Prognostic nomogram for hepatocellular carcinoma patients after transarterial chemoembolization based on des-γ-carboxy prothrombin reactivity and modified Response Evaluation Criteria in Solid Tumors

Aims

The aim of this study was to construct a nomogram that will predict the overall survival (OS) of hepatocellular carcinoma (HCC) patients after transarterial chemoembolization (TACE).

Materials and Methods

Imaging data, clinical characteristics, and serum des-γ-carboxy prothrombin (DCP) levels of 93 HCC patients treated with TACE were collected. Lasso regression, random forest, and other methods were used to screen the OS-related variables and construct the Cox prognosis model. The model was visualized by nomogram, and the net benefit of the clinical decision was assessed by decision curve analysis (DCA).

Results

It was found that DCP level after TACE was an important predictor of OS in HCC patients. The OS of the patients with lower serum DCP levels after TACE was significantly better than the group with higher levels (P = 0.003). The Cox prognostic model was constructed using four predictors including DCP reactivity (P = 0.001), modified Response Evaluation Criteria in Solid Tumors (mRECIST, P = 0.005), Child-Pugh class (P = 0.018), and portal vein thrombosis (P = 0.039). The C-index of the nomogram for OS of patients after TACE was 0.813. The clinical decision-making net benefits based on the nomogram were better than the decision-making based on the TNM stage system.

Conclusion

DCP reactivity and mRECIST are the key predictors of prognosis in HCC patients that received TACE as their initial treatment. The nomogram constructed with these two indicators as the core could predict the OS of HCC patients after TACE and help in clinical decision-making.

Annexin A2 promotion of hepatocellular carcinoma tumorigenesis via the immune microenvironment

Hepatocellular carcinoma (HCC) is the most common primary liver cancer with a dismal prognosis, especially when diagnosed at advanced stages. Annexin A2 (ANXA2), is found to promote cancer progression and therapeutic resistance. However, the underlining mechanisms of ANXA2 in immune escape of HCC remain poorly understood up to now. Herein, we summarized the molecular function of ANXA2 in HCC and its relationship with prognosis. Furthermore, we tentatively elucidated the underlying mechanism of ANXA2 immune escape of HCC by upregulating the proportion of regulatory T cells and the expression of several inhibitory molecules, and by downregulating the proportion of natural killer cells and dendritic cells and the expression of several inhibitory molecules or effector molecules. We expect a lot of in-depth studies to further reveal the underlying mechanism of ANXA2 in immune escape of HCC in the future.

[Research progress on abnormal liver function in pregnancy]

Abnormal liver function in pregnancy is a common clinical problem in the department of obstetrics and liver disease, but its severity can cause danger to the life of the mother and fetus. Therefore, the different cause of abnormal liver function in pregnancy should be assessed accurately in order to take early intervention measures. Moreover, it is necessary to comprehensively evaluate the situation of both mother and fetus to obtain the optimal treatment effect for abnormal liver function caused by different types of pregnancy-related liver diseases.

[Effect and mechanism of adipocyte co-culture on aquaporin-9 expression in HepG2 cells]

Objective: To observe the effect of differentiated mature adipocytes on hepatic steatosis and aquaporin-9 (AQP9) expressions in HepG2 cells and further explore its possible mechanism of action. Methods: Human preadipocytes were cultured and differentiated to full maturity. HepG2 cells were co-cultured with non-differentiated adipocytes and differentiated mature adipocytes for 48 h, and then labeled as control group and experimental group. Oil red O staining and intracellular triglyceride content were performed on co-cultured HepG2 cells and simultaneous changes in phosphatidylinositol 3-kinase (PI3K) - serine/threonine kinase (Akt) signaling pathway, and AQP9 mRNA and protein levels were detected. The experimental group was co-cultured with recombinant human insulin-like growth factor-I (IGF-I), with the addition of 100ng/ml PI3K-Akt pathway agonist, labeled as experimental group + IGF-I group. The activation of PI3K-Akt pathway was verified by Western blotting (WB). The expression of AQP9 was detected by RT-q PCR and WB. The recombinant lentivirus LV-AQP9 or empty-loaded virus LV-PWPI was transfected with HepG2 cells by recombinant lentiviral transfection tecnique, and labeled as HepG2-AQP9 and HepG2-PWPI. The transfection efficiency was assessed by confocal laser scanning microscopy and RT-qPCR and WB detected the change of AQP9 expression level after virus transfection. Afterwards, the stable over-expressed HepG2-AQP9 cells and the empty-loaded HepG2-PWPI cells were co-cultured with differentiated mature adipocytes for 48h, and labeled as HepG2-AQP9 co-culture group, and then intracellular triglyceride content were detected with Oil red O staining. Finally, IGF-I was added to the HepG2-AQP9 co-culture group, which was recorded as HepG2-AQP9 co-culture + IGF-I group. Intracellular triglyceride content was detected with Oil red O staining, and WB verified PI3K-Akt signaling pathway activation and changes in AQP9 mRNA and protein levels. A t-test was used to compare the two independent samples. Results: The intracellular lipid droplets and triglyceride content (0.052 ± 0.005) in the experimental group was increased significantly than the control group (0.033 ± 0.003) (t= 5.225,P= 0.006), suggesting that adipocyte co-culture had induced steatosis in HepG2 cells. RT-qPCR and WB results indicated that the expression levels of AQP9 mRNA (3.615 ± 0.330) and protein levels (0.072 ± 0.005) in the experimental group were significantly higher than the control group (t= 13.708, 11.225,P= 0.005, < 0.001). WB results showed that the expression level of phosphorylated Akt (p-Akt) protein (0.116±0.003) in the experimental group was significantly lower than the control group (0.202 ± 0.003) (t= 27.136,P< 0.001). The total Akt protein was constant, and the p-Akt/total Akt (0.182 ± 0.017)was significantly lower than the control group (0.327 ± 0.019) (t= 2.431,P= 0.001), suggesting that adipocyte co-culture had inhibited PI3K- Akt signaling pathway in HepG2 cells and up-regulated the expression level of AQP9. WB results indicated that the expression level of p-Akt protein (0.194 ± 0.021) in the experimental group + IGF-I group was significantly higher than the experimental group (0.132 ± 0.003) (t= 5.082,P= 0.007). The total Akt protein was constant, and the p-Akt/total Akt (0.281 ± 0.009) was significantly higher than the control group (0.184 ± 0.132) (t= 10.311,P< 0.001). Simultaneously, RT-qPCR and WB results indicated that the expression levels of AQP9 mRNA (0.327 ± 0.347) and protein levels (0.042 ± 0.004) in the experimental group + IGF-I group were significantly lower than the experimental group (t= 33.573, 5.598,P< 0.001, 0.005), suggesting that adipocyte co-culture had possibility to regulate the expression level of AQP9 through the PI3K-Akt pathway. Confocal laser microscopy analysis showed that the transfection efficiency was more than 90%. RT-q PCR and WB results indicated that the expression levels of AQP9 mRNA and protein levels (0.373 ± 0.221) in HepG2-AQP9 group were significantly higher than HepG2-PWPI group (t=14.953, 28.931,P= 0.002 and 0.000), suggesting that the stable overexpression of AQP9 cell line was successfully constructed. The intracellular lipid droplets and triglyceride content in HepG2-AQP9 co-culture group was significantly increased (t= 5.478, 5.369,P= 0.005) than HepG2-PWPI co-culture group and HepG2-AQP9 co-culture+ IGF-I group, suggesting that the increased expression of AQP9 had promoted HepG2 steatosis in co-cultured adipocytes. WB results showed the expression levels of p-Akt protein (0.168 ± 0.006) and p-Akt/total Akt (0.265±0.009) in HepG2-AQP9 co-culture + IGF-1 group was significantly increased (t= 16.311, 8.769,P< 0.001) than HepG2-AQP9 co-culture group, while the expression levels of AQP9 mRNA (0.327 ± 0.034) and protein (0.375 ± 0.025) was significantly decreased (t= 33.573, 9.146,P< 0.001 and 0.001). Conclusion: Adipocytes co-culture can induce steatosis in HepG2 cells, and may participate in inhibiting PI3K-Akt signaling pathway to upregulate the expression of AQP9 in steatotic HepG2 cells.

[Abnormal expression of angiopoietin-2 associated with invasion, metastasis and prognosis of lung cancer]

Objective: To investigate the relationship between abnormal angiopoietin-2 (Ang-2) expression and invasion/metastasis of lung cancer. Methods: Totally 122 cases of postoperative primary lung cancer tissues and their paracancerous tissues from Jan. 2009 to Dec. 2010 were collected from Affiliated Hospital of Nantong University and Ang-2 expression was analyzed by immunohistochemistry. At the cellular level, the protein and mRNA levels of Ang-2 in lung epithelial cell line Beas-2B and four lung cancer cell lines (SPCA-1, NCI-1650, A549 and NCI-H1975) were observed. The most effective Ang-2-shRNA for Ang-2 transcription was screened and transfected into A 549 lung cancer cells. The Ang-2 expression, Ang-2 gene transcription, cell proliferation, invasion/metastasis, and epithelial-mesenchymal transition (EMT) abilities of lung cancer cells were analyzed by Western blotting, fluorescent quantitative reverse transcriptase PCR, Cell Counting Kit-8 assay, and Transwell cell models for exploring the relationship between Ang-2 expression and invasion/metastasis of lung cancer. Results: The higher Ang-2 expression levels in lung cancerous tissues were closely related to tumor diameter (P=0.008), differentiating degree (P=0.033), TNM stage (P=0.025) and 5-year survival rate (P<0.001). According to the Kaplan-Meier survival curves, the 5-year survival rate of patients with higher expression levels of Ang-2 (16.1%) was significantly poorer than that of patients with lower Ang-2 (80.0%, P<0.001). Significant difference of 5-year survival rate was found in patients with different Ang-2 levels at TNM stage Ⅰ(P<0.001), but not at stage Ⅱ, Ⅲ and Ⅳ. Among Beas-2B and four lung cancer cell lines, the protein and mRNA levels of Ang-2 in A549 cells were the highest. After Ang-2-shRNA-1 plasmid successfully transfected into A549 cells, cell proliferation rate was significantly lower than that in the shRNA-negative or blank group at a time-dependent manner. The significant decrease of the invasion, migration and EMT abilities were also found in A549 cells after transfection of Ang-2 shRNA. Conclusion: Abnormal expression of Ang-2 is closely related to invasion, migration and prognosis of lung cancer, and interfering the activation of Ang-2 would be a novel molecular-targeted therapy for lung cancer.

MicroRNA-30c inhibits metastasis of ovarian cancer by targeting metastasis-associated gene 1

BACKGROUND

It is important to find reliable molecular markers or biological targets that associate with ovarian cancer (OC) metastasis for diagnosis and treatment. In this study, researchers investigated the regulated chain of microRNA-30c (miR-30c) and metastasis-associated gene 1 (MTA1) in OC tissues and cells.

MATERIALS AND METHODS

Expression of miR-30c and MTA1 was detected with quantitative real-time polymerase chain reaction and immunohistochemistry in 33 OC and matched adjacent tissues. MiR-30c mimics were synthetized and transfected into SKOV3 cells to target MTA1. The wound healing and transwell assays were detected to observe migration and invasion of transfected OC cells.

RESULTS

Compared with matching normal ovarian tissues, the MTA1 expression was upregulated and localized in the cytoplasm, and the expression of miR-30c was significantly reduced. The expression intensity of MTA1 was correlated with the Federation of Gynecology and Obstetrics stage, tumor grade, and metastasis of OC. Transfecting miR-30c mimics could significantly reduce the expression of MTA1 in SKOV3 cells and obviously inhibit the migration and invasion of SKOV3 cells.

CONCLUSION

MiR-30c and MTA1 abnormally expressed in OC, which may be related to metastasis of OC. In MiR-30c as a tumor suppressor gene, its expression in OC could lead to reduced expression of MTA1, which may be one of the mechanisms of metastasis of OC cells.

[Clinical values of Wnt3a as a novel biomarker in diagnosis and prognosis of hepatocellular carcinoma]

Objective: To explore Wnt3a expression in HCC tissues and serum, and to discuss its clinical diagnostic and prognostic value. Methods: The Wnt3a expressions were detected in a total of 186 patients (HCC, liver cirrhosis and chronic Hepatitis) and 40 controls by Elisa, comparing with AFP to evaluate its clinical diagnosis value. Wnt3a expressions in 80 HCC and surrounding tissues were analyzed by IHC, to explore its prognostic value. Results: Wnt3a with brown staining was mainly distributed in cytosol and of hepatocyte membrane. The higher expression (3-6 scores) was 71.3% in HCC, 13.8% in surrounding tissues, associated with poorly-differentiated grade, liver cirrhosis, HBV infection, higher TNM stage (P<0.05) and 5-year survival rate (P<0.001), identified as independent predictive factors for poor HCC outcome and closely related with lower five-year survival rate. Serum average Wnt3a levels were significantly higher (P<0.001) in the HCC group than those in any other groups of benign liver diseases, with about 4.0, 9.2 and 26.7 times higher than that in the liver cirrhosis, chronic hepatitis and normal control group. Wnt3a expression in HCC were closely related to AFP concentration, liver cirrhosis HBV infection, poor differentiation, TNM stagingand extra- hepatic metastasis (P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 92.5, 94.3, 93.2, 96.1 and 89.3% at 800 ng/L as cutoff value for Wnt3a. Combining Wnt3a and AFP test, the total sensitivity could rise to 96.3%. The area under ROC curve in Wnt3a (0.994)was higher than in AFP (0.710). Conclusions: Wnt3a as a critical signal molecule in the Wnt pathway is a new specific marker for HCC diagnosis and prognosis.

Diagnostic value of combined detection of angiopoietin-2 and Golgi protein 73 in primary liver cancer

AIM: To detect the expression of circulating angiopoietin-2 (Ang-2) and Golgi protein 73 (GP73) in patients with primary liver cancer and to analyze their value in the diagnosis and differential diagnosis of primary liver cancer (PLC).

METHODS: The levels of circulating Ang-2 and GP73 expression were detected by ELISA in patients with PLC, acute hepatitis, chronic hepatitis, or liver cirrhosis. The expression of Ang-2 and GP73 in cancerous and surrounding noncancerous tissues was analyzed by immunohistochemistry and confirmed by Western blot.

RESULTS: Positive expression of hepatic GP73 and Ang-2 was characterized by the presence of brown granules in the cytoplasm or cytomembrane. Hepatic GP73 and Ang-2 expression was significantly higher in cancerous tissue than in surrounding noncancerous tissue (P < 0.01). The levels of circulating Ang-2 and GP73 in PLC patients (40.8 ng/mL ± 3.5 ng/mL and 87.3 ng/mL ± 78.4 ng/mL, respectively) were significantly higher (P < 0.01) than those in normal subjects and patients with acute hepatitis, chronic hepatitis, or liver cirrhosis. There was a positive correlation between Ang-2 and GP73 (r = 0.987, P = 0.013). The area under the receiver operating curve (ROC) for the diagnosis of PLC was 0.915 for Ang-2 and 0.899 for GP73.

CONCLUSION: The overexpression of Ang-2 and GP73 is associated with HCC development and may be useful biomarkers for PLC diagnosis or differential diagnosis.

Down-regulation of hypoxia-inducible factor-1alpha expression inhibits cell proliferation and induces apoptosis in human hepatocellular carcinoma cell line HepG2

AIM: To detect the expression of hypoxia inducible factor-1alpha (HIF-1α) in human hepatocellular carcinoma and to observe the effect of silencing HIF-1α gene on the proliferation and apoptosis of hepatocellular carcinoma HepG2 cells.

METHODS: Hepatocellular carcinoma tissue samples and matched tumor-adjacent tissue samples were collected to detect the expression and cellular distribution of HIF-1α by immunohistochemistry. HIF-1α-specific miRNAs were synthesized and screened. After HepG2 cells were transfected with a miRNA, the expression of HIF-1α mRNA and protein was determined by real time-PCR and Western blot, respectively. Cell cycle progression and apoptosis were quantitatively analyzed by flow cytometry and annexin V-FITC/PI double dyeing assay.

RESULTS: HIF-1α was distributed mainly in the cytoplasm and less in the nucleus, which was especially prominent around the central vein. The positive rate of HIF-1α expression was significantly lower in hepatocellular carcinoma than in tumor-adjacent tissue (80% vs 100%, χ² = 22.35, P < 0.001). HIF-1α expression was correlated with tumor size and differentiation degree. After HepG2 cells were transfected with a miRNA, HIF-1α expression was down-regulated in a time-dependent manner, the apoptosis rate increased significantly (P < 0.01), and HepG2 cells were significantly arrested at G1 phase (proportion of cells in G₁ phase: 61.49% ± 1.12%, P < 0.01). In the presence of doxorubicin, the apoptosis rate and the proportion of cells in G1 phase were increased to 36.99% ± 0.88% and 65.68% ± 0.91%, respectively.

CONCLUSION: Abnormal HIF-1α expression is associated with the development of hepatocellular carcinoma. Silencing HIF-1α gene efficiently inhibits the proliferation of hepatocellular carcinoma cells possibly by regulating cell cycle progression and apoptosis.

Diagnostic value of expression of microRNA-183 family members in hepatocellular carcinoma

AIM: To investigate the expression of microRNA-183 family members in hepatocellular carcinoma (HCC) and to analyze their diagnostic value.

METHODS: The expression of miR-183 family members (miR-96, miR-182 and miR-183) was examined by real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR) in HCC and matched tumor-adjacent and tumor-distant tissues, and in 80 serum samples from patients with HCC, cirrhosis or chronic hepatitis B, and health controls.

RESULTS: The levels of miR-96 and miR-182 expression in tissues and sera of HCC patients were significant higher than those in any of other groups (all P < 0.001). The level of miR-183 in the liver was significantly lower in HCC than in matched tumor-adjacent and tumor-distant tissue (both P < 0.001), although there was no significant difference in serum miR-183 between each group. Liver expression of miR-183 family members was positively associated with their serum levels (r_miR-96 = 0.815, r_miR-182= 0.806, r_miR-183 = 0.851) in HCC. The areas under the receiver operating characteristic curve of serum miR-96 and miR-182 were 0.927 and 0.940. The relative level of serum miR-183 was significantly higher in patients with extrahepatic metastasis than in those without extrahepatic metastasis (P < 0.019).

CONCLUSION: Expression of miR-96 and miR-182 is up-regulated and that of miR-183 down-regulated in HCC. Circulating miR-96 and miR-182 are useful biomarkers for HCC diagnosis. Down-regulation of miR-183 is associated with HCC extrahepatic metastasis.

Values of circulating GPC-3 mRNA and alpha-fetoprotein in detecting patients with hepatocellular carcinoma

BACKGROUND

The prognosis of hepatocellular carcinoma (HCC) is poor and its early diagnosis is of the utmost importance. This study aimed to investigate the values of glypican-3 (GPC-3) expression in the liver and sera and its gene transcription for diagnosis and monitoring of metastasis of HCC.

METHODS

Liver GPC-3 was analyzed in HCC tissues from 36 patients by immunohistochemistry and Western blotting. GPC-3 mRNA from circulating peripheral blood mononuclear cells from 123 HCC patients or 246 patients with other diseases or 36 HCC tissues was amplified by RT-PCR, quantitative real-time PCR, and confirmed by DNA sequencing. Circulating GPC-3 level was detected by ELISA.

RESULTS

The increasing expression of GPC-3 was observed from non-cancerous to cancerous tissues, with brown granule-like staining localized in tumor parts of atypical hyperplasia and HCC formation. The positive rate of GPC-3 was 80.6% in HCC, 41.7% in their paracancerous tissues, and none in distal cancerous tissues (P<0.001), with no significant difference in differentiation grade and tumor number except for size (Z=2.941, P=0.003). Serum GPC-3 was detected only in HCC (52.8%) and significant difference was found between GPC-3 and tumor size (X2=6.318, P=0.012) or HBV infection (X2=23.362, P<0.001). Circulating GPC-3 mRNA was detected in 70.7% of HCC tissues, with relation to TNM stage, periportal cancerous embolus, and extra-hepatic metastasis (P<0.001). The combination of circulating GPC-3, GPC-3 mRNA and alpha-fetoprotein is of complementary value for HCC diagnosis (94.3%).

CONCLUSION

Both GPC-3 overexpression and GPC-3 mRNA abnormality could be used as markers for the diagnosis of HCC and monitoring its metastasis.

Association between expression of key insulin-like growth factor signaling molecules and malignant transformation of hepatocytes

AIM: To investigate the dynamic expression of key insulin-like growth factor (IGF) signaling IGF-Ⅱ and IGF-Ⅰreceptor (IGF-IR) during malignant transformation of rat hepatocytes.

METHODS: Hepatoma was induced in male Sprague-Dawley rats with 2-fluorenylacetamide (2-FAA). Morphological changes of the liver were observed, and dynamic changes in the levels of IGF-Ⅱ and IGF-1R in the liver and serum were quantitatively analyzed. The expression and distribution of IGF-Ⅱ and IGF-1R proteins were analyzed by immunohistochemistry. Serum IGF-1R and IGF-II levels were detected by ELISA. Expression of IGF-Ⅱ and IGF-IR mRNAs in the liver was detected by nested RT-PCR and confirmed by DNA sequencing.

RESULTS: After induction with 2-FAA, rat hepatocytes showed granule-like degeneration, atypical hyperplasia, and malignant transformation, and hepatic total RNA, IGF-1R, and IGF-Ⅱ levels significantly increased. The levels of IGF-Ⅱ in the liver (F = 48.1, P < 0.01) and serum (F = 13.2, P < 0.01) were significantly higher in the hepatoma group than in any of other groups. There was a positive relationship (r = 0.97, t = 5.97, P < 0.01) between liver IGF-II (nmol/mg wet liver) and serum IGF-Ⅱ (nmol/L). Similar results were also obtained for IGF-IR in the liver and serum, and IGF-IR expression in the hepatoma group was significantly higher (P < 0.01) than that in any of other groups.

CONCLUSION: IGF-1R and IGF-Ⅱ may participate in hepatocyte canceration. Overexpression of IGF-1R and IGF-Ⅱ might be useful molecular markers for early diagnosis and prognosis of hepatocellular carcinoma.

Oncofetal antigen glypican-3 as a promising early diagnostic marker for hepatocellular carcinoma

BACKGROUND

Hepatocellular carcinoma (HCC) is characterized by a multi-cause, multi-stage and multi-focus process of tumor progression. Its prognosis is poor and early diagnosis is of utmost importance. This study was undertaken to investigate the dynamic expression of oncofetal antigen glypican-3 (GPC-3) and GPC-3 mRNA in hepatocarcinogenesis and to explore their early diagnostic value for HCC.

METHODS

A hepatoma model was induced in male Sprague-Dawley rats with 0.05% 2-fluorenylacetamide and confirmed by hematoxylin and eosin staining and gamma-glutamyltransferase (GGT) expression. Total RNA was purified and transcribed into cDNA by reverse transcription. Fragments of the GPC-3 gene were amplified by nested RT-PCR, and confirmed by sequencing. GPC-3 was analyzed by immunohistochemistry, Western blotting or ELISA.

RESULTS

Positive GPC-3 expression showed as brown granule-like staining localized in the cytoplasm. Histological examination of hepatocytes revealed three morphological stages of granule-like degeneration, atypical hyperplasia (precancerous), and cancer formation, with a progressive increase of liver total RNA and GGT expression. The incidence of liver GPC-3 mRNA and GPC-3, and serum GPC-3 was 100%, 100% and 77.8% in the HCC group, 100%, 100%, and 66.7% in the precancerous group, 83.3%, 83.3%, and 38.9% in the degeneration group, and no expression in the liver or blood of the control group, respectively. There was a positive correlation between liver GPC-3 mRNA and total RNA level (r=0.475, P<0.05) or liver GPC-3 (r=1.0, P<0.001) or serum GPC-3 (r=0.994, P<0.001).

CONCLUSION

Abnormal oncofetal antigen GPC-3 and GPC-3 mRNA expression in hepatocarcinogenesis may be promising molecular markers for early diagnosis of HCC.

Construction of expression plasmids carrying miRNA targeting IGF-II and detection of their inhibitory effect on IGF-II expression in human HepG2 cells

AIM: To investigate inhibitory effect of transfection of eukaryotic expression plasmids carrying specific microRNA (miRNA) on insulin-like growth factor II (IGF-II) gene and protein expression in human HepG2 cells.

METHODS: Four miRNAs targeting the IGF-II gene were synthesized and inserted into the pcDNATM6.2-GW/EmGFPmiR vector. The recombinant plasmids were identified and transiently transfected into HepG2 cells. Their inhibitory efficiency on IGF-II expression was determined at gene level by real time-PCR and at protein level by ELISA.

RESULTS: Four eukaryotic expression plasmids carrying miRNA targeting IGF-II were constructed successfully and confirmed by sequencing. HepG2 cells were then transfected with these plasmids (MR-IGF-II-1 to 4). The highest transfection efficiency was up to 50%. The reduced rates of IGF-II gene expression were 33%, 43%, 0% and 3% in cells transfected with MR-IGF-II-1 to 4, respectively. Transfection of the MR-IGF-II-2 plasmid for 72 h reduced IGF-II protein expression by 44% in HepG2 cells.

CONCLUSION: The expression plasmids carrying miRNA targeting IGF-II have been successfully constructed. Transfection of these plamsids can efficiently inhibit IGF-II expression in HepG2 cells.

Delayed hepatocarcinogenesis through antiangiogenic intervention in the nuclear factor-kappa B activation pathway in rats

BACKGROUND

The active form of nuclear factor-kappa B (NF-kappaB) is involved in the initiation, generation, and development of hepatocellular carcinoma (HCC), and is up-regulated in inflammation-associated malignancies. We investigated the dynamic expression of NF-kappaB and its influences on the occurrence of HCC through antiangiogenic (thalidomide) intervention in NF-kappaB activation.

METHODS

Hepatoma models were induced with 2-fluorenylacetamide (2-FAA, 0.05%) in male Sprague-Dawley rats, and thalidomide (100 mg/kg body weight) was administered intragastrically to intervene in NF-kappaB activation. The pathological changes in the liver of sacrificed rats were assessed after hematoxylin and eosin staining. NF-kappaB mRNA was amplified by RT-nested PCR. The alterations of NF-kappaB and vascular endothelial growth factor (VEGF) expression were analyzed by enzyme-linked immunosorbent assay, immunohistochemistry, and Western blotting.

RESULTS

Rat hepatocytes showed denatured, precancerous, and cancerous stages in hepatocarcinogenesis, with an increasing tendency of hepatic NF-kappaB, NF-kappaB mRNA, and VEGF expression, and their values in the HCC group were higher than those in controls (P<0.001). In the thalidomide-treated group, the morphologic changes generated only punctiform denaturation and necrosis at the early or middle stages, and nodular hyperplasia or a little atypical hyperplasia at the final stages, with the expression of NF-kappaB (X2=9.93, P<0.001) and VEGF (X2=8.024, P<0.001) lower than that in the 2-FAA group.

CONCLUSION

NF-kappaB is overexpressed in hepatocarcinogenesis and antiangiogenic treatment down-regulates the expression of NF-kappaB and VEGF, and delays the occurrence of HCC.

Glypican-3 expression and its correlation with clinicopathological parameters in hepatocellular carcinoma

AIM: To investigate the expression of human glypican-3 (GPC-3) and analyze its correlation with clinicopathological parameters in hepatocellular carcinoma (HCC).

METHODS: Tumor specimens and matched tumor-adjacent and -distant specimens were taken from 36 HCC patients. The expression of GPC-3 in these specimens was detected by immunohistochemistry.

RESULTS: Positive GPC-3 signal was localized in both cell membrane and cytoplasm in HCC, and only in cytoplasm in tumor-adjacent tissue. No positive staining was found in tumor-distant tissue. The positive rate of GPC-3 expression was 80.6% in HCC and 41.7% in tumor-adjacent tissue. The intensity of GPC-3 expression was significantly higher in HCC than in tumor-adjacent and -distant tissues (χ² = 11.445, P < 0.01).

CONCLUSION: GPC-3 expression may be closely associated with the development and progression of HCC and can be used as a molecular marker for HCC diagnosis.

Clinical impact of plasma TGF-beta1 and circulating TGF-beta1 mRNA in diagnosis of hepatocellular carcinoma

BACKGROUND

Transforming growth factor-beta (TGF-beta) plays an important role in the regulation of cell growth and differentiation, angiogenesis, extracellular matrix formation, immunosuppression and cancer development. In this study, we investigated the levels of TGF-beta1 and TGF-beta1 mRNA expression, their relationship with HBV replication, and their diagnostic value for hepatocellular carcinoma (HCC).

METHODS

Total RNAs were extracted from HCC samples and matched non-tumor tissues, and from peripheral blood mononuclear cells in HCC patients. TGF-beta1 mRNA was amplified by RT-PCR and confirmed by DNA sequencing. The distribution of TGF-beta1 expression was assessed by immunohistochemistry. The clinical characteristics were analyzed between TGF-beta1 and HBV replication. The diagnostic value of circulating TGF-beta1 and TGF-beta1 mRNA levels were investigated in HCC patients.

RESULTS

The incidence of hepatic TGF-beta1 expression was 83.3% in HCC samples, 43.3% in the surrounding tissues, 94.7% in the HBV DNA-positive group, and 63.6% in the HBV DNA-negative group. Liver TGF-beta1 expression was associated with the degree of HCC differentiation and the status of HBV replication, but not with the size or number of tumors. Circulating TGF-beta1 level and incidence of TGF-beta1 mRNA were significantly higher in the HCC group than in any group of patients with benign liver disease, with a higher sensitivity of 89.5% and a specificity of 94.0% for HCC diagnosis when circulating TGF-beta1 levels were >1.2 microg/L. No significant correlation was found between TGF-beta1 expression and AFP level or tumor size. Combining TGF-beta1 level and serum AFP raised the detection rate to 97.4%.

CONCLUSIONS

Abnormal expression of hepatic TGF-beta1 is associated with the degree of HCC differentiation and HBV replication. Both circulating TGF-beta1 and TGF-beta1 mRNA can be used as sensitive biomarkers for the diagnosis and prognosis of HBV-induced HCC.

Dynamic expression of entire hepatic genomes and heat-shock protein gp96 abnormality during development of hepatocellular carcinoma

AIM: To investigate the dynamic expression of the entire hepatic genome during hepatocellular carcinoma (HCC) development, and the clinical values of heat-shock protein gp96 for early diagnosis of HCC and estimating its prognosis.

METHODS: A rat hepatoma model was induced with 0.05% 2-acetamidoflurene (2-FAA) in male Sprague-Dawley rats. Morphological changes were observed by pathological examination (HE staining). Total RNA was extracted from fresh liver tissues and analyzed by oligonucleotide array during liver carcinogenesis. Total RNA was transferred into cDNA by reverse transcription, and the gene fragment of gp96 was amplified by nested RT-PCR.

RESULTS: Histological examination showed that hepatocytes in rats fed with 2-FAA exhibited vacuole-like denaturation at an early stage, then dysplastic nodules appeared at the middle stage, and finally progressed to cancerous nest tubercles, all of which were highly differentiated during HCC development. gp96 increased three-fold in the liver of rats with HCC, compared with that of normal rats. gp96 mRNA in the liver of rats with denatured, precancerous and cancerous tissues increased compared with that in normal tissues(90.9%, 100%, 100% vs 16.67%, P < 0.05).

CONCLUSION: Alterations in the entire genome pattern and gp96 overexpression are observed during HCC development. gp96 may be a useful molecular marker for early diagnosis of HCC and prognosis estimation.

Dynamic analysis of B-cell lymphoma-2 apoptotic inhibitory effects during the development of hepatocellular carcinoma

AIM: To investigate the dynamic expression and clinicopathological alterations of B-cell lymphoma-2 (Bcl-2) during the development of hepatocellular carcinoma (HCC).

METHODS: Hepatoma was induced by 2-fluorenylacetamide (2-FAA) in male Sprague-Dawley rats. Morphological changes in rat livers were observed by pathological examination (HE staining). Dynamic changes in Bcl-2 in rat livers were quantitatively analyzed by enzyme-linked immunosorbent assay. The expression and cellular distribution of liver Bcl-2 were simultaneously detected by immunohistochemistry.

RESULTS: Histological examination confirmed that rat hepatocytes changed from granule-like degeneration to atypical hyperplasia and HCC development after induction by 2-FAA. There were progressive increases in the level of hepatic Bcl-2 expression during the course. The levels of Bcl-2 in hepatoma tissues were significantly higher than those in normal and degenerative tissue (5.28 ± 1.10 nmol/g vs 2.78 ± 1.07 nmol/g, 1.77 ± 0.60 nmol/g, F = 9.85, P < 0.01). Immunohistochemical evidence indicated positive expression and hepatocyte distribution of Bcl-2 in rat hepatoma tissue.

CONCLUSION: Hepatic Bcl-2 protein may participate in the carcinogenesis of hepatocytes, and its overexpression may accelerate the occurrence and development of HCC.

Combined serum hepatoma-specific alpha-fetoprotein and circulating alpha-fetoprotein-mRNA in diagnosis of hepatocellular carcinoma

BACKGROUND

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide, its prognosis is poor, and early detection is of utmost importance. Although alpha-fetoprotein (AFP) is a useful marker for detecting and monitoring HCC development, the false-negative or false-positive rates with AFP alone may be as high as 30%-40% for patients with small HCCs. To enhance the specificity and accuracy of AFP measurements for HCC, we analyzed AFP expression states in livers, detected the hepatoma-specific AFP (HS-AFP) fraction and AFP-mRNA from peripheral blood mononuclear cells, and explored their clinical implications for HCC diagnosis.

METHODS

AFP expression and hepatocyte distributions in liver specimens were investigated by an immunohistochemical assay. Total RNAs were extracted from circulating blood, synthesized to cDNA through random primers and reverse transcriptase, and fragments of the AFP gene were amplified by a nested-PCR assay. The HS-AFP fraction was separated by lectin-affinity chromatography and its level was detected by radioimmunoassay.

RESULTS

The incidence of AFP was 73.3% in HCC tissues and its expression in HCCs with moderate or low differentiation was significantly stronger than that of HCCs with high differentiation (P<0.05). The incidence of AFP gene fragments was 100% in HCCs, and 60% in paracancerous tissues (P<0.01). In the HCC and liver cirrhosis groups, the incidence of HS-AFP was 91.7% and 18% (P<0.01), and of AFP-mRNA was 56.7% and 16% (P<0.01), respectively, and neither was found in controls. HS-AFP or AFP-mRNA was not significantly related to size or number of HCC, but to its differentiation, metastasis, and relapse (P<0.05).

CONCLUSIONS

Different AFP expression is present in different parts of HCC tissues. HS-AFP and AFP-mRNA fragments improve sensitivity and specificity, and both are useful markers to diagnose HCC or monitor metastasis and relapse.

Dynamic expression and alteration characteristic of insulin-like growth factor-Ⅱ in the carcinogenesis of hepatocellular carcinoma

AIM: To investigate the dynamic expression and alteration of insulin-like growth factor-Ⅱ(IGF-Ⅱ) during in the pathogenesis and development of hepatocellular carcinoma.

METHODS: Hepatoma models were induced with 2-fluorenylacetamide (2-FAA) in male Sprague-Dawley (SD) rats. The morphological changes of rat livers were observed by HE staining. The dynamic changes of IGF-Ⅱ in rat livers and sera were quantitatively analyzed by enzyme linked immunosorbent assay (ELISA). Simultaneously, the expression and cellular distribution of IGF-Ⅱ were detected by immunohistochemistry.

RESULTS: Histological examination confirmed that the expression of IGF-Ⅱwas increased in gradient after granule-like degeneration, atypical hyperplasia and carcinoma appeared in hepatocytes, and it was significantly higher in carcinoma group than that in degeneration and control group (carcinoma vs degeneration, χ² = 9.55, P < 0.01; carcinoma vs control, χ² = 14.00, P < 0.01). IGF-Ⅱwas positively expressed inside the liver cancer cells, and there was positive correlation between tissue and serum IGF-Ⅱ expression (r = 0.97, P < 0.01).

CONCLUSION: IGF-Ⅱ is involved in the carcinogenesis of hepatocellular carcinoma, and its expression is up-regulated at the early stage of carcinoma, which can help to achieve early diagnosis and prognosis judgment.

[Expression of total RNA and amplification of myocardial troponin gene during monitoring viral cardiomyocyte injury.]

BACKGROUND

To investigate the value of circulating cTnI-mRNA detection for monitoring myocardial injury development and prognosis.

METHODS

Viral myocardial injury models in BALB/c mice were created by intraperitoneal inoculation with Coxsackievirus B3 (CVB3,1x108 TCID50) for inducing myocardial injury. The total RNAs were extracted and cTnI-mRNA in mice cardiac tissues and circulating blood were amplified by RT-PCR during mice myocardial injury.

RESULTS

In virus infected mice, the mRNA abundance for cTnI was up-regulated in heart and circulating blood and associated with salient myocardial histopathologic features, including myocardial swelling, inflammatory cell infiltration, pyknosis, karyorrhexis, karyolysis, denaturalization, necrosis, and calcification. The cTnI-mRNA form infected mice heart and circulating cardiac myocytes were analyzed by RT-PCR, the amplified gene fragments were found in all heart tissues. The incidence of cTnI-mRNA was 0, 0, 0, 16.7%, 40.0%, 71.4%, 83.3% and 87.5% in the controls, the 3rd, 6th, 9th, 12th, 15th, 18th,and 21st day in circulating bloods from the infected mice, respectively.

CONCLUSION

The present data suggest that cTnI-mRNA expression is up-regulated and released into blood on viral myocardial injury, and detection of circulating cTnI-mRNA is a sensitive genetic marker for monitoring myocardial injury development and prognosis.

Dynamic alteration of telomerase expression and its diagnostic significance in liver or peripheral blood for hepatocellular carcinoma

AIM: To investigate the dynamic alteration of telomerase expression during development of hepatocellular carcinoma (HCC) and its diagnostic implications in liver tissues or peripheral blood mononuclear cells for HCC.

METHODS: Dynamic expressions of liver telomerase during malignant transformation of hepatocytes were observed in Sprague-Dawly (SD) rats fed with 0.05% of 2-fluoenyacetamide (2-FAA). Total RNA and telomerase were extracted from rat or human liver tissues. The telomerase activities in livers and in circulating blood were detected by a telomeric repeat amplification protocol-enzyme-linked immunosorbent assay (TRAP-ELISA), and its diagnostic value was investigated in patients with benign or malignant liver diseases.

RESULTS: The hepatoma model displayed the dynamic expression of hepatic telomerase during HCC development. The telomerase activities were consistent with liver total RNA levels (r = 0.83, P < 0.01) at the stages of degeneration, precancerosis, and cancerization of hepatocytes. In HCC patients, the telomerase levels in HCC tissues were significantly higher than in their adjacent non-cancerous tissues, but liver total RNA levels were lower in the former than in the latter. Although the circulating telomerase of HCC patients was abnormally expressed among patients with chronic liver diseases, the telomerase activity was a non-specific marker for HCC diagnosis, because the incidence was 15.7% in normal control, 25% in chronic hepatitis, 45.9% in liver cirrhosis, and 85.2% in HCC, respectively when absorbance value of telomerase activity was more than 0.2. If the value was over 0.6, the incidence was 60% in HCC group and 0% in any of the others (P < 0.01) except in two cases with liver cirrhosis. However, the combination of circulating telomerase with serum alpha-fetoprotein level could increase the positive rate and the accuracy (92.6%, 125 of 135) of HCC diagnosis.

CONCLUSION: The overexpression of telomerase is associated with HCC development, and its abnormality in liver tissues or in peripheral blood could be a useful marker for diagnosis and prognosis of HCC.

Abnormal expression of HSP gp96 associated with HBV replication in human hepatocellular carcinoma

BACKGROUND

Heat shock protein (HSP) gp96 is a member of the HSP90 family and presumably overexpresses as a result of stimulation by mutated or abnormal proteins. Its abnormal expression correlates with carcinogenesis, progression and prognosis of hepatocellular carcinoma (HCC). In this study, we investigated the pathological characteristics of liver gp96 expression and its relationship with hepatitis B virus (HBV) replication in HCC patients.

METHODS

Tumor specimens were prospectively collected from 30 HCC patients undergoing liver resection. Total RNAs were extracted from HCC or their non-cancerous tissues. The distribution of gp96 expression in hepatocytes was investigated by streptavidin peroxidase (S-P) immunohistochemistry and tissue HBV-DNA was detected by the in situ molecular hybridization technique. The association of gp96 expression with HBV replication, and the histopathological characteristics of HCC were analyzed.

RESULTS

The gp96 was strongly expressed in HCC (73.3%, 22 of 30) and weakly (46.7%, 14 of 30) in non-cancerous tissues. The gp96 expression in HCC tissues was correlated with degree of tumor differentiation and tumor size, but not with tumor number (P>0.05). Immunohistochemical analysis showed that 17 of 19 HCC patients with HBV-DNA-positive were strongly expressed for gp96, whereas only 5 of 11 patients with HBV-DNA-negative were positive for gp96. A significant difference was found between the two groups (89.5% vs. 45.5%, P<0.05).

CONCLUSIONS

The abnormal expressions of HSP gp96 in HCC tissues are associated with HBV replication. This finding indicates that HBV infection plays an important role in the development of HCC.

Correlations of insulin-like growth factor-II expression with hepatitis B virus DNA replication and clinical pathological characteristics in human hepatocelullar carcinoma

AIM: To investigate the expression of insulin-like growth factor-II (IGF-II) in hepatocellular carcinoma (HCC) as well as its correlations with the pathogenesis, development and prognosis of HCC.

METHODS: IGF-II expression was detected by immunohistochemistry in 30 HCC and their corresponding non-cancerous tissues. Liver HBV DNA was detected by in situ molecular hybridization technique and the relationship was analyzed between IGF-II expression and HBV replication or the clinical pathological characteristics.

RESULTS: The stronger expression of IGF-II was found in liver cancer tissues. The positive rate of IGF-II expression was 83.3% in HCC, and 46.7% in non-cancerous liver tissues (P < 0.01), respectively. The expression of IGF-II was significantly higher in HCC with moderate or low differentiation than that with well differentiation (90.0%, 100% vs 42.9%, P < 0.05 or P < 0.01). IGF-II expression was markedly lower in HCC without serosa invasion than that with serosa invasion (95.0% vs 60.0%, P < 0.05). IGF-II expression was also correlated with tumor size (< 5 cm vs ≥ 5 cm: 58.3% vs 100%, P < 0.01), but with tumor number (P > 0.05). The level of IGF-II expression in HBV DNA-positive HCC was significantly higher than that in HBV DNA-negative ones (94.7% vs 63.6%, P < 0.05).

CONCLUSION: IGF-II is highly expressed in HCC, and the aberrant expression of IGF-II is correlated with the degree of differentiation, invasion and tumor size, and it may be used as a marker for development and prognosis of HCC.

Abnormal expression of hepatomas and circulating telomerase and its clinical values

BACKGROUND

Hepatocellular carcinoma (HCC) is one of the most common malignant tumours worldwide. Telomerase is reactivated in various types of malignant tumors and may contribute to the development of HCC. To evaluate the role of telomerase in formation and development of HCC, we analyzed its expression status in different parts of HCC tissues and peripheral blood mononuclear cells (PBMCs), and explored its clinical implications for diagnosis of HCC.

METHODS

Total RNAs and telomerase were extracted from HCC and their non-cancerous tissues, and both relationships were analyzed between them. The expression of telomerase reverse transcriptase (hTERT) mRNA and telomerase activities in liver tissues and PBMCs were detected by RT-PCR and telomeric repeat amplification protocol (TRAP)-ELISA, respectively. The diagnostic values of telomerase in PBMCs were investigated in the diagnosis and differentiation of HCC.

RESULTS

The specific activities of telomerase were 18.25+/-15.02 A/microg RNA in HCC tissues, and significantly higher than those in their non-cancerous tissues (8.16+/-6.22 A/microg RNA, P<0.05). But total RNA levels in HCC were 12.40+/-7.34 microg/mg wet liver and lower than 53.77+/-52.02 microg/mg wet liver in their non-cancerous parts (P<0.01). The different telomerase levels could be detected in PBMCs from patients with chronic liver diseases and control group. The enzyme activities were significantly higher in HCC than in any other groups (P<0.01). However, circulating telomerase levels were more obviously decreased in HCC patients after transcatheter arterial embolization treatment than before the treatment (P<0.01). The analysis of combined serum alpha-fetoprotein level and PBMCs telomerase was more sensitive and specific for the diagnosis of HCC.

CONCLUSION

The abnormal expression of telomerase in HCC tissues and circulating PBMCs could be a useful marker to the diagnosis and prognosis of HCC.

Expression and alteration of insulin-like growth factor II-messenger RNA in hepatoma tissues and peripheral blood of patients with hepatocellular carcinoma

AIM: To investigate the clinical values of serum free insulin-like growth factor II (IGF-II) levels and IGF-II mRNA in hepatocellular carcinoma (HCC) tissues and peripheral blood for diagnosis of HCC and monitoring of extrahepatic metastasis.

METHODS: Total RNAs were extracted from HCC tissues or peripheral blood mononuclear cells from patients with HCC, liver diseases devoid of cancer, non-hepatic tumors, and healthy controls, respectively. IGF-II cDNAs were synthesized through random primers and reverse-transcriptase, amplified by polymerase chain reaction (PCR), and confirmed by DNA sequencing analysis. Serum free IGF-II levels in patients with different liver diseases were analyzed by an enzyme-linked immunosorbent assay.

RESULTS: The amplified fragments of IGF-II mRNA by RT-PCR were identical to originally designed ones with a size of 170 bp and confirmed by sequencing analysis. The dilution experiments revealed that the lowest sensitivity of our system was 2 ng/L of total RNA. The positive frequencies of IGF-II mRNA were 100% in HCC tissues, 53.3% in para-cancerous tissues, and 0% in non-cancerous tissues, respectively. The serum free IGF-II levels were significantly higher in HCC than those in chronic hepatitis or liver cirrhosis. The positive frequency of circulating IGF-II mRNA was 34.2% in HCC, no amplified fragment was found in other liver diseases, extrahepatic tumors, and normal controls, respectively. The circulating IGF-II mRNA correlated with the stage of HCC, and its positive rate was 100% in HCC with extrahepatic metastasis and 35.5% in HCC with AFP-negative. No significant correlation was found between tumor sizes and circulating IGF-II mRNA fragment.

CONCLUSION: The abnormal expressions of free IGF-II and IGF-II mRNA are useful tumor markers for HCC diagnosis, differentiation of extrahepatic metastasis and monitoring postoperative recurrence.

Quantitative analysis of vascular endothelial growth factor, microvascular density and their clinicopathologic features in human hepatocellular carcinoma

BACKGROUND

Angiogenesis is known to be essential to the survival, growth, invasion, and metastasis of tumor cells. Vascular endothelial growth factor (VEGF) are an important angiogenic factor regulating tumor angiogenesis, but its significance and tumor pathologic features are unclear in hepatocellular carcinoma (HCC). In the present study, we analyzed expression of tissue VEGF, alteration of microvascular density (MVD) in microvessel angiogenesis, development and metastasis of HCC, and level of serum VEGF in differential diagnosis of benign and malignant liver diseases.

METHODS

Tumor specimens were prospectively collected from HCC patients undergoing resection. Total RNAs were extracted and the expression levels were detected from different parts of HCC tissues. The cellular distributions of VEGF and MVD of liver tumors and their paracancerous and distal cancerous tissues were investigated by streptavidin peroxidase (S-P) immunohistochemistry, respectively. The VEGF levels of circulating blood and hepatoma tissues were measured by enzyme-linked immunosorbent assay.

RESULTS

The incidence of VEGF expression was 63.9% in HCCs (23/36 cases), 78.3% in non-encapsulated HCCs (18/23), and 90.9% in HCCs with extrahepatic metastasis (10/11), respectively. The VEGF expression was tightly correlated with MVD (P<0.01). The MVD in HCC with metastasis, low differentiation or non-encapsulation was significantly higher than that in HCC with intact capsule, high differentiation, or no metastasis. No significant difference was found between VEGF, MVD, tumor size, and hepatitis virus infection. The level of total RNA in HCC tissues was significantly lower but the VEGF level significantly higher than those in paracancerous or distal cancerous ones (P<0.01). The abnormal expression levels of VEGF in sera of HCC patients were directly correlated with the metastasis and recurrence of tumors.

CONCLUSION

The high expression of VEGF and abnormality of tissue MVD are useful predictors for vascular invasion and metastasis of liver tumors.

Abnormal expression of hepatoma-derived gamma-glutamyltransferase subtyping and its early alteration for carcinogenesis of hepatocytes

BACKGROUND

Although the hepatoma-specific band of gamma-glutamyltransferase (GGT) is a highly sensitive marker in diagnosis of hepatocellular carcinoma, the kinetic expression and the early alterations of GGT in the development of hepatoma remain unclear. In this study, we investigated the expression and the alterations of GGT multiple molecular forms in hepatotumorigenesis.

METHODS

The expression of GGT in a chemically induced hepatocarcinogenesis model was examined by giving 0.05% of 2-fluoenylacetamide in diet for 12 weeks. The expression levels of total RNA and GGT, and the changes of liver pathology, GGT multiple molecular forms and sugar-chain heterogeneity were investigated at the different stages of rat hepatoma development.

RESULTS

Pathological examination and biochemical analysis found that liver GGT was over-expressed and secreted into blood during canceration. Serum total GGT and liver GGT specific activities (IU/g) including soluble and membrane-combined GGT were significantly higher (P<0.05) in experimental groups than those in control group, respectively. A highly positive correlation was found between total GGT activities and total RNA levels (r=0.90, P<0.05) of the liver. Both were higher six weeks later than before. Con A-non-reactive-GGT was increased consistantly during the development of rat hepatoma. GGT multiple molecular forms in the liver and sera of experimental rats showed that fetal liver-type GGT bands were associated with the development of hepatoma.

CONCLUSIONS

Fetal liver-type GGT in sera and the liver of rats is closely related to hepatotumorigenesis. It can be used as a sensitive enzymatic marker for the early diagnosis of liver cancer.