Table of Content

31 March 2023, Volume 10 Issue 1

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Original article

The mechanism of histone deacetylase inhibitor vorinostat inhibiting the growth of hepatocellular carcinoma cells

Gu Xinglu, Zhao Xiaohang, Sun Yulin

2023, 10(1):  15-24. 

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Objective: To investigate the mechanism of exonuclease 1 (EXO1) in hepatocellular carcinoma (HCC) and the possible mechanism of the histone deacetylase (HDAC) inhibitor vorinostat inhibiting the growth of HCC cells.
Methods: HCC cell lines with knockdown or overexpression of EXO1 were constructed. And the effects of EXO1 on the proliferation, migration and invasion in HCC were investigated by cell phenotype assays. The role of EXO1 in homologous recombination (HR) repair and its effect on ionizing radiation sensitivity of cells were detected by HR reportor assay, immunofluorescence and western blots. Additionally, HCC cells were treated with vorinostat. The effect of vorinostat on EXO1 expression and the possible mechanism of inhibiting the growth of HCC cells were detected by CCK-8, flow cytometry and Western blotting.
Results: High level of EXO1 promoted the proliferation, migration and invasion of HCC cells. EXO1 also promoted DNA double-strand break repair through the HR pathway and reduced cell sensitivity to ionizing radiation. In addition, elevated EXO1 levels were less sensitive to vorinostat, whereas knockdown of EXO1 increased the sensitivity of hepatocellular carcinoma cells to vorinostat. Vorinostat further inhibited the HR repair ability of HCC cells by suppressing EXO1 expression, thereby inhibiting cell growth.
Conclusion: Vorinostat can inhibit HR repair ability by decreasing the expression level of EXO1, which may serve as a potential therapeutic target for HCC

Relationship between nutritional status and sarcopenia incidence in patients with primary liver cancer

Sun Dibo, Ma Haiyan, Guo Fei, Wu Xueliang

2023, 10(1):  25-30. 

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Objective: To study the relationship between nutritional status and the incidence of sarcopenia in patients with primary liver cancer, so as to provide reference for the prevention and treatment of sarcopenia in patients with liver cancer.
Methods: A total of 207 patients with primary liver cancer who were admitted to The First Affiliated Hospital of Hebei North University from January 2017 to December 2021 were selected and divided into sarcopenia group (n=59) and non-sarcopenia group (n=148) according to the occurrence of sarcopenia. Their clinical datas were collected. The differences in demographic data, physical examination, laboratory examination, and daily living ability scores were compared between the two groups. The influencing factors of the patients with primary liver cancer for sarcopenia were screened by multivariate Logistic regression analysis.
Results: The age of sarcopenia group was higher than that of non-sarcopenia group, and the body weight and body mass index (BMI) were lower than those of non-sarcopenia group; fasting blood glucose, urinary albumin-to-creatinine ratio (UACR), lipoproteina (Lpa), high-sensitivity C-reactive protein (hs-CRP) were higher than those in the non-sarcopenia group (P<0.05). The red blood cell count and albumin in the sarcopenia group were lower than those in the non-sarcopenia group (P<0.05). Upper arm muscle circumference, lean body mass, skeletal muscle mass index (SMI), 4m walking speed (GS), maximal grip strength, activity of daily living (ADL) score, instrumental activity of daily living (IADL), and mini-nutrition assessment (MNA) scores of sarcopenia group were lower than those of the non-sarcopenic group (P<0.05), and the fat mass was higher than that of the non-sarcopenic group (P<0.05). Sarcopenia group (P<0.05), with the decrease of MNA score, sarcopenia patients had lower arm circumference, upper arm muscle circumference, lean body mass, SMI, 4m GS, maximal grip strength value, and increased fat mass. Comparison of indicators in patients with different MNA grades, the difference was statistically significant (P<0.05); age, BMI, fasting blood glucose, albumin, hs-CRP, upper arm muscle circumference, SMI, 4m GS, maximum grip strength, ADL score, IADL score and MNA score were all different from the original score. The incidence of sarcopenia in patients with hepatocellular carcinoma was related to the occurrence of sarcopenia (P<0.05).
Conclusion: Older age, low BMI, high fasting blood glucose, high hs-CRP level, low albumin, low upper arm muscle circumference, poor nutritional status, and low activity level in primary liver cancer patients have higher incidence of sarcopenia risk. Nutritional status is closely related to the development of sarcopenia especially.

Review

Advantages of irreversible electroporation for the ablation of hepatic hilar tumors

Wang Xiaowen, Zhao Jianjun

2023, 10(1):  31-34. 

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The local treatments of liver tumors included surgical procedures, interventional procedures, thermal ablation, cryoablation treatment and other treatments, which can cure most liver tumors. But for the hepatic hilar tumors, Due to the special part of the lesion location adjacent to blood vessels, nerve, biliary and other important structure, the tumor resection rate or damage rate, tumor around the protection of pipe structure, treatment injury, cirrhosis patients with residual liver protection, complications reduction must achieve a good balance. However,the traditional local treatmenst have limitations. Due to the advantages of irreversible electroporation (IRE) ablation technology, such as guidance of cell apoptosis, protect blood vessels, bile duct and other important structures, the application of IRE technology for the ablation of tumors in the special parts of the hepatic portal region has more obvious effectiveness and safety advantages. This review mainly introduces the principle, effectiveness and safety of IRE ablation in special parts of hepatic portal region compared with traditional thermal ablation.

Clinical progress of local treatment for unresectable colorectal liver metastases

Lan Dongmei, Huang Xiaozhun, Ran Yihong, Xu Lin, Huang Zhangkan, Yin Xin, Che Xu, Bi Xinyu, Zhao Jianjun, Wang Shubin

2023, 10(1):  35-38. 

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Liver is the most common site of metastasis in colorectal cancer patients. With the development of systematic therapeutic drugs, the survival rate of patients with colorectal cancer liver metastases (CRLM) has been significantly improved. Systemic treatment combined with local treatment is the current treatment strategy that can control the disease for a long time and even cure CRLM. As a local treatment, thermal ablation or stereotactic radiotherapy (SRT) can be safely performed in patients with special metastatic lesions, elderly patients or patients with comorbidities. This article reviews the clinical application and research progress of thermal ablation and SRT in CRLM based on existing research evidence.

Progress on protein induced by vitamin K absence or antagonist-Ⅱ in the diagnosis and therapy of hepatocellular carcinoma

Wang Yaning, Sheng Jiyao, Wang Zhenxiao, Zhang Xuewen

2023, 10(1):  39-44. 

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Protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ) is mainly used for the complementary diagnosis of hepatocellular carcinoma, but now more and more studies have found that PIVKA-Ⅱ is valuable in combination with other serological indices for highly specific and sensitive diagnosis, pre-treatment efficacy assessment and post-treatment prognosis evaluation, and its level changes can provide a new basis for choice of surgery timing of liver transplantation and hepatectomy and for microvascular invasion. This article will review and discuss the role of PIVKA-Ⅱ in the above diagnosis and treatment, aiming to provide more comprehensive theoretical support for the function of PIVKA-Ⅱ in hepatocellular carcinoma.

Research progress of the applied anatomy of the caudate lobe of liver

Zhi Weihua, Han Yue

2023, 10(1):  45-48. 

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In recent years, the anatomy of the caudate lobe of the liver has received more and more attention in the field of surgery, but there is still a lack of in-depth research on its anatomical structure, and the surgical methods and strategies of the caudate lobe need to be improved. The surgery of caudate lobe has always been one of the most challenging procedures, and only by knowing the location, morphology, adjacencency and structure of blood vessels and bile ducts can this surgery be performed safely. This article mainly reviews the local anatomy of the caudate lobe, surgical and interventional procedures of caudate lobe.