Construction and validation of a m6A RNA methylation and ferroptosis-related prognostic model for pancreatic cancer by integrated bioinformatics analysis

Background

Both N6-methyladenosine (m6A) ribonucleic acid (RNA) methylation and ferroptosis regulators are demonstrated to have significant effects on the malignant clinicopathological characteristics of pancreatic adenocarcinoma (PAAD) patients. However, the currently available clinical indexes are not sufficient to predict precise prognostic outcomes pf PAAD patients accurately. This study aims to examine the clinicopathologic features of m6A RNA methylation and ferroptosis regulators in predicting the outcomes of different types of cancer.

Methods

As the foundation for this research, the differentially expressed genes (DEGs) between PAAD tissues and adjacent normal tissues were first identified. Next, dimensional reduction analysis (DCA) based on m6A RNA methylation regulators and ferroptosis regulators were performed and DEGs between good/poor prognosis PAAD patient clusters were identified. DEGs were then screened by Cox analysis, and finally a risk signature was established by least absolute shrinkage and selection operator (LASSO) analyses. The prediction model based on risk score was further evaluated by a validation set from Gene Expression Omnibus (GEO) database.

Results

In total, 4 m6A RNA methylation regulator genes and 29 ferroptosis regulator genes were found to have close causal relationships with the prognosis of PAAD, and a risk score with 3 m6A methylation regulators (i.e., IGF2BP2, IGF2BP3, and METTL16) and 4 ferroptosis regulators (i.e., ENPP2, ATP6V1G2, ITGB4, and PROM2) was constructed and showed to be highly involved in PAAD progression and could serve as effective markers for prognosis with AUC value equaled 0.753 in training set and 0.803 in validation set.

Conclusions

The combined prediction model, composed of seven regulators of m6A methylation and ferroptosis, in this study more effectively reflects the progression and prognosis of PAAD than previous single genome or epigenetic analysis. Our study provides a broader perspective for the subsequent establishment of prognostic models and the patients may benefit from more precision management.

The AKR1B1 inhibitor epalrestat suppresses the progression of cervical cancer

Cervical cancer is the leading cause of cancer-related death among women worldwide. Identifying an effective treatment with fewer side effects is imperative, because all of the current treatments have unique disadvantages. Aldo-keto reductase family 1 member B1 (AKR1B1) is highly expressed in various cancers and is associated with tumor development, but has not been studied in cervical cancer. In the current study, we used CRISPR/Cas9 technology to establish a stable HeLa cell line with AKR1B1 knockout. In vitro, AKR1B1 knockout inhibited the proliferation, migration and invasion of HeLa cells, providing evidence that AKR1B1 is an innovative therapeutic target. Notably, the clinically used epalrestat, an inhibitor of aldose reductases, including AKR1B1, had the same effect as AKR1B1 knockout on HeLa cells. This result suggests that epalrestat could be used in the clinical treatment of cervical cancer, a prospect that undoubtedly requires further research. Moreover, aiming to determine the underlying regulatory mechanism of AKR1B1, we screened a series of differentially regulated genes (DEGs) by RNA sequencing and verified selected DEGs by quantitative RT-PCR. In addition, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of the DEGs revealed a correlation between AKR1B1 and cancer. In summary, epalrestat inhibits the progression of cervical cancer by inhibiting AKR1B1, and thus may be a new drug for the clinical treatment of cervical cancer.

Identification of prognostic risk factors for pancreatic cancer using bioinformatics analysis

Background

Pancreatic cancer is one of the most common malignant cancers worldwide. Currently, the pathogenesis of pancreatic cancer remains unclear; thus, it is necessary to explore its precise molecular mechanisms.

Methods

To identify candidate genes involved in the tumorigenesis and proliferation of pancreatic cancer, the microarray datasets GSE32676, GSE15471 and GSE71989 were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) between Pancreatic ductal adenocarcinoma (PDAC) and nonmalignant samples were screened by GEO2R. The Database for Annotation Visualization and Integrated Discovery (DAVID) online tool was used to obtain a synthetic set of functional annotation information for the DEGs. A PPI network of the DEGs was established using the Search Tool for the Retrieval of Interacting Genes (STRING) database, and a combination of more than 0.4 was considered statistically significant for the PPI. Subsequently, we visualized the PPI network using Cytoscape. Functional module analysis was then performed using Molecular Complex Detection (MCODE). Genes with a degree ≥10 were chosen as hub genes, and pathways of the hub genes were visualized using ClueGO and CluePedia. Additionally, GenCLiP 2.0 was used to explore interactions of hub genes. The Literature Mining Gene Networks module was applied to explore the cocitation of hub genes. The Cytoscape plugin iRegulon was employed to analyze transcription factors regulating the hub genes. Furthermore, the expression levels of the 13 hub genes in pancreatic cancer tissues and normal samples were validated using the Gene Expression Profiling Interactive Analysis (GEPIA) platform. Moreover, overall survival and disease-free survival analyses according to the expression of hub genes were performed using Kaplan-Meier curve analysis in the cBioPortal online platform. The relationship between expression level and tumor grade was analyzed using the online database Oncomine. Lastly, the eight snap-frozen tumorous and adjacent noncancerous adjacent tissues of pancreatic cancer patients used to detect the CDK1 and CEP55 protein levels by western blot.

Conclusions

Altogether, the DEGs and hub genes identified in this work can help uncover the molecular mechanisms underlying the tumorigenesis of pancreatic cancer and provide potential targets for the diagnosis and treatment of this disease.

Effects of TACE and preventive antiviral therapy on HBV reactivation and subsequent hepatitis in hepatocellular carcinoma: a meta-analysis

Background and aim

The impact of transarterial chemoembolization (TACE) and preventive antiviral therapy on the occurrence of hepatitis B virus (HBV) reactivation and subsequent hepatitis remains controversial. This meta-analysis aimed to evaluate the effect of TACE and preventive antiviral therapy on the risk of HBV reactivation and subsequent hepatitis. Meanwhile, we explored the role of HBeAg status in HBV reactivation after TACE.

Methods

We performed this meta-analysis with 11 included studies to assess the effect of TACE and preventive antiviral therapy on predicting clinical outcomes in HBV-related hepatocellular carcinoma (HCC). The pooled odds ratios (OR) were calculated using a random or fixed effects model. PUBMED, MEDLINE, EMBASE and the Cochrane Central Register of Controlled were searched for the included articles (from 2000 to December 2017).

Results

Our results showed that TACE significantly increased the risk of HBV reactivation (OR: 3.70; 95% CI 1.45–9.42; P < 0.01) and subsequent hepatitis (OR: 4.30; 95% CI 2.28–8.13; P < 0.01) in HCC patients. There was no significant difference in HBV reactivation after TACE between HBeAg positive and negative patients (OR: 1.28; 95% CI 0.31–5.34; P = 0.73). Preventive antiviral therapy could statistically reduce the rate of HBV reactivation (OR: 0.08; 95% CI 0.02–0.32; P < 0.01) and hepatitis (OR: 0.22; 95% CI 0.06–0.80; P = 0.02) in those with TACE treatment.

Conclusions

The present study suggested that TACE was associated with a higher possibility of HBV reactivation and subsequent hepatitis. Preventive antiviral therapy is significantly in favor of a protective effect.

High expression of Anxa2 and Stat3 promote progression of hepatocellular carcinoma and predict poor prognosis

AIM

To elucidate whether the interaction between Anxa2 and Stat3 could promote the progression of hepatocellular carcinoma (HCC) and that high co-expression of Anxa2 and Stat3 could predict poor prognosis in HCC patients.

METHODS

We investigated Anxa2 and Stat3 expression using Western blot analysis in 4 HCC and adjacent nontumor tissues and using immunohistochemistry in 100 patients' paraffin sections. Then we assessed the expression of Stat3, Anxa2 and co-expression of Stat3 and Anxa2 with relevant clinical pathological parameters and their prognostic value in HCC patients. The recurrence and overall survival rates were estimated using the Kaplan-Meier method and compared with the log-rank test. The prognostic analysis was carried out with univariate and multivariate Cox regressions models.

RESULTS

The incidence of high Stat3 expression in HCC tissues (35%) was significantly higher than that in non-HCC tissues (8%) (P < 0.001). The same result was observed in Anxa2 (P < 0.001). Also, the overexpression of Stat3 or Anxa2 showed a significant relationship with the recurrence of the 100 HCC patients (P = 0.012; P = 0.003). Additionally, tumor size >3 cm in diameter, multiple tumor number, and the presence of microvascular tumor thrombus were also significantly associated with recurrence in 100 patients. Then, all enrolled patients were divided into four groups according to IHC score of Stat3 and Anxa2, and the results indicated a significant difference in recurrence time between the subgroups (P < 0.001). What's more, co-highexpression of Stat3 and Anxa2 was related to the presence of microvascular tumor thrombus (P = 0.003) and poor tumor differentiation (P < 0.001), but not relevant with other clinical features (All P > 0.05).

CONCLUSION

The expression of Stat3, Anxa2, or co-high-expression of the two proteins was associated with HCC recurrence and survival.

Sex comb on midleg like-2 is a novel specific marker for the diagnosis of gastroenteropancreatic neuroendocrine tumors

Sex comb on midleg like-2 (SCML2) is a polycomb-group protein that encodes transcriptional repressors essential for appropriate development in the fly and in mammals. On the basis of previous findings, the present study aimed to explore the possibility of developing SCML2 into a new diagnostic marker for gastroenteropancreatic neuroendocrine tumors (GEP-NETs). A total of 64 paired GEP-NET tissues and adjacent non-tumorous tissues were obtained from patients who had undergone surgical resection between January 2009 and January 2014, and the expression of SCML2 and two neuroendocrine markers, namely synaptophysin (Syn) and chromogranin A (CgA), in the tissues was assessed by immunohistochemistry. Strong SCML2 staining was observed predominantly in the cell nuclei of GEP-NET tissues, and the overall expression rate and staining intensity of SCML2 were higher than those of Syn or CgA, respectively. Spearman rank correlation analysis demonstrated that SCML2 was not correlated with either Syn or CgA, while the combined detection of SCML2 with Syn or with CgA increased the diagnostic sensitivity to 100%. SCML2 expression in GEP-NETs was associated with several clinicopathological parameters, such as histological type, tumor grade, depth of invasion and clinical stage. Kaplan-Meier survival curves revealed that patients with higher SCML2 expression had lower survival rates than those with lower expression levels, while Cox proportional hazards regression analysis revealed that SCML2 was not an independent prognostic factor for GEP-NET patients. Therefore, SCML2 may have potential as a specific marker for joint use with other markers to improve the diagnostic efficiency of GEP-NETs.

Detection of clarithromycin-resistant Helicobacter pylori in clinical specimens by molecular methods: A review

Various molecular methods have been developed to rapidly detect clarithromycin (CLR) resistance in Helicobacter pylori isolates in clinical specimens. All of these assays for detecting CLR resistance in H. pylori are based on detection of mutations in the 23S rRNA gene. In this article, we summarise current knowledge regarding the detection of H. pylori CLR resistance in clinical specimens by molecular tests. The available data showed that restriction fragment length polymorphism (RFLP), 3'-mismatch PCR, DNA sequencing, the PCR line probe assay (PCR-LiPA) and fluorescence in situ hybridisation assay (FISH) are able to detect CLR-resistant H. pylori in clinical specimens with excellent specificity and sensitivity. However, several factors limit their clinical application, including fastidious, time-consuming preparation and low-throughput as well as carrying a risk of contamination. Furthermore, as an invasive method, FISH is not suitable for children or the elderly. Among the molecular methods, one that is most promising for the future is real-time PCR probe hybridisation technology using fluorescence resonance energy transfer (FRET) probes, which can rapidly detect CLR resistance with high sensitivity and specificity in biopsies and stool specimens, even though mixed infections are present in clinical specimens. Moreover, due to the advantages that this method is simple, rapid and economical, real-time PCR is technically feasible for clinical application in small- and medium-sized hospitals in developing countries. Second, with high sensitivity, specificity and throughput, DNA chips will also be a valuable tool for detecting resistant H. pylori isolates from cultures and clinical specimens.

Chronic pouchitis is associated with pouch polyp formation in patients with underlying ulcerative colitis

BACKGROUND

Polypoid lesions can develop in ileal pouches. The risk factors associated with the development of pouch polyps have not been studied.

AIM

To characterize clinical features, risk factors, and disease course of pouch polyp in a cohort of patients with underlying inflammatory bowel disease (IBD) from a subspecialty clinic.

METHOD

A total of 1094 patients with restorative proctocolectomy and IPAA for IBD presenting to our Pouchitis Clinic from 2002 to 2010 were included. Demographic, clinical, and endoscopic variables were analyzed.

RESULTS

The median durations from UC diagnosis to colectomy and from pouch creation to the last follow-up for the whole cohort were 6 (interquartile range [IQR]: 3-13) and 9years (IQR: 5-14), respectively. A total of 2472 surveillance and/or diagnostic pouchoscopies were performed for the cohort with a median follow-up of 5 (IQR: 2-6) years in the Pouchitis Clinic. The median number of pouchoscopies per patient was 2 (IQR: 1-3). Of the 1094 patients, 96 (8.8%) were found to have pouch polyps. The median size of the polyps was 1.2 (IQR: 1.0-2.0) cm. On histology, 93 patients (96.9%) had inflammatory-type polyps and 3 (3.1%) had polyps with low-grade dysplasia or indefinite for dysplasia. Multivariate logistic regression analysis demonstrated that chronic pouch inflammatory change was a risk factor for the development of pouch polyp with an odds ratio of 2.26 (95% confidence interval: 1.35-3.79; P=0.002).

CONCLUSION

The majority of pouch polyps in patients with underlying UC were benign. Patients with concomitant chronic pouch inflammatory changes had an increased risk for developing pouch polyps.

S100 family signaling network and related proteins in pancreatic cancer (Review)

The occurrence and development of pancreatic cancer is a complex process convoluted by multi-pathogenies, multi-stages and multi-factors. S100 proteins are members of the S100 family that regulate multiple cellular pathways related to pancreatic cancer progression and metastasis. S100 proteins have a broad range of intracellular and extracellular functions, including the regulation of protein phosphorylation and enzyme activity, calcium homeostasis and the regulation of cytoskeletal components and transcriptional factors. S100 proteins interact with receptor for advanced glycation end-products (RAGE), p53 and p21, which play a role in the degradation of the extracellular matrix (ECM) and metastasis, and also interact with cytoskeletal proteins and the plasma membrane in pancreatic cancer progression and metastasis. S100A11 and S100P are significant tumor markers for pancreatic cancer and unfavorable predictors for the prognosis of patients who have undergone surgical resection. Recently, S100A2 has been suggested to be a negative prognostic biomarker in pancreatic cancer, and the expression of S100A6 may be an independent prognostic impact factor. The expression of S100A4 and S100P is associated with drug resistance, differentiation, metastasis and clinical outcome. This review summarizes the role and significance of the S100 family signaling network and related proteins in pancreatic cancer.

Serum GP73 is complementary to AFP and GGT-II for the diagnosis of hepatocellular carcinoma

Golgi protein 73 (GP73) is a resident Golgi type II transmembrane protein that has been reported to markedly increase in chronic liver disease, particularly in hepatocellular carcinoma (HCC). However, it remains unclear as to whether serum GP73 represents a reliable serum marker for the diagnosis of HCC. The aim of the present study was to evaluate the diagnostic value of serum GP73 in patients with HCC and to determine the diagnostic accuracy of measuring serum GP73 in combination with α-fetoprotein (AFP) and γ-glutamyl transferase isoenzyme II (GGT-II) in HCC. Serum GP73 was detected using a time-resolved fluorescence immunological assay (TRFIA) and enzyme-linked immunosorbent assay (ELISA) in 79 HCC cases, including 16 liver cirrhosis, 30 chronic hepatitis and 28 healthy individuals. The correlation between serum GP73 and tumor size and HCC grading was analyzed and the complementary diagnostic value of serum GP73, AFP and GGT-II was evaluated. TRFIA was established for the detection of serum GP73 and was sensitive and reproducible. The expression levels of serum GP73 were markedly higher in the patients with HCC when compared with those of the individuals with liver cirrhosis and chronic hepatitis or the healthy individuals. According to the receiver operating characteristic (ROC) curve, diagnostic sensitivity and specificity for HCC with a cut-off value of 78.1 ng/l were 73.4 and 79.0%, respectively. However, no correlation was identified among serum GP73 and tumor size or grading, and no correlations were identified among serum GP73, AFP and GGT-II. The diagnostic sensitivities for HCC, as detected by TRFIA of GP73, AFP and GGT-II, were 73.4, 55.6 and 68.4%, respectively, and the specificities were 80.0, 86.7 and 97.1%, respectively. The combined determination of these markers increased the diagnostic sensitivity to 96.3% for HCC. TRFIA functions as a sensitive and replicable assay for the detection of serum GP73. The levels of serum GP73 were significantly higher in the HCC group when compared with the individuals with benign liver diseases. Serum GP73 may serve as a potential independent diagnostic candidate for HCC and the combined determination of serum GP73, AFP and GGT-II may increase the diagnostic efficiency of HCC.

Correlation between expression of neuropilin-1 and that of extracellular matrix components in liver fibrosis in rats

AIM: To investigate the expression of neuropilin-1 (NRP-1) in liver fibrosis in rats and to analyze its correlation with the expression of extracellular matrix components.

METHODS: Hepatic fibrosis was induced in rats using carbon tetrachloride. The mRNA and protein expression of NRP-1, collagen Ⅰ, collagen Ⅲ and α smooth muscle actin (α-SMA) in hepatic tissue of the rats was examined by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry, respectively. Correlation between the expression of NRP-1 and that of collagen Ⅰ, collagen Ⅲ and α-SMA was analyzed.

RESULTS: The expression of NRP-1, α-SMA, collagen Ⅰ, and collagen Ⅲ proteins was low in the liver tissue of normal rats. In rats with experimental liver fibrosis, the expression of NRP-1, α-SMA, collagen Ⅰ, and collagen Ⅲ proteins increased with the progression of hepatic fibrosis. At weeks 4 and 6, the expression of the above four proteins were significantly higher in liver fibrosis than in normal hepatic tissue (all P < 0.05). NRP-1 mRNA expression in fibrotic liver tissue was significantly higher than that in normal hepatic tissue (P < 0.05). Expression of α-SMA, collagen Ⅰ, and collagen Ⅲ mRNAs was low in normal liver tissue but was significantly increased at weeks 2, 4, and 6 after injection of carbon tetrachloride. The expression of NRP-1, α-SMA, collagen Ⅰ, and collagen Ⅲ mRNAs was gradually increased with the progression of hepatic fibrosis. NRP-1 expression had no apparent correlation with collagen Ⅰ and collagen Ⅲ expression at week 2, but showed a significant correlation at weeks 4 (r = 0.645, 0.530) and 6 (r = 0.834, 0.613). NRP-1 expression had a significant correlation with α-SMA expression during the whole process of hepatic fibrosis (r = 0.621, 0.690, 0.820, all P < 0.05).

CONCLUSION: NRP-1 is overexpressed in hepatic fibrosis, which correlates with the expression of collagen Ⅰ and collagen Ⅲ.

Combined analysis of serum γ-glutamyl transferase isoenzyme II, α-L-fucosidase and α-fetoprotein detected using a commercial kit in the diagnosis of hepatocellular carcinoma

γ-glutamyl transferase isoenzyme II (GGT-II) is a sensitive biomarker of hepatocellular carcinoma (HCC). However, numerous disadvantages of the traditional manual method affected its application. The commercial kit provided a convenient and fast method for the determination of GGT-II levels. The purposes of the present study were to compare the reproducibility and sensitivity between the manual and commercial kit methods and to evaluate the diagnostic efficiency for HCC with the combined analysis of GGT-II, α-L-fucosidase (AFU) and α-fetoprotein (AFP). In patients with various liver diseases (HCC, liver cirrhosis and chronic hepatitis) and normal subjects, GGT-II was detected by manual and commercial polyacrylamide gel electrophoresis (PAGE). The levels of AFU and AFP were assayed by colorimetry and a chemiluminescence immunoassay, respectively. The commercial PAGE had equal diagnostic efficiency with traditional manual PAGE and no significant differences were observed in intra- and average-gel reproducibility and GGT-II sensitivities between the manual and commercial PAGE (P>0.05). The incidence of GGT-II detected by commercial PAGE in HCC patients was 84.1% and <8% in benign liver disease. The levels of AFU and AFP in the benign liver diseases and normal subjects were lower than those in HCC. According to the cut-off value obtained by receiver operating characteristic curves, a total of 56.6 and 59.3% of HCC patients (64 out of 113 and 67 out of 113) had AFU >636.5 μmol/l h and AFP >44.0 μg/l, respectively. There were no significant correlations between GGT-II and AFU or AFP. Combined detection of GGT-II with AFU or AFP increased the diagnostic sensitivity to 92.9 and 93.8%, respectively. These results suggest that commercial PAGE provides a simple and reproducible method for GGT-II detection. Combined determination of GGT-II with AFU or AFP exhibited superior sensitivity and specificity for the diagnosis of HCC.

Correlation of nuclear factor κB expression with α-SMA and collagen Ⅲ expression in hepatic fibrosis in rats

AIM: To investigate the correlation of expression of nuclear factor κB with that of α-smooth muscle actin (α-SMA) and collagen Ⅲ in hepatic fibrosis in rats.

METHODS: Thirty-two male SD rats of SPF grade were divided randomly into control group and model group. Hepatic fibrosis was induced in rats by injecting carbon tetrachloride. The mRNA and protein expression of NF-κB, α-SMA, and collagen Ⅲ was examined using reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry, respectively. The correlation of NF-κB expression with α-SMA and collagen Ⅲ expression was then analyzed.

RESULTS: NF-κB, α-SMA and collagen Ⅲ were lowly expressed in normal liver tissue. After injection of carbon tetrachloride, the expression of NF-κB, α-SMA and collagen Ⅲ mRNAs and proteins began to increase at week 2 and was significantly higher at weeks 4 and 6 (both P < 0.05), showing a gradually rising trend. There was a positive correlation between the expression of NF-κB and that of α-SMA and collagen Ⅲ (both P < 0.05).

CONCLUSION: NF-κB plays an important role in the pathogenesis of hepatic fibrosis.

The expressions and clinical significances of tissue and serum galectin-3 in pancreatic carcinoma

PURPOSE

Galectin-3, a member of the beta-galactoside-binding protein family, is involved in many biological processes, including cell proliferation, regulating cell cycle, angiogenesis, tumorigenesis, metastasis, etc. The aim of this study is to elucidate the relationship between galectin-3 and clinicopathological variables and to evaluate the clinical significance of serum galectin-3 in the diagnosis of pancreas carcinoma.

METHODS

Galectin-3 expression in 78 pairs of pancreatic carcinoma tissues and the adjacent nontumorous tissues was tested by immunohistochemistry. The relationship between galectin-3 expression and clinical variables was analyzed. A sensitive method of time-resolved fluorescence immunological assay (TRFIA) for the detection of galectin-3 was established, and serum galectin-3 in cases with different pancreatic diseases was measured by TRFIA and ELISA. Further we compared the sensitivity and specificity of determining galectin-3, carcinoembryonic antigen (CEA) and carbohydrate antigen199 (CA199) for diagnosis of pancreatic carcinoma and assessed the complementary diagnostic value of galectin-3, CEA and CA199 for pancreatic carcinoma.

RESULTS

Immunohistochemistry showed that galectin-3 expression was significantly higher in the human pancreatic carcinoma tissues than in the adjacent nontumorous tissues. The expression levels were correlated with the differentiation degree with the higher expression in poor differentiation tissues. Serum galectin-3 detected by both TRFIA and ELISA was much higher in patients with pancreatic carcinoma than in other groups. Serum galectin-3 was not correlated with CEA and CA199. Combined determination of these three markers has the complementary diagnostic value for human pancreatic carcinoma and may increase the diagnostic sensitivity to 97.5%.

CONCLUSIONS

Galectin-3 is overexpressed in pancreatic carcinoma tissues, and it is correlated with the tumor differentiation. Serum galectin-3 is higher in cases with pancreatic carcinoma than in benign pancreatic diseases and healthy persons. Combined determination of serum galectin-3, CEA and CA199 may improve the diagnostic power for pancreatic carcinoma.

High expression of S100A11 in pancreatic adenocarcinoma is an unfavorable prognostic marker

S100A11 is a member of S100 protein family, and our previous study showed that S100A11 is one of the up-regulated proteins that have not been reported to be associated with pancreatic carcinoma. The purpose of this study was to investigate the relation between S100A11 expression and the clinicopathological variables and clinical outcome in patients with pancreatic adenocarcinoma. Immunohistochemistry analysis was performed for S100A11 in 78 pairs of specimens of human pancreatic adenocarcinoma tissues and adjacent nontumorous tissues. The univariate and multivariate survival analyses were also performed to determine its prognostic significance. S100A11 expression in pancreatic adenocarcinoma (62/78) was significantly higher than that in the adjacent nontumorous tissues (19/78) (P = 0.000). High expression of S100A11 was associated with the lymph node metastasis and histological differentiation (P = 0.003 and 0.004, respectively). Univariate analysis showed that S100A11 expression was associated with poor prognosis (P = 0.0000). Multivariate analysis using the Cox regression model indicated that age ≥ 65 years, CA19-9 ≥ 1,000 U/ml and positive S100A11 were independent prognostic indicators of pancreatic adenocarcinoma (P = 0.002, 0.004 and 0.001, respectively). These results suggested that S100A11 might be a significant tumor marker for pancreatic adenocarcinoma and an unfavorable predictor for prognosis of patients who have undergone surgical resection.

Clinical significance of PD-ECGF expression in human pancreatic carcinoma

AIM: To investigate the expression of platelet-derived endothelial cell growth factor (PD-ECGF) in human pancreatic carcinoma and evaluate its clinical significance.

METHODS: Immunohistochemistry was used to detect the expression of PD-ECGF in 36 paraffin-embedded pancreatic carcinoma specimens, 21 tumor-adjacent normal tissue specimens, and 60 cancerous specimens derived from other tissues (stomach, colon, esophagus, liver, lung and breast; 10 specimens each). The expression of PD-ECGF in different tissues was compared. The correlation between PD-ECGF expression and clinical parameters in pancreatic carcinoma was analyzed.

RESULTS: The positive rate of PD-ECGF in pancreatic carcinoma was higher than that in tumor-adjacent normal tissue (88.9% vs 28.6%, P < 0.01). The positive rates of PD-ECGF in cancerous colon, liver, breast, esophagus, stomach and lung tissues were 60%, 70%, 80%, 90%, 90% and 80%, respectively. The positive rate of PD-ECGF in pancreatic carcinoma at stage II-IV was higher than that at stage I (100% vs 75%, P < 0.05).

CONCLUSION: PD-ECGF is an organ-unspecific tumor-associated protein that may be associated with the progression of pancreatic carcinoma.

Expression of leptin in hepatic fibrosis and its relation with hepatic stellate cell activation

AIM: To investigate the expression of leptin in hepatic fibrosis and explore its correlation with the expression of TGF-β1 and α-SMA as well as its relation with the activation of hepatic stellate cells (HSC).

METHODS: Forty healthy male SD rats were randomly divided into normal control group and carbon tetrachloride treatment group. The rats were given a subcutaneous injection of either vehicle or carbon tetrachloride, and sacrificed at weeks 2, 4 and 6 after the injection, respectively. The mRNA and protein expression of leptin, TGF-β1 and α-SMA was assayed by reverse transcription-polymerase chain reaction (RT-PCR), Western blot and immunohistochemistry, respectively.

RESULTS: Leptin, TGF-β1 and α-SMA were lowly expressed in normal liver tissues. After injection of carbon tetrachloride, the expression of leptin, TGF-β1 and α-SMA began to increase at week 2 and was significantly higher at weeks 4 and 6 (P < 0.05), showing a gradually rising trend. The expression of leptin was positively correlated with that of TGF-β1 and α-SMA (r = 0.668 and 0.570, respectively; both P < 0.05).

CONCLUSION: The expression of leptin, TGF-β1 and α-SMA increases with the development of hepatic fibrosis. Leptin is probably involved in the activation of HSCs and the synthesis of extracellular matrix (ECM) in the development of hepatic fibrosis.

Value of insulin-like growth factor binding protein 2 in early diagnosis of nonalcoholic fatty liver disease

AIM: To study the value of quantitative determination of insulin-like growth factor binding protein 2 in the diagnosis of nonalcoholic fatty liver disease (NAFLD).

METHODS: ELISA was used to measure the serous IGFBP2 of patients with NAFLD, chronic hepatitis, and hepatic cirrhosis, primary carcinoma of the liver and healthy adults. The results were statistically analyzed.

RESULTS: The serous IGFBP2 was significantly higher in NAFLD group than in other groups (6.89 ± 2.37 µg/L, 4.86 ± 1.97 µg/L vs 1.77 ± 1.56 µg/L, 1.67 ± 1.36 µg/L, 1.76 ± 1.52 µg/L, 1.52 ± 1.43 µg/L, all P < 0.05). The serum IGFBP2 in mild NAFLD group was significantly higher than in middle or sever NAFLD groups (P < 0.05).

CONCLUSION: The study suggests that screening test of serous IGFBP2 is a useful marker for recognizing the stage and degree of NAFLD.

Comparative proteomic analysis of differentially expressed proteins in human pancreatic cancer tissue

BACKGROUND

Pancreatic cancer is one of the most common malignant tumors. Early diagnosis of pancreatic cancer is difficult because of the latent onset and lack of good biomarkers. This study aimed to look for and identify differentially expressed proteins in tissues of pancreatic cancer and adjacent noncancerous tissues by proteomic approaches so as to provide information about possible pancreatic cancer markers and therapeutic targets.

METHODS

Proteins extracted from 3 paired adjacent noncancerous and cancerous pancreatic tissue specimens were separated by two-dimensional gel electrophoresis (2-DE). The protein spots exhibiting statistical alternations between the two groups through computerized image analysis were then identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS). In addition, Western blotting and immunohistochemistry were performed to verify the expression of certain candidate proteins.

RESULTS

Twelve proteins were significantly upregulated and 4 were downregulated between cancerous and paired adjacent noncancerous pancreatic tissues. Several proteins (S100A11, Ig gamma-1 chain C region, GSTO1 and peroxiredoxin 4) were found for the first time to be associated with pancreatic cancer. Differential expression of some identified proteins was further confirmed by Western blotting analysis and/or immunohistochemical analysis.

CONCLUSIONS

Comparative proteomic analysis using 2-DE and MALDI-TOF-MS is an effective method for identifying differentially expressed proteins that may be the potential diagnostic biomarkers and therapeutic targets for pancreatic cancer.

[Clinical significance of serum GPDA-F determined by immunoelectrophoresis in diagnosis of hepatocellular carcinoma]

BACKGROUND & OBJECTIVE

Serum fast band of glycylproline dipeptidyl aminopeptidase isoenzyme (GPDA-F) is useful to the diagnosis of hepatocellular carcinoma, especially for the cases without expression of alpha-fetoprotein (AFP). Polyacrylamide electrophoresis for detection of GPDA-F is relatively complicated and has limitation in its clinical use. This study was to establish a simple and easy method of immunoelectrophoresis to detect serum GPDA-F, and evaluate clinical value of GPDA-F in the diagnosis of hepatocelluar carcinoma.

METHODS

Serum GPDA-F was purified to raise polyclonal GPDA-F antibody, and immunoelectrophoresis was established for the detection of serum GPDA-F. Serum GPDA-F in 99 specimens of hepatocellular carcinoma and 115 specimens of benign liver diseases (36 cases of liver cirrhosis, 23 cases of acute hepatitis, 38 cases of chronic hepatitis, and 18 cases of benign liver space-occupying lesions) was simultaneously detected by both polyacrylamide electrophoresis and immunoelectrophoresis. The clinical value of serum GPDA-F detected by immunoelectrophoresis was compared with that by polyacrylamide electrophoresis for the diagnosis of hepatocellular carcinoma.

RESULTS

If the cut-off was set at 71 u/L, the diagnostic sensitivity, specificity, and accuracy of immunoelectrophoresis in detecting GPDA-F in hepatocellular carcinoma were 83.8%, 85.2%, and 84.6%, respectively; while those of polyacrylamide electrophoresis were 81.8%, 77.3%, and 79.4%, respectively.

CONCLUSIONS

Serum GPDA-F detected by immunoelectrophoresis is useful to the diagnosis of hepatocellular carcinoma. Compared with polyacrylamide electrophoresis, this method is cheap, time-saving, and easy.

Clinical and endoscopic features of gastric mucosa-associated lymphoid tissue lymphoma

AIM: To investigate the clinical and endoscopic features of gastric mucosa associated lymphoid tissue (MALT) lymphoma, and to improve the accuracy of early diagnosis.

METHODS: The clinical and endoscopic data of 22 patients, who were surgically and pathologically diagnosed with gastric MALT lymphoma, were retrospectively reviewed and analyzed.

RESULTS: Most of the symptoms were exhibited as abdominal discomfort and upper gastrointestinal hemorrhage. Most of the pathological changes appeared in the gastric antrum and body in the form of bulgy, ulcerative and infiltrative lesions, featuring as multiform, multi-morphology, and diffuse changes under endoscope. All the 22 patients were diagnosed with B cell lymphoma, and Helicobacter pylori was founded in 18 cases (81.8%).

CONCLUSION: The clinical symptoms of gastric MALT lymphoma have no specificity. The endoscopic features are of variety, and the lesions are extensive. Clumpy and deep biopsy with timely immunohistochemistry can improve the accuracy of endoscopic diagnosis.

[Detection of GGT-II by dot-ELISA with monoclonal antibody in the diagnosis of hepatocellular carcinoma]

BACKGROUND & OBJECTIVE

Hepatoma-specific gamma- glutamyltransferase isoenzyme II(GGT-II) is considered as the best hepatoma marker except alpha-fetoprotein (AFP), but there is no simple and easy method to determine it now. The purpose of this study was to explore the value of detection of GGT-II by dot-ELISA with monoclonal antibody in the diagnosis of hepatocellular carcinoma (HCC).

METHODS

GGT-II was purified and then BALB/c mouse was immunized. The monoclonal antibody against GGT-II was raised by the hybridoma technique. Serum GGT-II was detected in 123 cases with hepatocellular carcinoma and 164 cases with various benign liver diseases using both dot-ELISA and electrophoresis simultaneously.

RESULTS

The positive rate of serum GGT-II in HCC by dot-ELISA was 71.5%, which was not significantly different from that by electrophoresis (76.4%). However, the false positive rates of GGT-II by dot-ELISA in liver cirrhosis (23.7%) and chronic hepatitis (27.1%) were significantly higher than those by electrophoresis (10.0% and 8.4% for liver cirrhosis and chronic hepatitis, respectively).

CONCLUSION

Detection of GGT-II by dot-ELISA with monoclonal antibody is helpful for the diagnosis of HCC, but its diagnostic specificity deserves to be improved.

Glycylproline dipeptidyl aminopeptidase isoenzyme in diagnosis of primary hepatocellular carcinoma

AIM: To investigate the role of glycylproline dipeptidyl aminopeptidase (GPDA) isoenzyme in the diagnosis of primary hepatocellular carcinoma (PHC), especially in patients with negative alpha-fetoprotein (AFP).

METHODS: A stage gradient polyacrylamide gel discontinuous electrophoresis system was developed to separate serum GPDA isoenzymes, which were determined in 102 patients with PHC, 45 cases with liver cirrhosis, 24 cases with chronic hepatitis, 35 cases with benign liver space-occupying lesions, 20 cases with metastatic liver cancer and 50 cases with extra-hepatic cancer, as well as 80 healthy subjects. The relationships between GPDA isoenzymes and AFP, the sizes of tumors, as well as alanine aminotransferase (ALT) were also analyzed.

RESULTS: Serum GPDA was separated into two isoenzymes, GPDA-S and GPDA-F. The former was positive in all subjects, while the latter was found mainly in majority of PHC (85.3%) and a few cases with liver cirrhosis (11.1%), chronic hepatitis (33.3%), metastatic liver cancer (15.0%) and non-hepatic cancer (16.0%). GPDA-F was negative in all healthy subjects and patients with benign liver space-occupying lesions, including abscess, cysts and angioma. There was no correlation between GPDA-F and AFP concentration or tumor size. GPDA-F was consistently positive and not correlated with ALT in PHC, but GPDA-F often converted to negative as decline of ALT in benign liver diseases. The electrophoretic migration of GPDA-F became sluggish after the treatment of neuraminidase.

CONCLUSION: GPDA-F is a new useful serum marker for PHC. Measurement of serum GPDA-F is helpful in diagnosis of PHC, especially in patients with negative AFP. GPDA-F is one kind of glycoproteins rich in sialic acid.

Diagnosis of hepatocellular carcinoma by quantitative detection of hepatoma-specific bands of serum gamma-glutamyltransferase

Tissues of hepatocellular carcinoma (HCC) can express hepatoma-specific gamma-glutamyltransferase (GGT) and secrete GGT into circulating blood. Serum GGT was separated into several bands (up to 11), including hepatoma-specific bands (HSBs, I', II, and II') by a vertical slab electrophoresis assay of polyacrylamide stage gradient gel. In the present study, the HSBs of serum GGT were separated, and the HSB activity was quantitatively measured in 91 patients with HCC and compared with that of 106 patients with benign liver disease, 16 patients with extrahepatic tumors, and 30 healthy control subjects. Significant differences of the HSB activity were observed between the HCC group and each study group. An HSB activity greater than 5.5 U/L seems to be diagnostic of HCC. The quantitative method has a sensitivity of 85.3%, a specificity of 97.2%, a positive predictive value of 95.1%, a negative predictive value of 91.2%, and an accuracy of 92.5% for detecting HCC. No correlation was found between HSB activity and the serum alpha-fetoprotein (AFP) level or tumor size in patients with HCC. The quantitative analysis of HSB activity of GGT is superior to detection of the AFP concentration and is useful in early diagnosis of small HCC or AFP-negative HCC.

Expression and kinetic changes of alkaline phosphatase and its isoenzymes in experimental rat hepatoma

AIM: To explore the expression and changes of hepatoma specific alkaline phospatase (ALP) in rats during canceration.

METHODS: The ALPs and isoenzymes of rat livers and sera were investigated in SD hepatomas induced with 0.05% 2-fluoenylacetamide (2-FAA).

RESULTS: By pathological examination and biochemical analysis. ALPs were overexpressed in rat livers during canceration and then were secreted into blood. Serum total ALP activities, liver ALP specific activities (U/g) including soluble and membrane-combined ALP activities of each group were all significantly higher (P < 0.01)than those of control group. The average ratios of soluble ALP to membrane-combined ALP were increased significantly after 6 weeks. ALP isoenzymes of rat sera and livers showed 5 bands on PAGE: ALP-I and ALP-II were specific for normal liver and rat hepatoma tissues, the ALP-II appeared in rat liver after 6 weeks and in sera after 8 weeks.

CONCLUSIONS: ALP with carcino-embryonic protein was overexpressed in hepatoma tissues; the abnormal ALP-II of ALP isoenzymes in sera and liver of rats can be used as a tumor marker for early diagnosis of rat hepatoma.