[Cell heterogeneity of laryngeal carcinoma and evolution trajectory of epithelial cells]

Objective: To analyze the classification and functions of cell subsets in laryngeal carcinoma and metastatic lymph nodes, and to explore the evolution trajectory of epithelial cells to tumor cells. Methods: Single-cell RNA sequencing was performed on 5 cases of laryngeal cancer, matched metastatic lymph nodes and 3 normal tissues. Patients were admitted to Ningbo Medical Center Lihuili Hospital from October 22, 2019 to December 16, all patients were male, aged 53-70 years old. Cell subsets of the above-mentioned tissues were analyzed by the Seurat, and the biological functions of cell subpopulation were investigated by functional enrichment analysis. Malignant epithelial cells were identified using copy number variation (CNV). The evolutionary trajectory of epithelial cells to cancer cells was analyzed by cell trajectory analysis, and cancerous transitional cells were identified. The highly expressed genes in transitional cells were analyzed by the FindAllMarker of the Seurat and verified by immunohistochemistry. Results: A total of 66 969 high-quality cells were obtained in 9 major clusters: epithelial cells, T cells, B cells, fibroblasts, endothelial cells, myeloid cells, mast cells, plasmacytoid dendritic cells and nerve cells. The first 5 cell clusters were divided into 8, 6, 4, 3 and 2 subgroups, respectively. Four epithelial cell subsets (C0, C1, C2 and C5) were derived from tumor tissues and metastatic lymph nodes, and had high levels of CNV and tumor cell content. Cell trajectory analysis showed that the evolution trajectory of epithelial cells was from normal epithelial subpopulation C4 to early cancerous cell population C0, which differentiated into three major malignant cell subsets C1, C3, and C5. Epithelial cell C0 may represent the transitional cell population of carcinogenesis, and were enriched in biological processes such as epithelial-mesenchymal transformation and angiogenesis. C0 highly expressed sulforaphane (SFN) which may be related to the occurrence and development of cancer. Immunohistochemistry confirmed that SFN was highly expressed in tumor tissues and metastatic lymph nodes compared with paracancerous tissues. Conclusion: Single-cell sequencing may be used to elucidate the diversity of cells and functions in laryngeal carcinoma tissues and metastatic lymph nodes, and cell population C0 plays a key role in the evolution of cells.

Relationship between hepatitis B virus serum markers and hepatitis B virus DNA quantities in Korean and Han patients with chronic hepatitis B in Yanbian area

AIM: To investigate the relationship between the HBV markers (HBV M) and contents of HBV DNA in Korean and Han patients with chronic hepatitis B (CHB) in Yanbian area.

METHODS: The contents of HBV DNA and the levels of HBV M were detected in 1773 patients (Korean, n = 1074; Han, n = 699) with CHB by fluorescence quantitative polymerase chain reaction (FQ-PCR) and enzyme linked immunosorbent assay (ELISA), respectively. The data were comparatively analyzed between the two ethnic groups.

RESULTS: For HBV M, Korean and Han patients covered percentages of 40.69% and 47.07% (P < 0.01), respectively, in group A (HBsAg+, HBeAg+, HBcAb+), 47.07% and 38.34% (P < 0.05), respectively, in group B (HBsAg+, HBeAb+, HBcAb+), and 7.18% and 4.58% (P < 0.05), respectively, in group C (HBsAg+, HBcAb+). The positive rates of HBV DNA had no significant difference between Korean and Han patients (A: 93.82%, 93.92%; B: 47.54%, 47.39%). The higher content of HBV DNA (≥ 10¹⁴-10¹⁶ copies/L) was prominent in group A (70.73%, 72.17%), and the lower content (≥ 10⁶-10¹⁰ copies/L) was dominant in group B (51.64%, 51.18%)in both Horean and Han patients.

CONCLUSION: HBV M levels are significantly different between Korean and Han patients with CHB in Yanbian area. The positive rate of HBV DNA is similar, but the content of HBV DNA is correlated with HBV M levels in two ethnic groups.

Morphological and serum hyaluronic acid, laminin and type IV collagen changes in dimethylnitrosamine-induced hepatic fibrosis of rats

AIM

To study the morphological and serum hyaluronic acid (HA), laminin (LN), and type IV collagen changes in hepatic fibrosis of rats induced by dimethylnitrosamine (DMN).

METHODS

The rat model of liver fibrosis was induced by DMN. Serum HA, type IV collagen, and LN were measured by ELISA. The liver/weight index and morphological changes were examined under electron microscope on d 7, 14, 21, and 28 by immunohistochemical alpha smooth muscle actin alpha-SMA staining as well as Sirius-red and HE staining.

RESULTS

The levels of serum HA, type IV collagen and LN significantly increased from d 7 to d 28 (P = 0.043). The liver/weight index increased on d 7 and decreased on d 28. In the model group, the rat liver stained with HE and Sirius-red showed evident hemorrhage and necrosis in the central vein of hepatic 10 lobules on d 7. Thin fibrotic septa were formed joining central areas of the liver on d 14. The number of alpha-SMA positive cells was markedly increased in the model group. Transitional hepatic stellate cells were observed under electron microscope. All rats in the model group showed micronodular fibrosis in the hepatic parenchyma and a network of alpha-SMA positive cells. Typical myofibroblasts were embedded in the core of a fibrous septum. Compared to the control group, the area-density percentage of collagen fibrosis and pathologic grading were significantly different in the model group (P<0.05) on different d (7, 14, and 28). The area-density percentage of collagen fibrosis in hepatic tissue had a positive correlation with the levels of serum HA, LN, and type IV collagen.

CONCLUSION

The morphological and serum HA, type IV collagen, and LN are changed in DMN-induced liver fibrosis in rats.

Vascularization in tissue remodeling after rat hepatic necrosis induced by dimethylnitrosamine

We observed postnecrotic tissue remodeling to examine vascularization in adult rat livers. Livers, bone marrow, and peripheral blood from rats at 24 h to 14 days after an injection of dimethylnitrosamine (DMN) were examined by light microscopic, immunohistochemical, and ultrastructural methods. Numerous ED-1 (a marker for rat monocytes/macrophages)-positive round mononuclear cells infiltrated in the necrotic areas at 36 h after DMN treatment. On day 5, when necrotic tissues were removed, some of the cells were transformed from round to spindle in shape. On day 7, these cells were contacted with residual reticulin fibers and became positive for SE-1, a marker of hepatic sinusoidal endothelial cells and Tie-1, an endothelial cell-specific surface receptor, associated with frequent occurrence of ED-1/SE-1 and ED-1/Tie-1 double-positive spindle cells. Ultrastructurally, the spindle cells simultaneously showed phagocytosis and endothelial cell-like morphology. With time necrotic areas diminished, and on day 14, the necrotic tissues were almost replaced by regenerated liver tissues and thin bundles of central-to-central bridging fibrosis. Bone marrow from 12 h to day 2 showed an increase of BrdU-positive mononuclear cells. Some of them were positive for ED-1. The BrdU-labeled and ED-1-positive cells appeared as early as 12 h after DMN injection and reached a peak in number at 36 h. They were similar in structure to ED-1-positive cells in necrotic liver tissues. These findings suggest that round mononuclear ED-1-positive cells proliferate first in bone marrow after DMN treatment, reach necrotic areas of the liver through the circulation, and differentiate to sinusoidal endothelial cells. Namely, hepatic sinusoids in DMN-induced necrotic areas may partly be reorganized possibly by vasculogenesis.

[Severe side effects of the treatment of acute promyelocytic leukemia with all-trans retinoic acid]

Sixty-three cases with acute promyelocytic leukemia (APL) were treated with all-trans retinoic acid (ATRA). The rates of hyperleukocytosis, intracranial hypertension, retinoic acid syndrome were 57.1%, 9.5%, and 3.2% respectively. Mortality of the treatment was 11.1%. Under ATRA treatment, hyperleukocytosis leading to leukostasis was the cause of death in patients with APL. We therefore suggest that the patients with such leukocyte levels (that is, 5.0 x 10(9).L-1 on the 6th day, 10.0 x 10(9).L-1 on the 10th day, 15.0 x 10(9).L-1 on the 15th day) can be used as guidelines for starting chemotherapy(homoharringtonine); before ATRA treatment, while leukocyte counts are > 10 x 10(9).L-1, the patients only receive homoharringtonine; when leukocyte counts are < or = 5.0 x 10(9).L-1, the patients receive a combination of homoharringtonine and ATRA. Retinoic acid syndrome is a distinctive complication of ATRA therapy in the patients with APL. While the syndrome occurs, the treatment of ATRA must be stopped and corticosteroids must be used.

Effect of homoharringtonine on proliferation and differentiation of human leukemic cells in vitro

Homoharringtonine (HHT) is a cephalotaxine ester derived from an evergreen tree of southern China. We studied the effect of HHT on the clonal proliferation and differentiation of human leukemic cells from cell lines and patients. Dose-response studies found that HHT inhibited colony formation of myeloid cell lines (50% inhibitory dose range, 7 to 12 ng/ml), lymphocytic cell lines (50% inhibitory dose range, 4 to 7 ng/ml), and fresh leukemic cells (50% inhibitory dose range, 2 to 25 ng/ml). Pulse-exposure studies showed that colony formation of HL-60 cells was inhibited 50% by HHT (10 to 20 ng/ml) at 45 h and completely inhibited at 72 h. Radioactive precursor studies using HL-60 cells showed that HHT predominantly inhibited protein synthesis as compared with RNA and DNA synthesis. Taking advantage of this, we have found that the combination of HHT with 1-beta-D-arabinofuranosylcytosine (inhibitor of DNA synthesis) was synergistic in the inhibition of HL-60 clonal growth. HHT (2 to 20 ng/ml) also was found to induce up to 28% of HL-60 cells to differentiate toward macrophage-like cells.