Comparison of Radiofrequency Ablation and Hepatic Resection for the Treatment of Hepatocellular Carcinoma 2 cm or Less

Purpose

To compare survival outcome of radiofrequency (RF) ablation and surgical resection (SR) for treatment of hepatocellular carcinoma (HCC) ≤ 2 cm.

Hepatocellular carcinoma-derived exosomal miRNA-21 contributes to tumor progression by converting hepatocyte stellate cells to cancer-associated fibroblasts

Background

Hepatocellular carcinoma (HCC) remains a global challenge due to its high morbidity and mortality rates as well as poor response to treatment. The communication between tumor-derived elements and stroma plays a critical role in facilitating cancer progression of HCC. Exosomes are small extracellular vesicles (EVs) that are released from the cells upon fusion of multivesicular bodies with the plasma membrane. There is emerging evidence indicating that exosomes play a central role in cell-to-cell communication. Much attention has been paid to exosomes since they are found to transport bioactive proteins, messenger RNA (mRNAs) and microRNA (miRNAs) that can be transferred in active form to adjacent cells or to distant organs. However, the mechanisms underlying such cancer progression remain largely unexplored.

Methods

Exosomes were isolated by differential ultracentrifugation from conditioned medium of HCC cells and identified by electron microscopy and Western blotting analysis. Hepatic stellate cells (HSCs) were treated with different concentrations of exosomes, and the activation of HSCs was analyzed by Western blotting analysis, wound healing, migration assay, Edu assay, CCK-8 assay and flow cytometry. Moreover, the different miRNA levels of exosomes were tested by real-time quantitative PCR (RT-PCR). The angiogenic ability of activated HSCs was analyzed by qRT-PCR, CCK-8 assay and tube formation assay. In addition, the abnormal lipid metabolism of activated HSCs was analyzed by Western blotting analysis and Oil Red staining. Finally, the relationship between serum exosomal miRNA-21 and prognosis of HCC patients was evaluated.

Results

We showed that HCC cells exhibited a great capacity to convert normal HSCs to cancer-associated fibroblasts (CAFs). Moreover, our data revealed that HCC cells secreted exosomal miRNA-21 that directly targeted PTEN, leading to activation of PDK1/AKT signaling in HSCs. Activated CAFs further promoted cancer progression by secreting angiogenic cytokines, including VEGF, MMP2, MMP9, bFGF and TGF-β. Clinical data indicated that high level of serum exosomal miRNA-21 was correlated with greater activation of CAFs and higher vessel density in HCC patients.

Conclusions

Intercellular crosstalk between tumor cells and HSCs was mediated by tumor-derived exosomes that controlled progression of HCC. Our findings provided potential targets for prevention and treatment of live cancer.

     

单体素1-H MRS在脊柱良恶性压缩性骨折鉴别诊断中的应用

目的:探讨磁共振氢质子波谱（proton magnetic resonance spectroscopy,1H -MRS）在脊柱骨质疏松和恶性肿瘤所致的压缩骨折中的不同特征,为鉴别脊柱良恶性压缩性骨折提供科学的依据。方法:收集2017年2月至2018年3月在西安市红会医院就诊的研究对象共109例,其中骨量正常组21例,骨量减少组38例,骨质疏松压缩骨折组28例,肿瘤压缩性骨折组22例。收集患者的年龄、性别和BMI等指标,所有研究对象均进行脂肪分数和脂水比值等指标的测量。本次研究采用3.0 T Siemens超导MR机及体部线圈进行波谱的采集。结果:四个组之间的脂肪分数和脂水比值之间存在显著差异。对于MRS FF而言,肿瘤组的MRS FF最低,为（16.3±6.7）%,骨质疏松组最高为（68.3±5.75）%,通过Bonferroni法进行不同组别之间的两两比较,发现任意两组之间均存在统计学差异,P＜0.001。MRS 脂肪分数（fat fraction,FF）和脂水比(lipid water ratio,LWR)具有高度相关性（r=0.835,P＜0.001）。结论:单体素1-H MRS在骨质疏松和肿瘤导致的压缩骨质中的MRS FF和LWR之间具有显著的统计学差异,可以有效的进行脊柱良恶性压缩性骨折的鉴别诊断。     

超声造影检查在乳腺BI-RADS 4类的乳腺肿块良恶性鉴别诊断中的价值

目的:探讨超声造影检查在常规超声诊断为乳腺BI-RADS 4类的乳腺肿块良恶性鉴别诊断中的价值。方法:对2016年7月至2017年10月在西安交通大学第一附属医院门诊就诊并经常规超声诊断为乳腺BI-RADS 4类的76例患者共76个乳腺肿块进行超声造影检查,以穿刺活检或手术切除病理结果为金标准建立诊断试验分析。结果:最终病理证实良性病变53例（良性组）,恶性病变23例（恶性组）。超声造影特点如形态不规则、边界不清晰、有穿入或扭曲血管、对比剂不均匀性增强、内部有充盈缺损及造影后面积较二维增大在恶性组的比例显著高于良性组,差异有统计学意义（P<0.05）。超声造影诊断乳腺BI-RADS 4类病灶良恶性鉴别诊断的敏感度、特异度及准确性分别为96%、85%和88%。结论:良恶性乳腺肿块的超声造影特征明显不同,超声造影可以有效鉴别BI-RADS 4类乳腺病灶的良恶性,有望提高穿刺活检的恶性检出率。     

原发性肝细胞癌合并门静脉癌栓的研究进展

门静脉癌栓（portal vein tumor thrombus,PVTT）是影响原发性肝细胞癌治疗策略及预后的重要因素。近年与PVTT相关的分子信号通路不断被发现,但PVVT形成机制及其研究和临床诊疗仍面临较大挑战。本文就原发性肝细胞癌合并PVTT的研究进展作一综述。     

In vivo monitoring of microwave ablation in a porcine model using ultrasonic differential attenuation coefficient intercept imaging

In this study, the feasibility of using ultrasonic differential attenuation coefficient intercept (Δα₀) imaging to evaluate thermal lesions induced by microwave ablation (MWA) was explored using an in vivo porcine model. The attenuation coefficient intercept (Δα₀ is estimated by subtracting an initial value of Δα₀ images. Receiver operating characteristic (ROC) curves and the area under ROC curve (AUC) were employed to statistically assess the predictability of ultrasonic imaging. Ultrasonic Δα₀ values were approximately 0.13?dB/cm and 0.16?dB/cm in a normal liver and kidney, respectively, increasing to 2.9?dB/cm and 2.55?dB/cm in ablated regions after MWA. The CNR values of the ultrasonic Δα₀ images (0.9?dB and 0.6?dB in the liver and kidney, respectively) were significantly higher (p?0 image was higher than the B-mode image value, 0.95 compared with 0.88. This in vivo study suggests that ultrasonic Δα₀ imaging has the potential to evaluate thermal lesions with high accuracy and better image contrast for monitoring MWA.     

包埋后的几丁质与软骨细胞体外培养的实验研究

目的 探讨几丁质作为组织工程技术中细胞培养支架的可行性。方法 采用聚乳酸、卵磷脂及多聚赖氨酸分别或工同包埋几丁质与软骨细胞体外培养,观察其产亲水性的改变、对细胞吸附力和细胞功能的影响。结果 以聚乳酸包埋的几丁质对细胞的生长有抵制作用;以卵磷脂包埋的几柄质亲水性增强;以多聚赖氨酸包埋的几丁质对细胞吸附力增强;以卵磷脂和多聚赖氨酸共同包埋的几丁质具有良好的亲水性和对细胞吸附力,并可使细胞更好地发挥功能     

应用套式聚合酶链反应技术检测孕妇与胎儿巨细胞病毒感染

目的评价套式聚合酶链反应技术（ＮＴ－ＰＣＲ）加限制酶分析在孕妇与胎儿人巨细胞病毒（ＨＣＭＶ）感染检测中的应用价值。方法应用ＮＴ－ＰＣＲ及限制酶分析、病毒分离、电镜观察和特异性抗体测定,对各孕期孕妇３６７例的外周血、部分孕妇脐血及死胎组织进行ＨＣＭＶ检测。结果孕早、中、晚期ＨＣＭＶ阳性检出率分别为８．６％、１．６％及７．０％,ＮＴ－ＰＣＲ检出率（４．９％）高于病毒分离（３．０％,Ｐ＜０．０２５）。６份ＨＣＭＶＤＮＡ阳性母血中,３份配对脐血ＨＣＭＶＤＮＡ也阳性。其中２对ＮＴ－ＰＣＲ、病毒分离及特异性ＩｇＭ、ＩｇＡ均阳性,１对ＮＴ－ＰＣＲ、病毒分离、特异性ＩｇＡ阳性,而ＩｇＭ阴性。２８例死胎组织中,发现１例死胎肺组织ＨＣＭＶＤＮＡ阳性。结论ＮＴ－ＰＣＲ能提高诊断ＨＣＭＶ感染的特异性与敏感性     

妊高征患者血小板蛋白激酶C活性变化的研究

目的探讨血小板蛋白激酶Ｃ（ＰＫＣ）比活变化与妊高征发生和发展的关系。方法用底物蛋白磷酸化法检测１８例妊高征患者（妊高征组）,２０例健康孕妇（正常妊娠组）及２０例健康育龄妇女（对照组）血小板质膜和胞液的ＰＫＣ比活。结果正常妊娠组血小板质膜和胞液的ＰＫＣ比活显著低于对照组（Ｐ＜０．０１）;妊高征组血小板质膜和胞液的ＰＫＣ比活高于正常妊娠组（Ｐ＜０．０５）。中、轻度妊高征患者仅血小板质膜ＰＫＣ比活明显高于正常妊娠组（Ｐ＜０．０１）,胞液的ＰＫＣ比活与正常妊娠组比较,则差异无显著性（Ｐ＞０．０５）。而重度妊高征患者血小板质膜和胞液的ＰＫＣ比活均高于正常妊娠组（Ｐ＜０．０１,Ｐ＜０．０５）,且重度妊高征患者血小板胞液ＰＫＣ比活高于中、轻度妊高征患者（Ｐ＜０．０５）,而质膜ＰＫＣ比活比较,则差异无显著性（Ｐ＞０．０５）。结论血小板ＰＫＣ比活变化与妊高征发生和发展有关。