抗凋亡蛋白Survivin和Ki-67在肝癌组织中的表达及相关性研究

目的:观察抗凋亡蛋白Survivin和Ki-67在原发性肝癌(PHC)中的表达并探讨其临床意义.方法:采用免疫组织化学S-P法检测34例原发性肝癌组织、14例癌旁正常肝组织中survivin和Ki-67的表达情况.结果:原发性肝癌组织中survivin的阳性表达定位于细胞浆和细胞核,阳性表达率明显高于癌旁正常肝组织(P＜0.05);Ki-67的阳性表达主要定位于细胞核,其阳性表达率亦明显高于癌旁正常肝组织(P＜0.05).二者的阳性表达与原发性肝癌患者的性别、年龄、肿瘤大小无相关性(P＞0.05),与淋巴结转移、组织分化程度及癌栓是否形成有关(P＜0.05);此外,二者在原发性肝癌组织中的表达呈显著正相关(P＜0.05).结论:Survivin和Ki-67在原发性肝癌组织中表达上调,均与原发性肝癌的组织分化程度及癌栓是否形成密切相关;检测survivin和Ki-67的表达有助于原发性肝癌的预防、治疗和预后评估.     

β-ME和BHA体外诱导人胎肝CD34+细胞向神经组织细胞分化研究

目的:建立巯基乙醇(β-mercaptoethanol,β-ME)和丁羟回醚(butylated hydroxyanisole,BHA)体外诱导人胎肝(fetal liver,FL)干细胞向神经细胞分化模型.方法:采用MACS试剂盒分离人胚胎肝CD34 细胞,以DMEM 10%胎牛血清培养液培养;第五代细胞待细胞融合达80%后,用DMEM 10%胎牛血清 1mmol/L β-ME 0.2 mmol/L BHA诱导24 h,PBS洗涤.然后在无血清培养基中培养5 h～5 d.用免疫细胞化学方法分析诱导前后的细胞表型特点.结果:经β-ME BHA诱导处理后,细胞表现神经元样细胞形态,表达神经组织细胞特异蛋白,如neustin、NeuN、NF-M、TuJ-1和NSE.统计显示81%细胞NeuN染色阳性,75%细胞TuJ-1染色阳性,47%染色NF-M阳性,90%染色NSE阳性.结论:β-ME和BHA能够诱导体外培养的人FL CD34 细胞分化为具有神经细胞特异性抗原和成分的神经样细胞;胚胎肝细胞具有向神经组织分化的潜能.     

CD133和maspin在肝癌中的表达及其临床病理意义

目的 探讨肿瘤干细胞标志物CD133和maspin在肝细胞性肝癌（hepatocellular carcinoma HCC）中的表达情况及其临床病理意义.方法 采用免疫组织化学ElivisionTM plus法检测100例HCC组织和20例癌旁肝组织中CD133和maspin蛋白的表达情况.结果 在癌旁肝组织中CD133和maspin蛋白的阳性表达率分别为5.0%和100%,而在HCC组中其阳性表达率分别为51.0%和48.0%,两组之间差异有显著性（P〈0.01）.CD133蛋白的表达水平与肿瘤的Edmondson分级、淋巴结转移、肿瘤的数目和有无血管侵犯有关（全部P〈0.05）;maspin蛋白的表达水平与肿瘤的Edmondson分级、肿瘤的数目和有无血管侵犯有关（全部P〈0.05）.且CD133蛋白的表达与maspin蛋白的表达呈负相关（P〈0.01）.结论 CD133和maspin蛋白的表达与HCC组织的Edmondson分级、肿瘤数目和血管侵犯有关;CD133和maspin的联合检测对HCC的进展及预后判断有重要意义.     

CD133在胃肠间质瘤的表达及其临床意义

目的 探讨胃肠间质瘤（gastrointestinal stromal tumor,GIST）中的CD133的表达及其与GIST临床病理特征的关系.方法 采用免疫组织化学法,检测122例胃肠间质瘤患者组织中的CD133、CD117、CD34、DOG-1、KI-67的表达情况.结果 CD133、CD117、CD34 、DOG-1、KI-67的阳性表达率分别为74.6%（91/122）、98.4%（120/122）、86.9%（106/122）、95.1%（116/122）、47.5%（58/122）.CD133的表达水平与胃肠间质瘤危险度分组高低、核分裂像数目、肿瘤部位有关（P〈0.05）,而与患者性别、年龄、肿瘤大小无明显相关性（P〉0.05）.CD133的表达水平与DOG-1的表达水平无明显相关性（P〉0.05）,而与CD117、CD34、KI-67的表达水平呈正相关.结论 CD133蛋白的表达可能与GIST的恶性行为与预后有关,与CD117、CD34和DOG-1联合检测对于判断GIST的病理性质可能具有重要价值.     

胃癌及相应癌旁组织中VEGF、CD34、CD44v6的检测及临床意义

目的:探讨血管内皮生长因子(Vascular endothelial growth factor,VEGF)、CD34和CD44v6在胃癌及相应癌旁组织中的表达及其与临床病理意义.方法:应用免疫组化技术检测60例胃癌以及相应癌旁组织中VEGF、CD34和CD44v6的表达.结果:胃癌组织VEGF阳性率为71.67%(43/60)明显低于癌旁组织88.34%(53/60),两组间有显著性差异(P=0.022);VEGF阳性表达与胃癌病理分级、浸润深度、淋巴结转移和临床分期密切相关(P＜0.05).癌旁组织中微血管密度(MVD)明显高于癌组织MVD(P=0.000),有淋巴结转移癌组织中MVD高于无淋巴结转移者(P=0.043),并随浸润深度、临床分期MVD升高(P=0.046,P=0.000).癌旁组织中CD44v6阳性率为48.34%(29/60)低于癌组织的61.67%(37/60),两者无明显差别.CD44v6的阳性率随胃癌浸润的加深而升高,与淋巴结转移和TNM分期呈正相关.VEGF、CD34及CD44v6三指标间两两相关(P＜0.05).结论:VEGF、CD34和CD44v6三者联合检测有助于判断胃癌的浸润、转移及预后情况.     

经典型霍奇金淋巴瘤CD30、CD15表达差异性的研究

探讨经典型霍奇金淋巴瘤(cHL)及其亚型的R-S细胞CD30、CD15蛋白表达的差异性.将32例cHL全部按WHO新分类标准进行病理分型,采用免疫组织化学SABC法进行CD30和CD15染色,观察每一病例及不同亚型R-S细胞阳性表达率.32例cHL中R-S细胞CD30阳性表达率为93.8%(30/32),CD15为78.1%(25/32),各亚型间均无显著性差异(P>0.05).CD30、CD15两者的阳性表达率无显著性差异性(P>0.05),但CD30的表达程度高于CD15(P<0.001).CD15和CD30可作为诊断cHL的参考依据,在R-S细胞中的表达差异可能与肿瘤细胞的异质性有关.     

CD117、CD34、DOG-1、WT-1 在胃肠道间质瘤中的表达及意义

目的:探讨DOG-1、CD117、CD34、WT-1在胃肠道间质瘤(GIST)中的表达及临床意义。方法:应用免疫组织化学SP法检测DOG-1、CD117、CD34、WT-1在39例GIST患者肿瘤组织中的表达。结果:GIST光镜下主要由梭形细胞和(或)上皮样细胞或多形性细胞混合或单一性组成。DOG-1、CD117、CD34和WT-1在GIST肿瘤组织中阳性表达率分别为92.3%(36/39)、71.7%(28/39)、64.1%(25/39)、23.1%(9/39),四者的阳性表达率在各风险程度组(极低及低度危险性GIST、中度危险性GIST、高度危险性GIST)两两比较中差异均无统计学意义(P>0.05)。DOG-1与CD117相比,在极低及低度危险组中表达有显著差异(P<0.05),DOG-1与CD34相比,在极低及低度危险组、高度危险组中表达有显著差异(P<0.05);WT-1与CD117相比,在中度及高度危险组中表达有显著差异(P<0.05),WT-1与CD34相比,在中度危险组中表达有显著差异(P<0.05)。对照组平滑肌瘤、纤维瘤、神经鞘瘤中CD117、DOG-1在GIST中的表达明显高于其他多种梭形细胞的表达(P<0.05)。结论:DOG1是GIST较为敏感和特异的标记物,WT-1在极低及低度危险性GIST中有一定的诊断价值,在GIST的诊断中加入两者将使患者更加受益。     

CD90在肝细胞肝癌组织中的表达及其与肝癌临床病理特征的关系

目的:探讨CD90在肝细胞肝癌(HCC)患者肿瘤组织中的表达及其与临床病理参数的关系,为HCC的临床治疗提供参考。方法:选择2014年3月-2015年3月在我院接受治疗的HCC患者80例,收集患者肿瘤组织及癌旁组织,另选择同期就诊的80例正常肝脏组织作为对照组。观察并比较CD90在肝癌组织、癌旁组织及正常肝脏组织中的表达情况。结果:CD90在肝癌组织、癌旁组织及正常肝脏组织中呈不同程度阳性表达(P0.05)。CD90在肝癌组织和癌旁组织中的表达显著高于正常肝脏组织,差异具有统计学意义(P0.05)。CD90在肝癌组织中的表达显著高于癌旁组织,差异具有统计学意义(P0.05)。CD90在HCC组织中的表达与肿瘤大小、肝内转移、TMN分期和病理分级有关(P0.05)。结论:CD90在肝癌组织中呈高表达,其表达水平与肝癌临床病理参数有关,可以作为HCC诊断、治疗及预后评估的参考指标。     

中国人前列腺癌VEGF-C mRNA、VEGFR-3和CD31表达与肿瘤转移的关系

研究前列腺癌组织VEGF-C mRNA、VEGFR-3和CD31的表达与前列腺癌中血管、淋巴管的生成及肿瘤转移的关系。取34例前列腺癌组织和12例癌周正常组织标本,应用原位杂交法检测VEGF-C mRNA表达,并经VEGFR-3和CD31免疫组织化学标记及图像分析,采用Weidner最高血管密度计数法,计数癌组织中阳性淋巴管数(MLC)和微血管密度(MVD)。前列腺癌VEGF-C mRNA阳性15例(44.12%),VEGF-C mRNA表达与前列腺癌淋巴结转移、TNM分期相关;MLC (8.26±2.73/mm~2)和MVD(74.82±11.76/mm~2)显著高于癌周正常组织的MLC(4.82±3.48/mm~2)和MVD(32.86±5.41/mm~2),两者比较具有显著性差异。VEGFR-3和CD31表达之间存在正相关。有淋巴转移和TNM分期Ⅲ、Ⅳ期的前列腺癌患者VEGF-C mRNA阳性表达和MLC、MVD分别高于无淋巴转移和Ⅰ、Ⅱ期患者,均具有显著性差异;VEGF-C mRNA表达阳性者VEGFR-3和CD31高于表达阴性者,两者比较具有显著性差异;前列腺癌在不同的组织学分级的差异无统计学意义。VEGF-C促进了肿瘤诱导的淋巴管新生和血管新生,在前列腺癌的淋巴转移中起重要作用;前列腺癌组织中的VEGFR-3和CD31表达水平与肿瘤的转移密切相关;前列腺癌组织MLC和MVD的显著增高,提示肿瘤组织有新淋巴管和血管的生成,也可作为判断肿瘤转移的生物学指标。     

能谱CT成像对甲状腺癌局部浸润深度的诊断价值及其定量参数与肿瘤组织中Ki67、VEGF、CD34、EGFR的相关性

摘要 目的：探讨能谱CT成像对甲状腺癌局部浸润深度的诊断价值及其定量参数与肿瘤组织中Ki67、VEGF、CD34、EGFR的相关性。方法：回顾性分析2018年6月-2021年6月我院经手术或穿刺活检病理证实为甲状腺肿瘤性病变的患者96例，其中29例为甲状腺癌局部浸润组（A组），34例为甲状腺癌无浸润组（B组），33例为甲状腺腺瘤组（C组）。另取56例甲状腺另一侧叶正常组织作为对照组（D组）。所有患者均完善能谱CT检查，采集图像后在能谱CT Viewer分析软件上测量病变区碘浓度，计算能谱曲线斜率。采用免疫组织化学染色分析Ki-67、VEGF、CD34、EGFR的表达情况。采用Spearman秩相关分析评价碘浓度、能谱曲线斜率与甲状腺癌肿瘤组织中Ki-67、VEGF、CD34、EGFR表达的相关性。结果：在平扫、动脉期、静脉期，A组、B组、C组和D组的碘浓度逐渐增大，两两比较差异均有统计学意义（P＜0.05）。甲状腺癌局部浸润组织能谱曲线呈"低平型"，斜率为较小负值，正常甲状腺组织能谱曲线为下降型，斜率为负值；在平扫、动脉期、静脉期，A组、B组、C组和D组的能谱曲线斜率逐渐变小，差异均有统计学意义（P＜0.05）。A组中Ki-67、VEGF、CD34和EGFR的阳性表达率均高于B组和C组，差异均有统计学意义（P＜0.05）。碘浓度在动脉期、静脉期与Ki-67、VEGF、CD34、EGFR表达呈正相关（P＜0.05），碘浓度在平扫与Ki-67表达呈正相关（P＜0.05），碘浓度在平扫与VEGF、CD34、EGFR表达无相关性（P＞0.05）。能谱曲线斜率在动脉期、静脉期与Ki-67、VEGF、CD34、EGFR表达呈正相关（P＜0.05），能谱曲线斜率在平扫与VEGF表达呈正相关（P＜0.05），能谱曲线斜率在平扫与Ki-67、CD34、EGFR表达无相关性（P＞0.05）。结论：能谱CT成像检查对甲状腺癌局部浸润深度的判断具有重要的价值，其定量参数碘浓度、能谱曲线斜率与Ki67、VEGF、CD34、EGFR具有相关性，可间接反映肿瘤微血管、肿瘤血管生成、甲状腺癌分化程度、浸润程度等情况，对评价甲状腺癌生物学行为可提供有价值的信息。     

Ecto-5′-nucleotidase (CD73) is a potential target of hepatocellular carcinoma

High expression of ecto-5′-nucleotidase (CD73) has been reported in a number of epithelium origin malignancies. Here, we hypothesize that CD73 promotes hepatocellular carcinoma (HCC) growth and metastasis and that the effect is mediated by epithelial growth factor receptor (EGFR). HCC cells with different malignancies and Tissue microarrays of the tumor and peritumoral liver tissues from 30 independent patients were used to examine CD73 and EGFR expression. Then, MTT and Ki67 detection, together with cell adhesion, invasion, and migration assays were used to evaluate the effects of CD73 on cell growth and metastasis. The expression of EGFR in HCC cells was also tested after suppressing or overexpressing CD73. Lastly, tumor tissues from nude mice, which had been injected subcutaneously with HCC cells, were transplanted subcutaneously into CD73^−/− and wild-type (WT) C57 mice. CD73 expression was higher in HCC cells with greater metastatic potentials and tumor tissues compared with low metastatic cells and peritumor tissues. CD73 and EGFR were coexpressed and positively correlated in tumor and peritumor liver tissues in HCC tissue microarrays. Up-regulationof CD73 by plasmid transfection or by pharmacological agents promoted EGFR expression in HCC cells, whereas suppression of CD73 inhibited these effects. The growth of transplanted tumor tissues was dramatically slower in CD73^−/− mice than in WT type mice in the in vivo experiments. CD73 promotes HCC growth and metastasis and upregulated the expression of EGFR in HCC. Thus, CD73 and EGFR are potential targets in the treatment of HCC.     

Role of CD10 immunochemistry in differentiating hepatocellular carcinoma from metastatic carcinoma of the liver

Background:  Differentiation of hepatocellular carcinoma (HCC) from metastatic carcinoma in liver may be difficult on fine needle aspiration cytology (FNAC), especially when both appear as moderate to poorly differentiated tumours. A panel of immunocytochemical stains is frequently used in case of diagnostic difficulty. Recently, CD10 immunostain with a canalicular staining pattern has been shown to be a specific marker for hepatocytic differentiation.
Objective:  The present study was designed to assess the value of CD10 immunostain in distinguishing HCC from metastatic carcinoma in material obtained by FNAC of liver masses.
Materials and methods:  Formalin-fixed, paraffin-embedded cell blocks of 22 cases (7 cases of HCC and 15 cases of metastatic carcinoma), direct acetone-fixed smears and destained smears of 28 cases (18 cases of HCC and 10 cases of metastatic carcinoma) prepared from FNAC of the liver were immunostained using monoclonal antibody against CD10.
Results:  Seventeen (68%) of twenty-five cases of HCC were positive for CD10 with a canalicular staining pattern. Among them 7 (70%) of 10 cases were well-differentiated HCC and 10 (66%) of 15 cases were moderate to poorly differentiated HCC. Of 25 cases of metastatic carcinoma, four (16%) were positive for CD10 with a cytoplasmic (three cases) and membranous staining (one case) pattern.
Conclusion:  CD10 immunostaining is useful in discriminating HCC and metastatic carcinoma of the liver and is easily applied on cell blocks as well as FNAC smears.     

Two-color immunostaining of liver fine needle aspiration biopsies with CD34 and carcinoembryonic antigen. Potential utilization in the diagnosis of primary hepatocellular carcinoma vs. metastatic tumor

OBJECTIVE: To examine immunohistochemical staining of cell block material with antibodies against vascular marker CD34 and polyclonal carcinoembryonic antigen (pCEA) for their clinical utility as part of a 2-color staining protocol in fine needle aspiration (FNA) biopsy of liver masses to distinguish metastases from primary hepatocellular carcinoma (HCC). STUDY DESIGN: The authors obtained cell block material from 96 liver FNAs and performed simultaneous (i.e., "dual-color") immunohistochemical staining utilizing antibodies against vascular marker CD34 and pCEA. Cases were blinded and evaluated by the authors for staining pattern and intensity. A consensus was obtained, the results were unblinded, and the diagnoses were correlated. RESULTS: After staining, 89 cases had sufficient tissue for evaluation. Of the 19 HCC cases, 16 (84%) showed peripheral staining with CD34, and 13 (68%) showed a canalicular or mixed canalicular-cytoplasmic staining pattern for pCEA. Thirteen cases (68%) showed staining for both antigens. All HCC exhibited immunostaining for at least 1 antibody in an appropriate staining pattern. Of the 67 cases of metastatic malignancy, 5 (7%) showed a predominantly transgressing pattern of CD34 staining, 43 (64%) showed a predominantly cytoplasmic or mixed cytoplasmic-canalicular pattern of pCEA staining, and 2 cases (3%) showed staining for both antigens in a transgressing CD34 pattern and cytoplasmic pCEA pattern. None of the 3 normal liver tissue blocks showed staining with either antigen. CONCLUSION: Two-color immunohistochemical staining of liver cell block material obtained by FNA with antibodies to CD34 and pCEA can be helpful in differentiating metastatic tumors vs. primary HCC.     

Diagnostic Value of Immunohistochemical Staining of GP73, GPC3, DCP,CD34, CD31, and Reticulin Staining in Hepatocellular Carcinoma

It has been reported that Golgi protein-73 (GP73), glypican-3 (GPC3), and des-γ-carboxy prothrombin (DCP) could serve as serum markers for the early detection of hepatocellular carcinoma (HCC). This study aimed to evaluate a panel of immunostaining markers (including GP73, GPC3, DCP, CD34, and CD31) as well as reticulin staining to distinguish HCC from the mimickers. Our results revealed that CD34 immunostaining and reticulin staining were highly sensitive for the diagnosis of HCC. A special immunoreaction pattern of GP73—a diffuse coarse-block pattern in a perinuclear region or a concentrated cluster-like or cord-like pattern in a certain part of the cytoplasm—was observed in HCC cells, in contrast to the cytoplasmic fine-granular pattern in surrounding non-tumor cells and non-malignant nodules. This coarse-block pattern correlated significantly with less differentiated HCC. In comparison, GPC3 displayed a good advantage in diagnosing well-differentiated HCC. In our study, DCP and CD31 showed little diagnostic value for HCC as an immunostaining marker. When GP73, GPC3, and CD34 were combined, the specificity improved to 96.6%. Our findings demonstrate for the first time that the immunohistochemical panel of GP73, GPC3, and CD34 as well as reticulin staining is highly specific for the pathological diagnosis of HCC.     

Immunohistochemical expression of pi class glutathione S-transferase and alpha-fetoprotein in hepatocellular carcinoma and chronic liver disease

OBJECTIVE: To determine whether tumor marker pi glutathione transferase (GST-pi) is expressed in hepatocellular carcinoma (HCC) and other chronic liver diseases and to compare its expression with that of alpha-fetoprotein (AFP). STUDY DESIGN: Samples used were formalin-fixed, paraffin-embedded liver tissues: normal (n = 3), chronic hepatitis B (n = 15), cirrhosis (n = 15) and HCC (n = 30). The expression of AFP and GST-pi was detected by using immunohistochemistry with the peroxidase-antiperoxidase method. AFP immunoreactivity was based on the cytoplasm of the hepatocytes, while GST-pi immunoreactivity was based on the nuclei of hepatocytes. RESULTS: In normal liver tissues, AFP was not expressed. However, there was strong staining of GST-pi in bile duct epithelium cells and weak staining in hepatocytes. Our results showed higher AFP immunoreactivity in cases of HCC (36.7%) as compared to cirrhosis (6.7%) and hepatitis B (0%), whereas GST-pi immunoreactivity was lower in cases of HCC (53.3%) as compared to cases of cirrhosis (100.0%) and hepatitis B (93.3%). Percent sensitivity of AFP determination for HCC was 36.7% as compared to 53.3% for GST-pi, thus making GST-pi a more sensitive marker for detection of HCC. This study showed a significant relationship between the intensity and percentage of cells stained in hepatitis B, cirrhosis and HCC for GST-pi immunoreactivity (P < .001, .001 and .05, respectively) but not for AFP (P > .05). Statistical analysis showed that there was no significant relationship between expression of AFP and GST-pi in cirrhosis and HCC cases. Hepatitis B virus infection in HCC cases showed a positive rate of 46.7%, with AFP staining positively in 42.9% of tissues and GST-pi staining positively in 57.1% of tissues. CONCLUSION: AFP is a diagnostic but rather insensitive tissue marker for HCC. However, the absence of AFP in benign chronic liver disease makes this marker useful in differentiating between HCC and other chronic liver diseases, whereas GST-pi can be used as a diagnostic marker for HCC as well as in detecting other chronic liver diseases.     

血清CD5L对肝脏疾病患者的临床意义研究

摘要 目的：检测CD5L水平在肝脏疾病患者血清中的变化,并分析其临床意义。方法：采用ELISA法检测41例慢性肝炎患者、192例肝硬化患者、69例肝癌患者和136例健康对照血清CD5L水平。全自动生化分析仪测定肝功能指标,Spearman相关性分析用于评估CD5L与肝功能指标的关系。受试者工作曲线（receiver operator characteristic, ROC）分析血清CD5L的潜在诊断价值。结果：与健康对照相比,CD5L水平在肝炎、肝硬化、肝癌患者中显著降低（P<0.01）。肝硬化患者血清CD5L水平较肝炎及肝癌患者显著降低（P<0.01）。肝硬化代偿期和失代偿期患者血清CD5L水平无显著差异。血清CD5L水平与FIB-4指数(肝纤维化评分)呈显著负相关（r=-0.2688,P=0.0001）。Spearman相关性分析结果显示：在肝炎患者中,血清CD5L与总胆红素（T-BIL）、直接胆红素（D-BIL）、间接胆红素（I-BIL）显著正相关;在肝硬化患者中,CD5L与其他肝功指标无显著相关性;在肝癌患者中,CD5L与碱性磷酸酶（ALP）显著正相关。以健康人为对照组,肝硬化患者为病例组,ROC分析显示血清CD5L的诊断特异性为85.3%,敏感性为77.1%。结论：CD5L水平在肝炎、肝硬化及肝癌患者血清中显著降低,且在肝硬化患者中最低。CD5L水平与肝纤维化评分FIB-4指数负相关,可作为监测肝纤维化进展的潜在生物标志物。     

Serum and urine metabolite profiling reveals potential biomarkers of human hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a common malignancy in the world with high morbidity and mortality rate. Identification of novel biomarkers in HCC remains impeded primarily because of the heterogeneity of the disease in clinical presentations as well as the pathophysiological variations derived from underlying conditions such as cirrhosis and steatohepatitis. The aim of this study is to search for potential metabolite biomarkers of human HCC using serum and urine metabolomics approach. Sera and urine samples were collected from patients with HCC (n = 82), benign liver tumor patients (n = 24), and healthy controls (n = 71). Metabolite profiling was performed by gas chromatography time-of-flight mass spectrometry and ultra performance liquid chromatography-quadrupole time of flight mass spectrometry in conjunction with univariate and multivariate statistical analyses. Forty three serum metabolites and 31 urinary metabolites were identified in HCC patients involving several key metabolic pathways such as bile acids, free fatty acids, glycolysis, urea cycle, and methionine metabolism. Differentially expressed metabolites in HCC subjects, such as bile acids, histidine, and inosine are of great statistical significance and high fold changes, which warrant further validation as potential biomarkers for HCC. However, alterations of several bile acids seem to be affected by the condition of liver cirrhosis and hepatitis. Quantitative measurement and comparison of seven bile acids among benign liver tumor patients with liver cirrhosis and hepatitis, HCC patients with liver cirrhosis and hepatitis, HCC patients without liver cirrhosis and hepatitis, and healthy controls revealed that the abnormal levels of glycochenodeoxycholic acid, glycocholic acid, taurocholic acid, and chenodeoxycholic acid are associated with liver cirrhosis and hepatitis. HCC patients with alpha fetoprotein values lower than 20 ng/ml was successfully differentiated from healthy controls with an accuracy of 100% using a panel of metabolite markers. Our work shows that metabolomic profiling approach is a promising screening tool for the diagnosis and stratification of HCC patients.     

Thymidine kinase-1/CD31 double immunostaining for identifying activated tumor vessels

Although angiogenesis plays a crucial role in cancer growth and progression, no reliable method for assessing angiogenesis in tumor tissue sections currently is available. Using biomarkers with high specificity for proliferating endothelial cells could help quantify angiogenic activity. Thymidine kinase-1 (TK1) is an enzyme involved in the salvage pathway of DNA synthesis and its activity is correlated with cell proliferation. We investigated the use of double immunostaining for TK1 and CD31 for identifying activated tumor vessels. Differences in TK1/CD31 positive vessel rates (PVRs) between tumor and adjacent normal tissues were evaluated in 39 colorectal carcinoma (CRC) samples and compared with those of Ki67/CD31 double stained tissues. Mean TK1/CD31 PVR (23.6%) in CRCs was 13.9 fold greater than in adjacent normal tissues (1.7%)). By comparison, mean Ki67/CD31 PVR in CRCs was 20.0%, i.e. only 4.8 fold greater than in normal tissues (4.2%). Also, mean TK1/CD31 PVR in normal tissues was significantly less than mean Ki67/CD31 PVR. Our findings indicate that double immunostaining for TK1/CD31 can detect activated tumor vessels more accurately than staining for Ki67/CD31 and potentially could identify tumors that will respond to anti-angiogenic therapy.     

Secreted ERBB3 isoforms are serum markers for early hepatoma in patients with chronic hepatitis and cirrhosis

Most hepatocellular carcinoma (HCC) is generated from chronic hepatitis and cirrhosis. To discover new markers for early HCC in patients with chronic hepatitis and cirrhosis, we initiated our search in the interstitial fluid of tumor (TIF) via differential gel electrophoresis and antibody arrays and identified secreted ERBB3 isoforms (sERBB3). The performance of serum sERBB3 in diagnosis of HCC was analyzed using receiver operating characteristic curves (ROC). The serum sERBB3 level was significantly higher in HCC than in cirrhosis (p < 0.001) and chronic hepatitis (p < 0.001). The accuracy of serum sERBB3 in detection of HCC was further validated in two independent sets of patients. In discrimination of early HCC from chronic hepatitis or cirrhosis, serum sERBB3 had a better performance than alpha-fetoprotein (AFP) (areas under ROC [AUC]: sERBB3 vs AFP = 93.1 vs 81.0% from chronic hepatitis and 70.9 vs 62.7% from cirrhosis). Combination of sERBB3 and AFP further improved the accuracy in detection of early HCC from chronic hepatitis (AUC = 97.1%) or cirrhosis (AUC = 77.5%). Higher serum sERBB3 levels were associated with portal-vein invasion and extrahepatic metastasis of HCC (p = 0.017). Therefore, sERBB3 are serum markers for early HCC in patients with chronic hepatitis and cirrhosis.