung-Sheng Chang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (Y.-S.C.); (S.-C.C.)
| | - Chien-Wei Su
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - San-Chi Chen
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (Y.-S.C.); (S.-C.C.)
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
- Department of Oncology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Yen-Ying Chen
- Department of Pathology, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
| | - Yuh-Jin Liang
- Medical Research Department, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; (Y.-S.C.); (S.-C.C.)
- Medical Research Department, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Correspondence: ; Tel.: +886-2-28712121 (ext. 3218)
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Truong VA, Lin YH, Nguyen NTK, Hsu MN, Pham NN, Chang YH, Chang CW, Shen CC, Lee HS, Lai PL, Parfyonova YV, Menshikov M, Wu JC, Chang YH, Hu YC. Bi-directional gene activation and repression promote ASC differentiation and enhance bone healing in osteoporotic rats. Mol Ther 2022; 30:92-104. [PMID: 34450254 PMCID: PMC8753367 DOI: 10.1016/j.ymthe.2021.08.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/16/2021] [Accepted: 08/08/2021] [Indexed: 01/07/2023] Open
Abstract
Calvarial bone healing is challenging, especially for individuals with osteoporosis because stem cells from osteoporotic patients are highly prone to adipogenic differentiation. Based on previous findings that chondrogenic induction of adipose-derived stem cells (ASCs) can augment calvarial bone healing, we hypothesized that activating chondroinductive Sox Trio genes (Sox5, Sox6, Sox9) and repressing adipoinductive genes (C/ebp-α, Ppar-γ) in osteoporotic ASCs can reprogram cell differentiation and improve calvarial bone healing after implantation. However, simultaneous gene activation and repression in ASCs is difficult. To tackle this problem, we built a CRISPR-BiD system for bi-directional gene regulation. Specifically, we built a CRISPR-AceTran system that exploited both histone acetylation and transcription activation for synergistic Sox Trio activation. We also developed a CRISPR interference (CRISPRi) system that exploited DNA methylation for repression of adipoinductive genes. We combined CRISPR-AceTran and CRISPRi to form the CRISPR-BiD system, which harnessed three mechanisms (transcription activation, histone acetylation, and DNA methylation). After delivery into osteoporotic rat ASCs, CRISPR-BiD significantly enhanced chondrogenesis and in vitro cartilage formation. Implantation of the engineered osteoporotic ASCs into critical-sized calvarial bone defects significantly improved bone healing in osteoporotic rats. These results implicated the potential of the CRISPR-BiD system for bi-directional regulation of cell fate and regenerative medicine.
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Affiliation(s)
- Vu Anh Truong
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Ya-Hui Lin
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | | | - Mu-Nung Hsu
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Nam Ngoc Pham
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Yi-Hao Chang
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Chin-Wei Chang
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Chih-Che Shen
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Hsiang-Sheng Lee
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Po-Liang Lai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan,Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yelena V. Parfyonova
- National Medical Research Center of Cardiology, Russian Ministry of Health, Moscow, Russia,Faculty of Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Mikhail Menshikov
- Institute of Experimental Cardiology, National Cardiology Research Center, Moscow, Russia
| | - Jaw-Ching Wu
- Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan,Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yu-Han Chang
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan,Corresponding author: Yu-Chen Hu, Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan.
| | - Yu-Chen Hu
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan,Frontier Research Center on Fundamental and Applied Sciences of Matters, National Tsing Hua University, Hsinchu, Taiwan,Corresponding author: Yu-Han Chang, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
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20
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Chang TE, Su CW, Huang YS, Huang YH, Hou MC, Wu JC. Hepatitis D virus dual infection increased the risk of hepatocellular carcinoma compared with hepatitis B virus mono infection: A meta-analysis. J Chin Med Assoc 2022; 85:30-41. [PMID: 35006125 DOI: 10.1097/jcma.0000000000000606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Hepatitis delta virus (HDV) is a defective virus that relies on the supply of hepatitis B surface antigen (HBsAg) from hepatitis B virus (HBV) to assemble HDV virions and infect hepatocytes. However, controversy remains in whether the presence of HDV increases the risk of hepatocellular carcinoma (HCC). Our aim is to evaluate the influence of HDV on the risk of HCC through a systematic review and meta-analysis. METHODS A review of all English-language literature was conducted in the major medical databases using the subject search terms "hepatocellular carcinoma," "liver cancer," "hepatic tumor," and "hepatitis delta." A meta-analysis of the qualifying publications was then performed. RESULTS The meta-analysis included 21 studies, which revealed a significantly higher risk of HCC among patients with HDV/HBV dual infection (odds ratio [OR] = 2.08, 95% confidence interval [CI], 1.37-3.14, p < 0.01) compared with those with HBV monoinfection. Those with HDV/HBV dual infection remained at higher risk of HCC in the subgroup analysis, irrespective of the status of hepatitis C virus (HCV) or human immunodeficiency virus (HIV) coinfection and in different ethnicities. The HCC risk remained higher in patients with HDV/HBV dual infection with heterogeneous fibrosis stage (OR = 2.04, 95% CI, 1.31-3.17, p < 0.01). The difference in the risk of HCC between HDV/HBV dual infection and HBV monoinfection was not statistically significant in patients with cirrhosis or advanced fibrosis (OR = 1.84, 95% CI, 0.48-7.02, p = 0.37). However, this subgroup comprised only two studies. CONCLUSION HDV and HBV dual infection significantly increase the risk of HCC development compared with HBV monoinfection.
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Affiliation(s)
- Tien-En Chang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Shin Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Teng W, Chang TT, Yang HI, Peng CY, Su CW, Su TH, Hu TH, Yu ML, Yang HC, Wu JC. Risk scores to predict HCC and the benefits of antiviral therapy for CHB patients in gray zone of treatment guidelines. Hepatol Int 2021; 15:1421-1430. [PMID: 34741723 DOI: 10.1007/s12072-021-10263-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUNDS ALT ≥ 80 U/L and HBV DNA ≥ 2000 IU/ml are treatment criteria of APASL guidelines for chronic hepatitis B (CHB) patients. The need of antiviral therapy for patients in gray zone (ALT < 80 U/L or HBV DNA < 2000 IU/ml) is controversial. This study aimed to develop a scoring system to predict hepatocellular carcinoma (HCC) and evaluate the benefit of antiviral therapy in these patients. METHODS Seven hundred and forty-nine patients were analyzed. Significant variables were weighted to develop a scoring system for HCC prediction. The area under receiver operating curves (AUROC) were estimated and validated by REVEAL-HBV cohort (n = 3527). RESULTS Older age (p < 0.001), male sex (p = 0.036), family history of HCC (p = 0.002) and HBV DNA ≥ 2000 IU/ml (p = 0.045) were independently associated with HCC. A 14-point risk score system predicts 3 and 5-years HCC risk to be 0.866 and 0.868 of AUROC, respectively in the derivation cohort; 0.821 and 0.820, in the REVEAL-HBV cohort. The cumulative HCC incidence was higher in the high risk (score ≥ 8) group both in derivation and validation cohorts (p < 0.001). Patients with antiviral therapy had lower HCC incidence compared to those without (p = 0.016). Of note, antiviral therapy significantly decreased HCC in the high risk group (p = 0.005), but not in the low risk group (p = 0.705). CONCLUSIONS A risk scoring system is established and validated. Of CHB patients in gray zone of APASL guidelines, those with risk scores ≥ 8 had higher risk of HCC, but the risk could be significantly reduced by antiviral therapy.
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Affiliation(s)
- Wei Teng
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Republic of China
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
| | - Ting-Tsung Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
| | - Hwai-I Yang
- Genomics Research Center, Academia Sinica, Taipei, Taiwan, Republic of China
| | - Cheng-Yuan Peng
- Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Tung-Hung Su
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Tsung-Hui Hu
- Department of Gastroenterology and Hepatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
| | - Hung-Chih Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Republic of China.
- Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Republic of China.
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22
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Liang YJ, Teng W, Chen CL, Sun CP, Teng RD, Huang YH, Liang KH, Chen YW, Lin CC, Su CW, Tao MH, Wu JC. Clinical Implications of HBV PreS/S Mutations and the Effects of PreS2 Deletion on Mitochondria, Liver Fibrosis, and Cancer Development. Hepatology 2021; 74:641-655. [PMID: 33675094 DOI: 10.1002/hep.31789] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/11/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS PreS mutants of HBV have been reported to be associated with HCC. We conducted a longitudinal study of the role of HBV preS mutations in the development of HCC, particularly in patients with chronic hepatitis B (CHB) having low HBV DNA or alanine aminotransferase (ALT) levels, and investigated the effects of secretion-defective preS2 deletion mutant (preS2ΔMT) on hepatocyte damage in vitro and liver fibrosis in vivo. APPROACH AND RESULTS Association of preS mutations with HCC in 343 patients with CHB was evaluated by a retrospective case-control follow-up study. Effects of preS2ΔMT on HBsAg retention, endoplasmic reticulum (ER) stress, calcium accumulation, mitochondrial dysfunction, and liver fibrosis were examined. Multivariate analysis revealed a significant association of preS mutations with HCC (HR, 3.210; 95% CI, 1.072-9.613; P = 0.037) including cases with low HBV DNA or ALT levels (HR, 2.790; 95% CI, 1.133-6.873; P = 0.026). Antiviral therapy reduced HCC risk, including cases with preS mutations. PreS2ΔMT expression promoted HBsAg retention in the ER and unfolded protein response (UPR). Transmission electron microscopic examination, MitoTracker staining, real-time ATP assay, and calcium staining of preS2ΔMT-expressing cells revealed aberrant ER and mitochondrial ultrastructure, reduction of mitochondrial membrane potential and ATP production, and calcium overload. Serum HBV secretion levels were ~100-fold lower in preS2ΔMT-infected humanized Fah-/-/ Rag2-/-/Il2rg-/- triple knockout mice than in wild-type HBV-infected mice. PreS2ΔMT-infected mice displayed up-regulation of UPR and caspase-3 and enhanced liver fibrosis. CONCLUSIONS PreS mutations were significantly associated with HCC development in patients with CHB, including those with low HBV DNA or ALT levels. Antiviral therapy reduced HCC occurrence in patients with CHB, including those with preS mutations. Intracellular accumulation of mutated HBsAg induced or promoted ER stress, calcium overload, mitochondrial dysfunction, impaired energy metabolism, liver fibrosis, and HCC.
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Affiliation(s)
- Yuh-Jin Liang
- Translational Research DivisionMedical Research DepartmentTaipei Veterans General HospitalTaipeiTaiwan, ROC.,Cancer Progression Research CenterNational Yang-Ming UniversityTaipeiTaiwan, ROC
| | - Wei Teng
- Department of Gastroenterology & HepatologyChang Gung Memorial Hospital, Linkou Medical CenterTaoyuanTaiwan, ROC.,Institute of Clinical MedicineNational Yang-Ming UniversityTaipeiTaiwan, ROC
| | - Chih-Li Chen
- School of MedicineCollege of MedicineFu Jen Catholic UniversityTaipeiTaiwan, ROC
| | - Cheng-Pu Sun
- Institute of Biomedical SciencesAcademia SinicaTaipeiTaiwan, ROC
| | - Rui-Dung Teng
- Institute of Clinical MedicineNational Yang-Ming UniversityTaipeiTaiwan, ROC
| | - Yen-Hua Huang
- Center for Systems and Synthetic Biology and Institute of Biomedical InformaticsNational Yang-Ming UniversityTaipeiTaiwan, ROC
| | - Kung-Hao Liang
- Translational Research DivisionMedical Research DepartmentTaipei Veterans General HospitalTaipeiTaiwan, ROC
| | - Yi-Wen Chen
- Translational Research DivisionMedical Research DepartmentTaipei Veterans General HospitalTaipeiTaiwan, ROC
| | - Chung-Chih Lin
- Department of Life Sciences and Institute of Genome SciencesYang-Ming UniversityTaipeiTaiwan, ROC
| | - Chien-Wei Su
- Division of GastroenterologyDepartment of MedicineTaipei Veterans General HospitalTaipeiTaiwan, ROC.,Faculty of MedicineSchool of MedicineNational Yang-Ming UniversityTaipeiTaiwan, ROC
| | - Mi-Hua Tao
- Institute of Biomedical SciencesAcademia SinicaTaipeiTaiwan, ROC
| | - Jaw-Ching Wu
- Translational Research DivisionMedical Research DepartmentTaipei Veterans General HospitalTaipeiTaiwan, ROC.,Cancer Progression Research CenterNational Yang-Ming UniversityTaipeiTaiwan, ROC.,Institute of Clinical MedicineNational Yang-Ming UniversityTaipeiTaiwan, ROC
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23
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Lin HH, Hsu SJ, Lu SN, Chuang WL, Hsu CW, Chien RN, Yang SS, Su WW, Wu JC, Lee TH, Peng CY, Tseng KC, Qin A, Huang YW, Chen PJ. Ropeginterferon alfa-2b in patients with genotype 1 chronic hepatitis C: Pharmacokinetics, safety, and preliminary efficacy. JGH Open 2021; 5:929-940. [PMID: 34386602 PMCID: PMC8341194 DOI: 10.1002/jgh3.12613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/16/2021] [Accepted: 07/01/2021] [Indexed: 12/11/2022]
Abstract
Background and Aim Ropeginterferon alfa‐2b (P1101) is a novel long‐acting mono‐PEGylated recombinant proline interferon (IFN) conjugated to a 40 kDa branched polyethylene glycol (PEG) chain at its N‐terminus, allowing every‐two‐week injection. It received European Medicines Agency and Taiwan marketing authorization for the treatment of polycythemia vera in 2019 and 2020, respectively. This phase 2 study aimed to evaluate the pharmacokinetics, safety, and preliminary efficacy of ropeginterferon alfa‐2b as compared with PEG‐IFN‐α2a in patients with chronic hepatitis C virus genotype 1 infection. Methods One hundred six treatment naive patients were enrolled in this phase 2 study and randomized to four treatment groups: subcutaneous weekly PEG‐IFN‐α2a 180 μg (group 1), weekly ropeginterferon alfa‐2b 180 μg (group 2), weekly ropeginterferon alfa‐2b 270 μg (group 3), or biweekly ropeginterferon alfa‐2b 450 μg (group 4) plus ribavirin for 48 weeks. Results After multiple weekly administration, serum exposure (AUC0‐τ) in ropeginterferon alfa‐2b 180 μg was approximately 41% greater and the accumulation ratio of 2‐fold greater than PEG‐IFN‐α2a 180 μg. The incidences of flu‐like symptoms were 66.7% (18/27), 53.3% (16/30), 55.0% (11/20), and 48.3% (14/29), anxiety were 14.8% (4/27), 6.7% (2/30), 0%, and 0%, and depression were 25.9% (7/27), 13.3% (4/30), 0%, and 3.4% (1/29), for groups 1–4, respectively. Two grade 2 of 3 depression were noted in PEG‐IFN‐α2a arm, but none in ropeginterferon arms. The SVR24 rates were 77.8% (21/27), 66.7% (20/30), 80% (16/20), and 69% (20/29), respectively. Conclusions Ropeginterferon alfa‐2b showed longer effective half‐life and superior safety profile than PEG‐IFN‐α2a. Biweekly injection of ropeginterferon alfa‐2b will be studied in larger viral hepatitis patient population.
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Affiliation(s)
- Hsien-Hong Lin
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Taipei Tzu Chi Hospital Taipei Taiwan
| | - Shih-Jer Hsu
- Department of Internal Medicine National Taiwan University Hospital Yunlin Branch Douliu and Huwei Taiwan.,Hepatology Medical Center, Department of Internal Medicine National Taiwan University Hospital Yunlin Branch Douliu Taiwan
| | - Sheng-Nan Lu
- Division of Hepatogastroenterology, Department of Internal Medicine Chia-Yi Chang Gung Memorial Hospital Puzi Taiwan
| | - Wan-Long Chuang
- Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan
| | - Chao-Wei Hsu
- Division of Hepatology, Department of Gastroenterology and Hepatology Linkou Medical Center, Chang Gung Memorial Hospital Taoyuan Taiwan
| | - Rong-Nan Chien
- Division of Hepatology, Department of Gastroenterology and Hepatology Linkou Medical Center, Chang Gung Memorial Hospital Taoyuan Taiwan
| | - Sien-Sing Yang
- Liver Center, Department of Internal Medicine Cathay General Hospital Medical Center Taipei Taiwan
| | - Wei-Wen Su
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Changhua Christian Hospital Changhua Taiwan
| | - Jaw-Ching Wu
- Medical Research Department Taipei Veterans General Hospital Taipei Taiwan
| | - Tzong-Hsi Lee
- Division Gastroenterology, Department of Internal Medicine Far-Eastern Memorial Hospital New Taipei City Taiwan
| | - Cheng-Yuan Peng
- Center for Digestive Medicine, Department of Internal Medicine China Medical University Hospital, and School of Medicine, China Medical University Taichung Taiwan
| | - Kuan-Chiao Tseng
- Department of Medical Research PharmaEssentia Corp Taipei Taiwan
| | - Albert Qin
- Department of Medical Research PharmaEssentia Corp Taipei Taiwan
| | - Yi-Wen Huang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine Taipei Medical University Taipei Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine Taipei Medical University Hospital Taipei Taiwan.,Department of Internal Medicine, School of Medicine National Taiwan University College of Medicine Taipei Taiwan
| | - Pei-Jer Chen
- Graduate Institute of Clinical Medicine National Taiwan University College of Medicine Taipei Taiwan.,Hepatitis Research Center National Taiwan University Hospital Taipei Taiwan
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24
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Wu JC, Wu Z, Yu P, Yang S, Luo YC, Liu C. [Cone-beam CT evaluation of the Monson's spherical radius of young adults in Guangdong]. Zhonghua Kou Qiang Yi Xue Za Zhi 2021; 56:196-199. [PMID: 33557505 DOI: 10.3760/cma.j.cn112144-20200517-00281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To measure and analyze the spherical radius of Monson of normal young people in Guangdong province using cone-beam CT (CBCT), and to establish a personalized measurement method of the spherical radius of Monson to provide a reference for clinical application of Monson spherical radius in occlusal reconstruction. Methods: Sixty healthy young adults from physical examination population at Stomatology Hospital of Guangzhou Medical University [30 males and 30 females, aged (22.1±2.0) years 18-26 years) were recruited, and their CBCT were taken. Three-dimensional reconstruction of CBCT data was carried out, and the reconstructed models were fixed, traced and measured. The difference of Monson spherical radius between male and female was compared by using a single sample t-test. Results: The Monson spherical radius was (100.72±4.89) mm. The Monson spherical radius of male and female were (103.48±4.19) mm and (97.97±3.93) mm respectively. The difference between male and female was statistically significant (P<0.01). Conclusions: CBCT can be used to accurately measure the spherical radius of Monson and can be used as a reference for reconstruction of occlusal plane.
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Affiliation(s)
- J C Wu
- Department of Prosthodontics, Stomatology Hospital of Guangzhou Medical University & Guangzhou Institute of Oral Disease & Key Laboratory of Oral Medicine, Guangzhou 510140, China
| | - Z Wu
- Department of Prosthodontics, Stomatology Hospital of Guangzhou Medical University & Guangzhou Institute of Oral Disease & Key Laboratory of Oral Medicine, Guangzhou 510140, China
| | - P Yu
- Department of Prosthodontics, Stomatology Hospital of Guangzhou Medical University & Guangzhou Institute of Oral Disease & Key Laboratory of Oral Medicine, Guangzhou 510140, China
| | - S Yang
- Department of Prosthodontics, Stomatology Hospital of Guangzhou Medical University & Guangzhou Institute of Oral Disease & Key Laboratory of Oral Medicine, Guangzhou 510140, China
| | - Y C Luo
- Department of Prosthodontics, Stomatology Hospital of Guangzhou Medical University & Guangzhou Institute of Oral Disease & Key Laboratory of Oral Medicine, Guangzhou 510140, China
| | - C Liu
- Department of Orthodontics, Stomatology Hospital of Guangzhou Medical University & Guangzhou Institute of Oral Disease & Key Laboratory of Oral Medicine, Guangzhou 510140, China
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Chang CY, Wei CY, Chen PH, Hou MC, Chao Y, Chau GY, Lee RC, Huang YH, Su YH, Wu JC, Su CW. The role of albumin-bilirubin grade in determining the outcomes of patients with very early-stage hepatocellular carcinoma. J Chin Med Assoc 2021; 84:136-143. [PMID: 33433133 DOI: 10.1097/jcma.0000000000000482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Patients with hepatocellular carcinoma (HCC) and with a single tumor <2 cm in size are classified as having Barcelona Clinic Liver Cancer (BCLC) stage 0 HCC. We aimed to investigate the role of the albumin-bilirubin (ALBI) grade in predicting outcomes in patients with BCLC stage 0 HCC. METHODS We retrospectively enrolled patients with BCLC stage 0 HCC in Taipei Veterans General Hospital from 2007 to 2015. Prognostic factors were analyzed using a Cox proportional hazards model and propensity score matching (PSM) analysis. RESULTS There were 420 patients enrolled, including 207 with ALBI grade 1, and 213 with ALBI grade 2 or 3. After a median follow-up of 60.0 months (interquartile range, 37.2-84.6 months), 179 patients died. The cumulative 5-year overall survival (OS) rates were 80.6% in patients with ALBI grade 1 and 53.7% in those with ALBI grade 2 or 3, respectively (p < 0.001). Multivariate analysis showed that age >65 years, negative hepatitis B surface in serum, creatinine >1.0 mg/dL, platelet count ≤105/mm3, tumor size >1.5 cm, nonsurgical resection (SR) therapy, and higher ALBI grade were independent risk factors related to poor OS. Patients who underwent SR had a better OS and recurrence-free survival than those who received radiofrequency ablation, which was confirmed by a multivariate analysis and PSM analysis. CONCLUSION The ALBI grade can determine OS for patients with BCLC stage 0 HCC. SR can also provide a better outcome than nonsurgical treatment.
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Affiliation(s)
- Chung-Yu Chang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Healthcare and Services Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Cheng-Yi Wei
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ping-Hsien Chen
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of Gastroenterology and Hepatology, Department of Medicine, West Garden Hospital, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yee Chao
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Gar-Yang Chau
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Rheun-Chuan Lee
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yu-Hui Su
- Department of Accounting, School of Business, Soochow University, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Cancer Progression Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Lai KL, Niddam DM, Fuh JL, Chen WT, Wu JC, Wang SJ. Reply to letter to the editor: Insights into chronic migraine pathophysiology - what measures of gray matter reveal. Cephalalgia 2020; 40:1138-1139. [PMID: 32536269 DOI: 10.1177/0333102420933262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Lai KL, Niddam DM, Fuh JL, Chen WT, Wu JC, Wang SJ. Cortical morphological changes in chronic migraine in a Taiwanese cohort: Surface- and voxel-based analyses. Cephalalgia 2020; 40:575-585. [PMID: 32299230 DOI: 10.1177/0333102420920005] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous voxel- or surface-based morphometric analysis studies have revealed alterations in cortical structure in patients with chronic migraine, yet with inconsistent results. The discrepancies may be derived partly from the sample heterogeneity. Employing both methods in a clinically homogenous group may provide a clearer view. METHODS Structural MRI data from 30 prevention-naïve patients with chronic migraine without medication overuse headache or a history of major depression and 30 healthy controls were analyzed. Vertex-wise (surface-based) or voxel-wise (voxel-based) linear models were applied, after controlling for age and gender, to investigate between-group differences. Averaged cortical thicknesses and volumes from regions showing group differences were correlated with parameters related to clinical profiles. RESULTS Surface-based morphometry showed significantly thinner cortices in the bilateral insular cortex, caudal middle frontal gyrus, precentral gyrus, and parietal lobes in patients with chronic migraine relative to healthy controls. Additionally, the number of migraine days in the month preceding MRI examination was correlated negatively with right insular cortical thickness. Voxel-based morphometry (VBM) did not show any group differences or clinical correlations. CONCLUSION Patients with chronic migraine without medication overuse headache, major depression, or prior preventive treatment had reduced cortical thickness in regions within the pain-processing network. Compared to voxel-based morphometry, surface-based morphometry analysis may be more sensitive to subtle structural differences between healthy controls and patients with chronic migraine.
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Affiliation(s)
- Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Wei CY, Chen PC, Chau GY, Lee RC, Chen PH, Huo TI, Huang YH, Su YH, Hou MC, Wu JC, Su CW. Comparison of prognosis between surgical resection and transarterial chemoembolization for patients with solitary huge hepatocellular carcinoma. Ann Transl Med 2020; 8:238. [PMID: 32309385 PMCID: PMC7154415 DOI: 10.21037/atm.2019.12.157] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background For patients with solitary huge (>10 cm in size) hepatocellular carcinoma (HCC) and without major vascular invasion, the treatment efficacy between surgical resection (SR) and transarterial chemoembolization (TACE) is not well studied. We aimed to compare the prognoses between SR and TACE for patients with solitary huge HCC. Methods We enrolled 143 patients with treatment-naïve, solitary HCC (>10 cm) who had received either SR or TACE treatment between 2007–2016. Factors of overall survival (OS) were analyzed by multivariate analysis. Propensity scores matching (PSM) method was adopted to adjust baseline demographic differences for further analysis. Results Ninety patients underwent SR and 53 patients received TACE. After a median follow-up of 17.0 (interquartile range 7.7–45.6) months, 83 patients had died. The cumulative 5-year OS rate was 44.7% and 11.7% for the SR group and the TACE group, respectively (P<0.001). A multivariate analysis showed that TACE [hazard ratio (HR): 3.515, 95% confidence interval (CI): 2.202–5.610, P<0.001], and albumin-bilirubin (ALBI) grade >1 (HR: 2.181, 95% CI: 1.343–3.543, P=0.002) were the independent risk factors associated with poorer OS. After PSM, 37 pairs of matched patients were selected from each treatment arm. After matching, patients who underwent SR still evinced a significantly higher OS than did those who underwent TACE (P=0.010). Conclusions SR provided a better OS than did TACE for patients with solitary huge (≥10 cm) HCC. As such, SR is recommended as the therapeutic priority for these patients.
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Affiliation(s)
- Cheng-Yi Wei
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei
| | - Po-Chun Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei
| | - Gar-Yang Chau
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei.,Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei
| | - Rheun-Chuan Lee
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei.,Department of Radiology, Taipei Veterans General Hospital, Taipei
| | - Ping-Hsien Chen
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei.,Institute of Biophotonics, National Yang-Ming University, Taipei
| | - Teh-Ia Huo
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei.,Institute of Pharmacology, National Yang-Ming University, Taipei.,Department of Medical Research, Taipei Veterans General Hospital, Taipei
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei.,Institute of Clinical Medicine, National Yang-Ming University, Taipei
| | - Yu-Hui Su
- Department of Accounting, School of Business, Soochow University, Taipei
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei
| | - Jaw-Ching Wu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei.,Institute of Clinical Medicine, National Yang-Ming University, Taipei
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei
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Su CW, Fang KC, Lee RC, Liu CA, Chen PH, Lee PC, Kao WY, Huang YH, Huo TI, Hou MC, Lin HC, Wu JC. Association between esophagogastric varices in hepatocellular carcinoma and poor prognosis after transarterial chemoembolization: A propensity score matching analysis. J Formos Med Assoc 2020; 119:610-620. [DOI: 10.1016/j.jfma.2019.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/26/2019] [Accepted: 09/06/2019] [Indexed: 02/07/2023] Open
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Abstract
BACKGROUND Nucleos(t)ide analogue (NA) therapy reduces the risk of disease progression in chronic hepatitis B virus-infected patients. However, the risk of liver decompensation, hepatic failure, and mortality after discontinuation of NA therapy remains unknown. METHODS Among 51,574 chronic hepatitis B patients who received NAs in the Taiwan National Health Insurance Research Database, we identified 8,631 patients who continued NA therapy (treatment cohort) and 8,631 propensity-score matched patients who stopped NA therapy after their initial 1.5 years treatment (off-therapy cohort) between October 1, 2003 and December 31, 2011. All study subjects were followed up from the index date, that is, the date 1.5 years after the first prescription of NA, until development of liver decompensation and hepatic failure, death or end of 18-month follow-up period. RESULTS Treatment cohort had significantly lower risks of liver decompensation (1.05%; 95% confidence interval [CI], 0.81%-1.30% vs 2.13%; 95% CI, 1.82%-2.45%; p < 0.001), hepatic failure (0.35%; 95% CI, 0.21%-0.49% vs 0.63%; 95% CI, 0.46%-0.80%; p = 0.008) and overall mortality (1.67%; 1.37%-1.98% vs 2.44%; 95% CI, 2.10%-2.77%; p < 0.001) during the 18-month follow-up period. After adjusting for potential confounders, NA continuous therapy was associated with reduced risks of liver decompensation (hazard ratio [HR]: 0.47; 95% CI, 0.36-0.62, p < 0.001), hepatic failure (HR: 0.53; 95% CI, 0.33-0.86, p = 0.01) and overall mortality (HR: 0.67; 95% CI, 0.53-0.84, p = 0.001). The number needed to reduce one less disease progression and mortality was 47. The protective effect of NA continuous therapy was found in nearly all subgroups. CONCLUSION NA continuous therapy is associated with reduced risks of liver decompensation, hepatic failure, and overall mortality.
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Affiliation(s)
- Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chun-Ying Wu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Public Health and Graduate Institute of Clinical Medical Sciences, China Medical University, Taichung, Taiwan, ROC
- National Institute of Cancer Research, National Health Research Institutes, Miaoli, Taiwan, ROC
- Department of Life Sciences and RongHsing Research Center for Translational Medicine, National Chung-Hsing University, Taichung, Taiwan, ROC
| | - Jaw-Town Lin
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
- Division of Gastroenterology and Hepatology, Fu-Jen Catholic University Hospital, New Taipei City, Taiwan, ROC
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC
| | - Hsiu J Ho
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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31
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Gyongyosi M, Lukovic D, Pavo N, Gugerell A, Winkler J, Spannbauer A, Pavo IJ, Michel-Behnke I, Emmert MY, Hoerstrup SP, Marian T, Balkay L, Trencsenyi G, Wu JC, Zlabinger K. P5990In vivo tracking of long-term survival of xenogeneic porcine mesenchymal stem cells seeded on tissue-engineered heart valve implanted in sheep. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Long-term survival of xenogeneic transplanted cells in adults requires strong immunosuppression and/or encapsulation of the cells to achieve peripheral transplant tolerance.
Purpose
The aim of our project was to seed decellularized tissue engineered heart valves (TEHV) with xenogeneic (porcine) mesenchymal stem cells (pMSCs) transfected transiently (Lipofectamine) with a positron emission tomography (PET)-reporter gene (pMSC-PETr), followed by implantation as pulmonary valve replacement into sheep without immunosuppression. The fate of the seeded pMSC-PETr was tracked via serial in-vivo non-invasive PET-computed tomography (PET-CT).
Methods
Static cultivation of TEHV scaffold led to successful ingrowth of the pMSC-PETr. For enabling quantitative assessment of viable pMSC-PETr in the TEHV scaffold after in vivo implantation, vials containing 5x104, 2x105, and 4x105 pMSC-PETr were in vitro mixed with the [18F]-FHBG PET tracer for 1 hr, then the non-bound tracer was washed out and vials were in vitro PET-CT imaged, giving reference values. TEHV-pMSC-PETr were then implanted percutaneously into the pulmonary valve position of sheep (n=4) under general anesthesia, while an additional sheep with no valve implantation served as a control. Ten mCi of [18F]-FHBGPET radiotracer was produced for each procedure and serial PET-CT imaging of the sheep was performed at 3 hr, 24 hr, 2 or 3 weeks, and 5 and 6 months after valve implantation. The study followed the Principles of laboratory animal care.
Results
PET-CT of vials containing increasing number of pMSC-PETr showed dose-dependent tracer uptake in the transfected cells in vitro (Figure). PET-CT images of the sheep 3 hr after implantation of the TEHV-pMSC-PETr showed a clear signal of transfected cells, with a mean estimated number of viable pMSC-PETr of 5.18±1.19x106. No meaningful decrease of the amount of living cells occurred at 24 hr or 2 or 3 weeks. Interestingly, 5- and 6-month follow-up PET-CT images showed clear in vivo and in vitro (after explantation) PET signals of the pMSC-PETr on TEHV, indicating spontaneous stable transfection of the PET reporter plasmid (insertional mutagenesis). Histology confirmed the survival of the pMSC-PETr at 5 and 6-month after xenogeneic transplantation. Merged immunohistochemistry and fluorescence imaging of anti-pig SLA I and anti-sheep MHC I antibodies and PET-reporter gene (HSV1-tk) suggested in vivo inter-species lateral jump gene transfer between pig MSCs and host sheep cells.
Figure 1
Conclusions
This is the first report on serial non-invasive in vivo tracking of long-term survival of xenogeneic pMSCs-PETr seeded on TEHVs and percutaneously implanted into the pulmonary position of sheep. Long-term follow-up revealed spontaneous stable transfection of the plasmid PET-reporter gene, which suggests the risk of insertional mutagenesis induced by the plasmid (transposon), and PET-reporter gene shuttle from xenogeneic pig MSCs to sheep cells.
Acknowledgement/Funding
LifeValve EU project (grant number: 242008)
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Affiliation(s)
- M Gyongyosi
- Medical University of Vienna, Vienna, Austria
| | - D Lukovic
- Medical University of Vienna, Vienna, Austria
| | - N Pavo
- Medical University of Vienna, Vienna, Austria
| | - A Gugerell
- Medical University of Vienna, Vienna, Austria
| | - J Winkler
- Medical University of Vienna, Vienna, Austria
| | | | - I J Pavo
- Medical University of Vienna, Vienna, Austria
| | | | - M Y Emmert
- Institute for Regenerative Medicine (IREM), Zurich, Switzerland
| | - S P Hoerstrup
- Institute for Regenerative Medicine (IREM), Zurich, Switzerland
| | - T Marian
- University of Debrecen, Debrecen, Hungary
| | - L Balkay
- University of Debrecen, Debrecen, Hungary
| | | | - J C Wu
- Stanford University Medical Center, Stanford, United States of America
| | - K Zlabinger
- Stanford University Medical Center, Stanford, United States of America
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32
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Chen PC, Kao WY, Cheng YL, Wang YJ, Hou MC, Wu JC, Su CW. The correlation between fatty liver disease and chronic kidney disease. J Formos Med Assoc 2019; 119:42-50. [PMID: 30876789 DOI: 10.1016/j.jfma.2019.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/15/2018] [Accepted: 02/21/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/PURPOSE The impact of non-alcoholic fatty liver disease (NAFLD) on the prevalence of chronic kidney disease (CKD) is not fully elucidated. We aimed to assess the correlation between NAFLD and CKD in a large population study. METHODS We included consecutive subjects who had received health check-up service at Taipei Veterans General Hospital from 2002 to 2009. NAFLD was diagnosed with abdominal ultrasound, and advanced liver fibrosis was determined with NAFLD fibrosis score (NAFLD-FS). CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. RESULTS Among the 29,797 subjects enrolled in this study, NAFLD and CKD were diagnosed in 44.5% and 20.2% of the population, respectively. Subjects with NAFLD had a higher proportion of CKD compared to those without NAFLD (24.1% vs. 17.1%, p < 0.001). However, NAFLD was not related to CKD with an odds ratio (OR) of 1.015 (95% confidence interval [CI] 0.954-1.081, p = 0.630) after multivariate analyses. Nevertheless, further analyses revealed that among patients with NAFLD, those with advanced fibrosis were more likely to have CKD after adjusting for confounding factors (OR 2.284, 95% CI 1.513-3.448, p < 0.001). CONCLUSION NAFLD per se was not a risk factor for CKD, but NAFLD patients with advanced fibrosis faced a higher possibility of CKD. Hence, patients with NAFLD and advanced fibrosis should be screened for CKD and prompted to receive treatment if the diagnosis was made.
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Affiliation(s)
- Po-Chun Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Yu Kao
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taiwan
| | - Yuan-Lung Cheng
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology, Department of Medicine, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan.
| | - Yuan-Jen Wang
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Healthcare and Services, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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33
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Kao WY, Su CW, Chia-Hui Tan E, Lee PC, Chen PH, Tang JH, Huang YH, Huo TI, Chang CC, Hou MC, Lin HC, Wu JC. Proton Pump Inhibitors and Risk of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B or C. Hepatology 2019; 69:1151-1164. [PMID: 30175498 DOI: 10.1002/hep.30247] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/21/2018] [Indexed: 12/16/2022]
Abstract
Researchers have hypothesized that the long-term use of proton pump inhibitors (PPIs) can increase the risk of developing cancer. However, the association between PPI use and hepatocellular carcinoma (HCC) risk is unclear. Using data from the Taiwan National Health Insurance Research Database for the period between 2003 and 2013, we identified 35,356 patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. One-to-one propensity score matching by gender, age, cohort entry year, comorbidity, and medication resulted in the inclusion of 7,492 pairs of patients (PPI users and non-PPI users) for analyses. We performed multivariate and stratified analysis using the Kaplan-Meier method and Cox proportional hazards models in order to estimate the association between PPI use and the risk of developing HCC. In the HBV cohort, 237 patients developed HCC during a median follow-up of 53 months. However, PPI use was not associated with an increased risk of developing HCC (adjusted hazard ratio [aHR], 1.25; 95% confidence interval [CI], 0.90-1.73; P = 0.18). In the HCV cohort, 211 patients developed HCC; but again, PPI use was not associated with an increase in the risk of developing HCC (aHR, 1.19; 95% CI, 0.88-1.61; P = 0.25). We observed no relationship between a dose-dependent effect of PPI use and HCC risk. Subgroup analysis also confirmed that PPI use was not correlated to an increased HCC risk. Conclusion: Based on a retrospective population-based cohort study throughout Taiwan, where the prescription of PPI is tightly regulated, PPI use is not associated with the risk of developing HCC among patients with chronic HBV or HCV infections.
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Affiliation(s)
- Wei-Yu Kao
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Elise Chia-Hui Tan
- National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei, Taiwan
| | - Pei-Chang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Pharmacology, Taipei, Taiwan
| | - Ping-Hsien Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jui-Hsiang Tang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Teh-Ia Huo
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Pharmacology, Taipei, Taiwan
| | - Chun-Chao Chang
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Han-Chieh Lin
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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34
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Chen PC, Chiu NC, Su CW, Huang YH, Hou MC, Lin HC, Wu JC. Albumin-bilirubin grade may determine the outcomes of patients with very early stage hepatocellular carcinoma after radiofrequency ablation therapy. J Chin Med Assoc 2019; 82:2-10. [PMID: 30839396 DOI: 10.1097/jcma.0000000000000001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND To assess long-term prognoses of patients with solitary hepatocellular carcinoma (HCC) < 2 cm (the Barcelona Clinic Liver Cancer, BCLC stage 0) after radiofrequency ablation (RFA). METHODS We retrospectively enrolled 271 patients with BCLC stage 0 HCC who had undergone RFA at Taipei Veterans General Hospital from 2002 to 2016. Factors determining poor overall survival (OS) and recurrence after RFA were analyzed by Cox proportional hazards model. RESULTS After a median follow-up duration of 43.4 months, 76 patients had died. The cumulative 5- and 10-year OS rates were 67.1% and 56.4%, respectively. Multivariate analysis disclosed age > 65 years (hazard ratio [HR] 1.608, 95% confidence interval, [CI] 1.015-2.545; p = 0.043), platelet count < 100,000/mm (HR 1.704, 95% CI 1.027-2.828; p = 0.039), and albumin-bilirubin (ALBI) grade 2 or 3 (HR 2.191, 95% CI 1.261-3.805; p = 0.005) were the independent risk factors predicting worse OS. One-hundred twelve patients had tumor recurrence after undergoing RFA. Multivariate analysis showed that ALBI grade 2 or 3 (HR 1.825, 95% CI 1.288-2.585; p = 0.001) was the only one independent risk factor associated with poor recurrence-free survival (RFS) after RFA. Most of the subgroup analyses also demonstrated that patients with ALBI grade 2 or 3 had poorer OS and RFS than those with ALBI grade 1. CONCLUSION For patients with BCLC stage 0 HCC, RFA could provide a long-term outcome with a 10-year overall survival rate of 56.4%. Moreover, the ALBI grade can discriminate prognosis in such patients.
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Affiliation(s)
- Po-Chun Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Nai-Chi Chiu
- Division of Gastrointestinal Radiology, Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Han-Chieh Lin
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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35
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Fang KC, Kao WY, Su CW, Chen PC, Lee PC, Huang YH, Huo TI, Chang CC, Hou MC, Lin HC, Wu JC. The Prognosis of Single Large Hepatocellular Carcinoma Was Distinct from Barcelona Clinic Liver Cancer Stage A or B: The Role of Albumin-Bilirubin Grade. Liver Cancer 2018; 7:335-358. [PMID: 30488023 PMCID: PMC6249598 DOI: 10.1159/000487407] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 02/04/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND/AIMS Whether single large hepatocellular carcinoma (SLHCC) is classified as Barcelona Clinic Liver Cancer (BCLC) stage A or B is still controversial. We aimed to compare the clinical manifestations, treatment modalities, and prognoses among patients with SLHCC and those in BCLC stage A and B. METHODS We enrolled 2,285 treatment-naive hepatocellular carcinoma (HCC) patients with BCLC stage A or B from October 2007 to December 2015. Factors in terms of prognoses were analyzed by multivariate analysis. RESULTS We enrolled 1,210, 466, and 609 patients in a BCLC-A, SLHCC, and BCLC-B group, respectively. After a median follow-up duration of 21.2 months, 898 patients had died. The cumulative 5-year survival rates were 57.0, 42.6, and 27.3% for patients in the BCLC-A, SLHCC, and BCLC-B groups, respectively, which were significantly different (p < 0.001). Multivariate analysis indicated that the following independent risk factors were associated with poor prognosis: age > 65 years, alkaline phosphatase > 100 U/L, creatinine > 1.0 mg/dL, alpha-fetoprotein > 20 mg/mL, noncurative treatment, albumin-bilirubin (ALBI) grade, and HCC staging. Subgroup analysis also confirmed that patients in the SLHCC group had a survival rate intermediate to those in the BCLC-A and BCLC-B groups. However, for patients in the SLHCC group and with ALBI grade 1, outcomes were close to those in the BCLC-A group, especially in the setting of curative treatment. For those with ALBI grades 2 or 3, the prognoses were similar to those of the SLHCC and BCLC-B groups. CONCLUSION Patients in the SLHCC group had an overall survival rate intermediate to those of the BCLC-A and BCLC-B groups. It is suggested that the SLHCC group could be classified as occupying a different stage from the BCLC stages A and B. The ALBI grade could help to stratify SLHCC into a different prognostic group. However, the results need to be validated externally in other regions of the world.
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Affiliation(s)
- Kuan-Chieh Fang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wei-Yu Kao
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan,Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan,*Chien-Wei Su, MD, PhD, Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, #201, Section 2, Shih-Pai Road, Taipei 112 (Taiwan), E-Mail
| | - Po-Chun Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Chang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Teh-Ia Huo
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Department and Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Chao Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan,Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Han-Chieh Lin
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan,*Jaw-Ching Wu, MD, PhD, Department of Medical Research, Taipei Veterans General Hospital, #201, Section 2, Shih-Pai Road, Taipei 112 (Taiwan), E-Mail
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36
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Chen CL, Tsai YS, Huang YH, Liang YJ, Sun YY, Su CW, Chau GY, Yeh YC, Chang YS, Hu JT, Wu JC. Lymphoid Enhancer Factor 1 Contributes to Hepatocellular Carcinoma Progression Through Transcriptional Regulation of Epithelial-Mesenchymal Transition Regulators and Stemness Genes. Hepatol Commun 2018; 2:1392-1407. [PMID: 30411085 PMCID: PMC6211324 DOI: 10.1002/hep4.1229] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 06/09/2018] [Indexed: 12/19/2022] Open
Abstract
Lymphoid enhancer factor 1 (LEF1) activity is associated with progression of several types of cancers. The role of LEF1 in progression of hepatocellular carcinoma (HCC) remains poorly known. We investigated LEF1 expression in HCC and its interactions with epithelial-mesenchymal transition (EMT) regulators (e.g., Snail, Slug, Twist) and stemness genes (e.g., octamer-binding transcription factor 4 [Oct4], sex determining region Y-box 2 [Sox2], Nanog homeobox [Nanog]). Microarray analysis was performed on resected tumor samples from patients with HCC with or without postoperative recurrence. LEF1 expression was associated with postoperative recurrence as validated by immunohistochemical staining in another HCC cohort. Among 74 patients, 44 displayed a relatively high percentage of LEF1 staining (>30% of HCC cells), which was associated with a reduced recurrence-free interval (P < 0.001) and overall survival (P = 0.009). In multivariate analysis, a high percentage of LEF1 staining was significantly associated with low albumin level (P = 0.035), Twist overexpression (P = 0.018), Snail overexpression (P = 0.064), co-expression of Twist and Snail (P = 0.054), and multinodular tumors (P = 0.025). Down-regulation of LEF1 by short hairpin RNA decreased tumor sphere formation, soft agar colony formation, and transwell invasiveness of HCC cell lines Mahlavu and PLC. Xenotransplant and tail vein injection experiments revealed that LEF1 down-regulation in Mahlavu reduced tumor size and metastasis. LEF1 up-regulation in Huh7 increased sphere formation, soft agar colony formation, and transwell invasiveness. LEF1 was shown to physically interact with and transcriptionally activate promoter regions of Oct4, Snail, Slug, and Twist. Furthermore, Oct4, Snail, and Twist transactivated LEF1 to form a regulatory positive-feedback loop. Conclusion: LEF1 plays a pivotal role in HCC progression through transcriptional regulation of Oct4 and EMT regulators.
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Affiliation(s)
- Chih-Li Chen
- School of Medicine, College of Medicine Fu Jen Catholic University New Taipei City Taiwan
| | - Yu-Shuen Tsai
- Center for Systems and Synthetic Biology and Institute of Biomedical Informatics National Yang-Ming University Taipei Taiwanl
| | - Yen-Hua Huang
- Center for Systems and Synthetic Biology and Institute of Biomedical Informatics National Yang-Ming University Taipei Taiwanl
| | - Yuh-Jin Liang
- Translational Research Division, Medical Research Department Taipei Veterans General Hospital Taipei Taiwan
| | - Ya-Yun Sun
- Graduate Institute of Biomedical and Pharmaceutical Science Fu Jen Catholic University New Taipei City Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan.,Faculty of Medicine National Yang-Ming University School of Medicine Taipei Taiwan
| | - Gar-Yang Chau
- Department of Surgery and Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Yi-Chen Yeh
- Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Yung-Sheng Chang
- Institute of Clinical Medicine, School of Medicine National Yang-Ming University Taipei Taiwan
| | - Jui-Ting Hu
- School of Medicine, College of Medicine Fu Jen Catholic University New Taipei City Taiwan.,Liver Center Cathay General Hospital Taipei Taiwan
| | - Jaw-Ching Wu
- Translational Research Division, Medical Research Department Taipei Veterans General Hospital Taipei Taiwan.,Institute of Clinical Medicine, School of Medicine National Yang-Ming University Taipei Taiwan.,Cancer Progression Research Center
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37
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Lin MW, Tseng YW, Shen CC, Hsu MN, Hwu JR, Chang CW, Yeh CJ, Chou MY, Wu JC, Hu YC. Synthetic switch-based baculovirus for transgene expression control and selective killing of hepatocellular carcinoma cells. Nucleic Acids Res 2018; 46:e93. [PMID: 29905834 PMCID: PMC6125686 DOI: 10.1093/nar/gky447] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/04/2018] [Accepted: 05/31/2018] [Indexed: 12/13/2022] Open
Abstract
Baculovirus (BV) holds promise as a vector for anticancer gene delivery to combat the most common liver cancer-hepatocellular carcinoma (HCC). However, in vivo BV administration inevitably results in BV entry into non-HCC normal cells, leaky anticancer gene expression and possible toxicity. To improve the safety, we employed synthetic biology to engineer BV for transgene expression regulation. We first uncovered that miR-196a and miR-126 are exclusively expressed in HCC and normal cells, respectively, which allowed us to engineer a sensor based on distinct miRNA expression signature. We next assembled a synthetic switch by coupling the miRNA sensor and RNA binding protein L7Ae for translational repression, and incorporated the entire device into a single BV. The recombinant BV efficiently entered HCC and normal cells and enabled cis-acting transgene expression control, by turning OFF transgene expression in normal cells while switching ON transgene expression in HCC cells. Using pro-apoptotic hBax as the transgene, the switch-based BV selectively killed HCC cells in separate culture and mixed culture of HCC and normal cells. These data demonstrate the potential of synthetic switch-based BV to distinguish HCC and non-HCC normal cells for selective transgene expression control and killing of HCC cells.
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Affiliation(s)
- Mei-Wei Lin
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Yen-Wen Tseng
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Chih-Che Shen
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Mu-Nung Hsu
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Jih-Ru Hwu
- Department of Chemistry, National Tsing Hua University, Hsinchu, Taiwan
- Frontier Research Center on Fundamental and Applied Sciences of Matters, National Tsing Hua University, Hsinchu, Taiwan
| | - Chin-Wei Chang
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Chung-Ju Yeh
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Min-Yuan Chou
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Jaw-Ching Wu
- Medical Research Department, Taipei Veterans General Hospital, Taipei Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chen Hu
- Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
- Frontier Research Center on Fundamental and Applied Sciences of Matters, National Tsing Hua University, Hsinchu, Taiwan
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38
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Sarajärvi T, Jäntti M, Paldanius KMA, Natunen T, Wu JC, Mäkinen P, Tarvainen I, Tuominen RK, Talman V, Hiltunen M. Protein kinase C -activating isophthalate derivatives mitigate Alzheimer's disease-related cellular alterations. Neuropharmacology 2018; 141:76-88. [PMID: 30138694 DOI: 10.1016/j.neuropharm.2018.08.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/15/2018] [Accepted: 08/19/2018] [Indexed: 12/26/2022]
Abstract
Abnormal protein kinase C (PKC) function contributes to many pathophysiological processes relevant for Alzheimer's disease (AD), such as amyloid precursor protein (APP) processing. Phorbol esters and other PKC activators have been demonstrated to enhance the secretion of soluble APPα (sAPPα), reduce the levels of β-amyloid (Aβ), induce synaptogenesis, and promote neuroprotection. We have previously described isophthalate derivatives as a structurally simple family of PKC activators. Here, we characterised the effects of isophthalate derivatives HMI-1a3 and HMI-1b11 on neuronal viability, neuroinflammatory response, processing of APP and dendritic spine density and morphology in in vitro. HMI-1a3 increased the viability of embryonic primary cortical neurons and decreased the production of the pro-inflammatory mediator TNFα, but not that of nitric oxide, in mouse neuron-BV2 microglia co-cultures upon LPS- and IFN-γ-induced neuroinflammation. Furthermore, both HMI-1a3 and HMI-1b11 increased the levels of sAPPα relative to total sAPP and the ratio of Aβ42/Aβ40 in human SH-SY5Y neuroblastoma cells. Finally, bryostatin-1, but not HMI-1a3, increased the number of mushroom spines in proportion to total spine density in mature mouse hippocampal neuron cultures. These results suggest that the PKC activator HMI-1a3 exerts neuroprotective functions in the in vitro models relevant for AD by reducing the production of TNFα and increasing the secretion of neuroprotective sAPPα.
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Affiliation(s)
- T Sarajärvi
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - M Jäntti
- Drug Research Program and Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - K M A Paldanius
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - T Natunen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - J C Wu
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - P Mäkinen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - I Tarvainen
- Drug Research Program and Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - R K Tuominen
- Drug Research Program and Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
| | - V Talman
- Drug Research Program and Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - M Hiltunen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland.
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Gara E, Ong SG, Winkler J, Zlabinger K, Lukovic D, Jakab A, Merkely B, Wu JC, Gyongyosi M, Pavo N. 240Mesenchymal stem cells transfected with minicircle-HIF-1a decreases LV adverse remodelling via release of cardioprotective miRNAs and pro-angiogenic factors. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Gara
- Semmelweis University, Heart Center, Budapest, Hungary
| | - S G Ong
- School of Medicine, Stanford Cardiovascular Institute, Stanford, United States of America
| | - J Winkler
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
| | - K Zlabinger
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
| | - D Lukovic
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
| | - A Jakab
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
| | - B Merkely
- Semmelweis University, Heart Center, Budapest, Hungary
| | - J C Wu
- School of Medicine, Stanford Cardiovascular Institute, Stanford, United States of America
| | - M Gyongyosi
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
| | - N Pavo
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
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40
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Liu WC, Wu IC, Lee YC, Lin CP, Cheng JH, Lin YJ, Yen CJ, Cheng PN, Li PF, Cheng YT, Cheng PW, Sun KT, Yan SL, Lin JJ, Yang JC, Chang KC, Ho CH, Tseng VS, Chang BCH, Wu JC, Chang TT. Hepatocellular carcinoma-associated single-nucleotide variants and deletions identified by the use of genome-wide high-throughput analysis of hepatitis B virus. J Pathol 2017; 243:176-192. [PMID: 28696069 DOI: 10.1002/path.4938] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/31/2017] [Accepted: 07/04/2017] [Indexed: 12/26/2022]
Abstract
This study investigated hepatitis B virus (HBV) single-nucleotide variants (SNVs) and deletion mutations linked with hepatocellular carcinoma (HCC). Ninety-three HCC patients and 108 non-HCC patients were enrolled for HBV genome-wide next-generation sequencing (NGS) analysis. A systematic literature review and a meta-analysis were performed to validate NGS-defined HCC-associated SNVs and deletions. The experimental results identified 60 NGS-defined HCC-associated SNVs, including 41 novel SNVs, and their pathogenic frequencies. Each SNV was specific for either genotype B (n = 24) or genotype C (n = 34), except for nt53C, which was present in both genotypes. The pathogenic frequencies of these HCC-associated SNVs showed a distinct U-shaped distribution pattern. According to the meta-analysis and literature review, 167 HBV variants from 109 publications were categorized into four levels (A-D) of supporting evidence that they are associated with HCC. The proportion of NGS-defined HCC-associated SNVs among these HBV variants declined significantly from 75% of 12 HCC-associated variants by meta-analysis (Level A) to 0% of 10 HCC-unassociated variants by meta-analysis (Level D) (P < 0.0001). PreS deletions were significantly associated with HCC, in terms of deletion index, for both genotypes B (P = 0.030) and C (P = 0.049). For genotype C, preS deletions involving a specific fragment (nt2977-3013) were significantly associated with HCC (HCC versus non-HCC, 6/34 versus 0/32, P = 0.025). Meta-analysis of preS deletions showed significant association with HCC (summary odds ratio 3.0; 95% confidence interval 2.3-3.9). Transfection of Huh7 cells showed that all of the five novel NGS-defined HCC-associated SNVs in the small surface region influenced hepatocarcinogenesis pathways, including endoplasmic reticulum-stress and DNA repair systems, as shown by microarray, real-time polymerase chain reaction and western blot analysis. Their carcinogenic mechanisms are worthy of further research. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Wen-Chun Liu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.,Infectious Disease and Signalling Research Centre, National Cheng Kung University, Tainan, Taiwan, ROC
| | - I-Chin Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.,Infectious Disease and Signalling Research Centre, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Yen-Chien Lee
- Department of Oncology, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan, ROC.,Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | | | - Ji-Hong Cheng
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Yih-Jyh Lin
- Department of Surgery, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan, ROC
| | - Chia-Jui Yen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.,Infectious Disease and Signalling Research Centre, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Pin-Nan Cheng
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.,Infectious Disease and Signalling Research Centre, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Pei-Fu Li
- Institute of Medical Informatics, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Yi-Ting Cheng
- Institute of Medical Informatics, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Pei-Wen Cheng
- Department of Information and Learning Technology, Science and Engineering College, National University of Tainan, Tainan, Taiwan, ROC
| | - Koun-Tem Sun
- Department of Information and Learning Technology, Science and Engineering College, National University of Tainan, Tainan, Taiwan, ROC
| | - Shu-Ling Yan
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Jia-Jhen Lin
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Jui-Chu Yang
- Human Biobank, Research Centre of Clinical Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
| | - Kung-Chao Chang
- Human Biobank, Research Centre of Clinical Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
| | - Cheng-Hsun Ho
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.,Infectious Disease and Signalling Research Centre, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Vincent S Tseng
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan, ROC
| | | | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.,Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ting-Tsung Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.,Infectious Disease and Signalling Research Centre, National Cheng Kung University, Tainan, Taiwan, ROC
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Wang YF, Chen YT, Luo JC, Chen TJ, Wu JC, Wang SJ. Proton-Pump Inhibitor Use and the Risk of First-Time Ischemic Stroke in the General Population: A Nationwide Population-Based Study. Am J Gastroenterol 2017; 112:1084-1093. [PMID: 28397874 DOI: 10.1038/ajg.2017.101] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 02/01/2017] [Accepted: 03/07/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES An increased risk of adverse cardiovascular events was reported for concomitant use of proton-pump inhibitors (PPIs) in patients taking antiplatelet agents. The present study aimed at determining whether PPI use alone could be associated with first-time ischemic stroke. METHODS This was a retrospective nationwide study using database from Taiwan National Health Insurance and involved subjects aged ≥20 years. In propensity score-matched analysis, patients with current PPI use were compared with propensity score-matched PPI non-use controls at a 1:1 ratio. Patients with prior stroke or hospitalization before the index date were excluded. The primary outcome measure was hospitalization with a primary diagnosis of ischemic stroke during 120-day follow-up. A parallel analysis adopting a nested case-control design was carried out. Patients hospitalized for a first-time ischemic stroke were identified and were compared with matched controls using conditional logistic regression analyses focusing on PPI use before the index date. RESULTS The propensity score-matched analysis included 198,148 PPI treatment courses and control periods without PPI use. PPI use was associated with a higher risk of hospitalization due to ischemic stroke with a hazard ratio of 1.36 (95% confidence interval (CI) 1.14-1.620, P=0.001). Based on subgroup analysis, patients aged <60 years were more susceptible (P=0.043 for interaction), whereas gender, history myocardial infarction, diabetes mellitus, hypertension, use of antiplatelet agents of non-steroidal anti-inflammatory drugs, or type of PPIs had no effect on the risk. In the nested case-control analysis, 15,378 patients hospitalized owing to ischemic stroke were identified and were compared with 15,378 matched controls. An association between PPI use and increased cerebrovascular risks was identified, and the adjusted odds ratios for PPI use were 1.77 (95% CI 1.45-2.18, P<0.001) within 30 days, 1.65 (95% CI 1.31-2.08, P<0.001) between 31 and 90 days, and 1.28 (95% CI 1.03-1.59, P=0.025) between 91 and 180 days before the onset of first-time ischemic stroke. CONCLUSIONS PPI use is associated with an increased risk of first-time ischemic stroke in the general population, and the risk is independent of antiplatelet agents. However, caution should be exercised when considering its clinical relevance as the magnitude of association was modest and a cause-and-effect relationship remained to be established.
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Affiliation(s)
- Yen-Feng Wang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yung-Tai Chen
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan
| | - Jiing-Chyuan Luo
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Jaw-Ching Wu
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
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42
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Kao WY, Su CW, Chiou YY, Chiu NC, Liu CA, Fang KC, Huo TI, Huang YH, Chang CC, Hou MC, Lin HC, Wu JC. Hepatocellular Carcinoma: Nomograms Based on the Albumin-Bilirubin Grade to Assess the Outcomes of Radiofrequency Ablation. Radiology 2017; 285:670-680. [PMID: 28562211 DOI: 10.1148/radiol.2017162382] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose To construct a nomogram with the albumin-bilirubin (ALBI) grade to assess the long-term outcomes of patients with early-stage hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). Materials and Methods This retrospective study was approved by the institutional review board, and informed consent was waived. We studied 622 treatment-naïve patients with HCC according to the Milan criteria who subsequently underwent RFA from 2002 to 2013. Baseline characteristics were collected to identify the risk factors for determination of poor overall survival after RFA. The multivariate Cox proportional hazards model based on significant prognostic factors of overall survival was used to construct the nomogram. Results After a median follow-up time of 35.7 months, 190 patients had died. The cumulative 5- and 10-year overall survival rates were 63.1% and 48.7%, respectively. Stratified according to ALBI grade, the cumulative 5- and 10-year survival rates were 80.0% and 67.9% for patients with grade 1, respectively, and 48.6% and 35.1% for those with grades 2-3, respectively (P < .001). Multivariate analysis results showed that patient age older than 65 years, a prothrombin time international normalized ratio greater than 1.1, α-fetoprotein level greater than 20 ng/mL, multiple tumors, and ALBI grade 2 or 3 were associated with overall mortality. A nomogram was developed on the basis of these five variables. Internal validation with 200 bootstrapped sample sets had a good concordance index of 0.770 (95% confidence interval: 0.633, 0.876). Conclusion This simple nomogram based on the ALBI grade offers personalized long-term survival data for patients with early-stage HCC who undergo RFA. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Wei-Yu Kao
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Chien-Wei Su
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Yi-You Chiou
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Nai-Chi Chiu
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Chien-An Liu
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Kuan-Chieh Fang
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Teh-Ia Huo
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Yi-Hsiang Huang
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Chun-Chao Chang
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Ming-Chih Hou
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Han-Chieh Lin
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
| | - Jaw-Ching Wu
- From the Division of Gastroenterology and Hepatology, Department of Medicine (W.Y.K., C.W.S., K.C.F., T.I.H., Y.H.H., M.C.H., H.C.L.), Division of Gastrointestinal Radiology, Department of Radiology (Y.Y.C., N.C.C., C.A.L.), Endoscopy Center for Diagnosis and Treatment (M.C.H.), and Division of Translational Research, Department of Medical Research (J.C.W.), Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan; Faculty of Medicine (W.Y.K., C.W.S., Y.Y.C., N.C.C., C.A.L., M.C.H., H.C.L.), Institute of Pharmacology (T.I.H.), and Institute of Clinical Medicine (Y.H.H., J.C.W.), School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (W.Y.K., C.C.C.); and Division of Gastroenterology and Hepatology, Department of Internal Medicine (W.Y.K., C.C.C.), and Graduate Institute of Clinical Medicine , School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W.Y.K.)
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Fang KC, Cheng YL, Su CW, Wang YJ, Lan KH, Huo TI, Huang YH, Chu CJ, Lin CC, Hou MC, Lin HC, Lee FY, Wu JC, Lee SD. Higher platelet counts are associated with metabolic syndrome independent of fatty liver diagnosis. J Chin Med Assoc 2017; 80:125-132. [PMID: 27686501 DOI: 10.1016/j.jcma.2016.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/31/2016] [Accepted: 06/30/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Platelet count (PC) and fatty liver are both associated with metabolic syndrome (MS), obesity, and type 2 diabetes. While PC increases in obesity and type 2 diabetes, the severity of hepatic fibrosis caused by fatty liver reduces PC. We aimed to investigate the correlation of PC and MS in patients with and without fatty liver. METHODS We enrolled consecutive patients who received health check-ups at Taipei Veterans General Hospital from 2002 to 2009. Ultrasonography was used to diagnose fatty liver, and MS was diagnosed according to the criteria defined by the International Diabetes Federation Task Force on Epidemiology and Prevention. RESULTS Among the 29,797 patients, MS was present in 28.74%. Higher PC was correlated with MS using multivariate analysis, while fatty liver had the strongest association with MS. After dividing the patients by the presence or absence of fatty liver, higher PC was still associated with MS in both groups. The patients were further stratified by age and gender, and MS was correlated with PC among all age groups in women and in men under 60 years of age; however, the association between PC and MS did not reach statistical difference in men older than 60 years. CONCLUSION There is a significant correlation between PC and MS, and the correlation exists independent of gender, age, and fatty liver. PC may act as a surrogate marker for MS, and physicians should be concerned with the presence of MS among patients with high PC.
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Affiliation(s)
- Kuan-Chieh Fang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yuan-Lung Cheng
- Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan, ROC; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
| | - Yuan-Jen Wang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Healthcare Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Keng-Hsin Lan
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Teh-Ia Huo
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chi-Jen Chu
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
| | - Chung-Chi Lin
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Healthcare Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Healthcare Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Han-Chieh Lin
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
| | - Fa-Yauh Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Dong Lee
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Division of Gastroenterology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
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Hsieh WY, Chen PH, Lin IY, Su CW, Chao Y, Huo TI, Huang YH, Hou MC, Lin HC, Wu JC. The impact of esophagogastric varices on the prognosis of patients with hepatocellular carcinoma. Sci Rep 2017; 7:42577. [PMID: 28209963 PMCID: PMC5314332 DOI: 10.1038/srep42577] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/12/2017] [Indexed: 02/07/2023] Open
Abstract
Whether or not esophagogastric varices (EGV) could determine the outcomes of patients with hepatocellular carcinoma (HCC) is still unclear. A total of 990 treatment-naive HCC patients who received an esophagogastroduodenoscopy at the time of HCC diagnosis were retrospectively enrolled. The factors in terms of prognosis were analyzed by Cox proportional hazards model and propensity score matching analysis. Among the enrolled patients, 480 (48.5%) patients had EGV. Patients with EGV had a significantly lower cumulative 5-year survival rate than those without EGV (24.9% versus 46.4%, p < 0.001). It was confirmed by a multivariate analysis and propensity score matching analysis. Stratified by tumor stage, the patients with EGV had lower survival rates than the patients without EGVs in all Barcelona Clinic Liver Cancer stages except stage D. Moreover, the patients with EGV had lower survival rates than those without EGV, both by curative or non-curative treatment modalities. In conclusion, EGV was an independent risk factor predicting poor prognosis for the patients with HCC by multivariate analysis, propensity score matching analysis, and subgroup analysis.
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Affiliation(s)
- Wei-Yao Hsieh
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ping-Hsien Chen
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
| | - I-Yen Lin
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yee- Chao
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Teh-Ia Huo
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department and Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Han-Chieh Lin
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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Teng YC, Neo JC, Wu JC, Chen YF, Kao CH, Tsai TF. Expression of a hepatitis B virus pre-S2 deletion mutant in the liver results in hepatomegaly and hepatocellular carcinoma in mice. J Pathol 2017; 241:463-474. [PMID: 27868197 DOI: 10.1002/path.4850] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 10/07/2016] [Accepted: 11/09/2016] [Indexed: 12/18/2022]
Abstract
Hepatocellular carcinoma (HCC) is the most common form of liver cancer and has a poor prognosis and a low survival rate; its incidence is on the rise. Hepatitis B virus (HBV) infection is one of the main causes of HCC. A high prevalence of pre-S deletions of HBV surface antigen, which encompass T-cell and/or B-cell epitopes, is found in HBV carriers; antiviral therapy and viral immune escape may cause and select for these HBV mutants. In particular, the presence of pre-S2 deletion mutants is an important risk factor associated with cirrhosis and HCC. We generated Alb-preΔS2 transgenic mice that express a naturally occurring pre-S2 mutant protein containing a 33-nucleotide deletion (preΔS2); the aim was to investigate its effect on hepatocarcinogenesis. After 30 months of follow-up, the liver pathology of the mice fell into four groups: G1, chronic inflammation solely; G2, chronic inflammation and fibrosis; G3, inflammation, fibrosis, and hepatomegaly accompanied by rectal prolapse (4-12%); and G4, hepatomegaly and spontaneous HCC (12-15%). Striking degeneration of the endoplasmic reticulum (ER) was present in the mouse livers at an early stage (4 months old). At 8 months, overt ER stress and the Atf6 pathway of the unfolded protein response (UPR) were induced; at the same time, metabolic pathways associated with mevalonate and cholesterol biogenesis, involving the peroxisomes and the ER, were disturbed. At 20 months and older, the protein kinase RNA-like endoplasmic reticulum kinase (PERK) pathway of the UPR was induced and the Hippo transducer Yap was activated. Together, these ultrastructural aberrations and metabolic disturbance all seem to contribute to the molecular pathogenesis and hepatocarcinogenesis present in the Alb-preΔS2 mice. These findings may contribute to the development of therapies for the liver disorders and HCC associated with pre-S2 deletion mutations among HBV carriers. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Yuan-Chi Teng
- Program in Molecular Medicine, School of Life Sciences, National Yang-Ming University and Academia Sinica, Taipei, Taiwan.,Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Jenq Chyuan Neo
- Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Translational Research Division, Medical Research Department, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Fan Chen
- The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Heng Kao
- Center of General Education, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Fen Tsai
- Program in Molecular Medicine, School of Life Sciences, National Yang-Ming University and Academia Sinica, Taipei, Taiwan.,Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, Taipei, Taiwan.,Genome Research Center, National Yang-Ming University, Taipei, Taiwan.,Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Molecular and Genomic Medicine, National Health Research Institutes, Zhunan, Taiwan
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Fang KC, Su CW, Chiou YY, Lee PC, Chiu NC, Liu CA, Chen PH, Kao WY, Huang YH, Huo TI, Hou MC, Lin HC, Wu JC. The impact of clinically significant portal hypertension on the prognosis of patients with hepatocellular carcinoma after radiofrequency ablation: a propensity score matching analysis. Eur Radiol 2016; 27:2600-2609. [PMID: 27678133 DOI: 10.1007/s00330-016-4604-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/26/2016] [Accepted: 09/07/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To assess the impact of clinically significant portal hypertension (CSPH) on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). METHODS We retrospectively enrolled 280 treatment-naïve early-stage HCC patients who had Child-Pugh grade A or B and received upper gastrointestinal endoscopy at the time of HCC diagnosis. CSPH was defined as (1) a platelet count < 100,000/mm3 associated with splenomegaly and/or (2) the presence of oesophageal/gastric varices by endoscopy. Factors determining poor overall survival and recurrence after RFA were analysed by Cox proportional hazards model and propensity score matching analysis. RESULTS A total of 192 (68.6 %) patients had CSPH. The cumulative 5-year survival rates were 50.6 % and 76.7 % in patients with and without CSPH, respectively (p = 0.015). Based on multivariate analysis, age > 65 years (hazard ratio (HR) 1.740, p = 0.025), serum albumin levels ≤ 3.5 g/dL (HR 3.268, p < 0.001) and multiple tumours (HR 1.693, p = 0.046), but not CSPH, were independent risk factors associated with poor overall survival after RFA. Moreover, the overall survival rates were comparable between patients with and without CSPH after adjusting for confounding factors via propensity score matching analysis. CONCLUSIONS CSPH was not associated with poor outcomes after RFA. KEY POINTS • CSPH was common in HCC patients who underwent RFA therapy. • CSPH was not an independent risk factor in determining poor prognosis. • Serum albumin level was more important to determine the outcomes.
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Affiliation(s)
- Kuan-Chieh Fang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chien-Wei Su
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yi-You Chiou
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Division of Gastrointestinal Radiology, Department of Radiology, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei, 112, Taiwan.
| | - Pei-Chang Lee
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Yuanshan Branch, Taipei Veterans General Hospital, Yilan, Taiwan.,Department and Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Nai-Chi Chiu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastrointestinal Radiology, Department of Radiology, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei, 112, Taiwan
| | - Chien-An Liu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastrointestinal Radiology, Department of Radiology, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei, 112, Taiwan
| | - Ping-Hsien Chen
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Yu Kao
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Teh-Ia Huo
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department and Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Han-Chieh Lin
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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Ji GY, Wang Y, Wu SQ, Liu QQ, Wu JC, Zhang MM, Sandford AJ, He JQ. Association between TXNRD1 polymorphisms and anti-tuberculosis drug-induced hepatotoxicity in a prospective study. Genet Mol Res 2016; 15:gmr8296. [PMID: 27706680 DOI: 10.4238/gmr.15038296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Anti-tuberculosis drug-induced hepatotoxicity (ATDH) is a serious adverse reaction to anti-tuberculosis (TB) treatment. Thioredoxin reductase 1 (TXNRD1), encoded by the TXNRD1 gene, is an important enzyme involved in oxidant challenge. TXNRD1 plays a key role in regulating cell growth and transformation, and protects cells against oxidative damage. We investigated the association between TXNRD1 polymorphisms and ATDH susceptibility. In this prospective study, 280 newly diagnosed TB patients were followed-up for 3 months after beginning anti-TB therapy. Tag single-nucleotide polymorphisms (tag-SNPs) of TXNRD1 were selected using Haploview 4.2 based on the HapMap database of the Chinese Han in Beijing (CHB) panel. Genotyping was performed using the MassARRAY platform. Of the 280 patients enrolled in this study, 33 were lost to follow-up, 24 had ATDH, and 223 were free from ATDH. After adjusting for sex, age, smoking status, and body mass index, there were no significant differences in the allele and genotype frequency distributions of TXNRD1 SNPs between the ATDH and non-ATDH groups (all P > 0.05). The haplotype analysis showed that haplotype TCAGCC was associated with an increased risk of ATDH susceptibility [P = 0.024, OR (95%CI) = 6.273 (1.023-38.485)]. Further stratified analyses showed that the haplotype TCAGCC was associated with ATDH susceptibility in female subjects [P = 0.036, OR (95%CI) = 5.711 (0.917-35.560)] and non-smokers [P = 0.029, OR (95%CI) = 6.008 (0.971-37.158)]. Our results suggest that TXNRD1 variants may favor ATDH susceptibility in females and non-smokers. Further studies are required to verify this association.
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Affiliation(s)
- G Y Ji
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - S Q Wu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Q Q Liu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Guoxue Alley, Chengdu, Sichuan, China
| | - J C Wu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - M M Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - A J Sandford
- Centre for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
| | - J Q He
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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48
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Chen DS, Liaw YF, Chen CJ, Wu JC, Chuang WL, Peng CY, Chien RN. Differences in hepatitis viral etiology of hepatocellular carcinoma in Taiwan and China. Hepatology 2016; 64:1008-9. [PMID: 26661317 DOI: 10.1002/hep.28378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- Ding-Shinn Chen
- Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Yun-Fan Liaw
- Liver Research Unit, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Graduate Institute of Epidemiology and Preventative Medicine, National Taiwan University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Division of Gastroenterology, Institute of Clinical Medicine, Veterans General Hospital-Taipei, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Long Chuang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Yuan Peng
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Rong-Nan Chien
- Liver Research Unit, Chang Gung Memorial Hospital and University, Keelung, Taiwan
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49
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Lee PC, Yeh CM, Hu YW, Chen CC, Liu CJ, Su CW, Huo TI, Huang YH, Chao Y, Chen TJ, Lin HC, Wu JC. Antiplatelet Therapy is Associated with a Better Prognosis for Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma after Liver Resection. Ann Surg Oncol 2016; 23:874-883. [PMID: 27541812 DOI: 10.1245/s10434-016-5520-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recurrence of hepatocellular carcinoma (HCC) with unsatisfactory survival is common after surgical resection. Antiplatelet therapy with aspirin or clopidogrel was recently shown to prevent hepatic carcinogenesis in a murine model, but its effect in humans had not been clarified. This study aimed to investigate the association between antiplatelet therapy and the outcomes for patients with hepatitis B virus (HBV)-related HCC after liver resection. METHODS By analyzing data from the Taiwan National Health Insurance Research Database, 9461 HBV-related HCC patients who had undergone liver resection between January 1997 and December 2011 were identified. After one-to-four matching by sex, age, and propensity score, 442 patients with antiplatelet therapy and 1768 patients without antiplatelet therapy were enrolled for the analysis. The Kaplan-Meier method and modified Cox proportional hazards models were used for survival and multivariable, stratified analyses. RESULTS Recurrence-free survival and overall survival after resection surgery were significantly better after 5 years in the treated cohort than in the untreated cohort (52.8 vs 47.9 %; p = 0.021 and 80.3 vs 65.4 %; p < 0.001, respectively). Besides, antiplatelet therapy reduced the risk of HCC recurrence (hazard ratio [HR] 0.73; p < 0.001) and overall mortality (HR 0.57; p < 0.001) in the multivariable analysis. However, antiplatelet use significantly increased the risk of upper gastrointestinal bleeding (odds ratio [OR] 1.91; p < 0.001). CONCLUSIONS Use of aspirin or clopidogrel was associated with better recurrence-free survival and overall survival among patients with HBV-related HCC after liver resection. However, these agents should be used with caution due to the adverse effects of upper gastrointestinal bleeding.
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Affiliation(s)
- Pei-Chang Lee
- Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Medicine, Yuanshan Branch, Taipei Veterans General Hospital, Yilan, Taiwan
| | - Chiu-Mei Yeh
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Wen Hu
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Chia Chen
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Jen Liu
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. .,Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Chien-Wei Su
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Teh-Ia Huo
- Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yee Chao
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Han-Chieh Lin
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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50
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Wu JC, Song JD, Zhao ZY, Shi J, Xu HS, Zhao JY, Liu XG, Zhao X, Sun XF. Thermal conductivity of the diamond-chain compound Cu₃(CO₃)₂(OH)₂. J Phys Condens Matter 2016; 28:056002. [PMID: 26761589 DOI: 10.1088/0953-8984/28/5/056002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Thermal conductivity (κ) of a distorted spin diamond-chain system, Cu3(CO3)2(OH)2, is studied at low temperatures down to 0.3 K and in magnetic fields up to 14 T. In zero field, the κ(T) curve with heat current along the chain direction has very small magnitudes and shows a pronounced three-peak structure. The magnetic fields along and perpendicular to the chains change the κ strongly in a way having good correspondence to the changes of magnetic specific heat in fields. The data analysis based on the Debye model for phononic thermal conductivity indicates that the heat transport is due to phonons and the three-peak structure is caused by two resonant scattering processes by the magnetic excitations. In particular, the spin excitations of the chain subsystem are strongly scattering phonons rather than transporting heat.
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Affiliation(s)
- J C Wu
- Hefei National Laboratory for Physical Sciences at Microscale, University of Science and Technology of China, Hefei, Anhui 230026, People's Republic of China
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