AIM To investigate novel predictors of survival in hepatocellular carcinoma(HCC) patients following transarterial chemoembolization(TACE).METHODS One hundred sixty seven patients with un-resectable HCC were retrospect...AIM To investigate novel predictors of survival in hepatocellular carcinoma(HCC) patients following transarterial chemoembolization(TACE).METHODS One hundred sixty seven patients with un-resectable HCC were retrospectively analyzed to identify factors that might contribute to their HCC biology and aggressiveness. We correlated routine laboratory results(total bilirubin, AST, ALKP, GGTP, albumin etc.) to maximum tumor diameter, number of tumor nodules, portal vein thrombosis and blood alpha-fetoprotein levels. These 4 parameters were previously combined to form an aggressiveness index(AgI). We used The Wilcoxon ranksum(Mann-Whitney), to test the correlation between the AgI categories and liver function parameters. The Cox proportional hazards model was applied to evaluate the categories of AgI associated with overall survival. RESULTS The AgI was strongly correlated with survival in this novel patient population. Three year survival probability for AgI > or < 4 was 42.4% vs 61.8%; P < 0.0863 respectively. Several factors independently correlated with AgI using univariate multiple logistic regression of AgI with 8 laboratory parameters. Lower albumin levels had an OR of 2.56(95%CI: 1.120-5.863 P < 0.026), elevated Alkaline phosphatase and gamma glutamyl transpeptidase(GGTP) had ORs of 1.01(95%CI: 1.003-1.026, P < 0.017) and 0.99(95%CI: 0.99-1.00, P < 0.053) respectively. In a Cox proportional hazard model combining mortality for AgI score and liver function parameters, only GGTP levels and the AgI were independently associated with survival. An AgI > 4 had HR for mortality of 2.18(95%CI: 1.108-4.310, P < 0.024). GGTP's single unit change had a HR for mortality of 1.003(95%CI: 1.001-1.006, P < 0.016). These were considered in the final multivariate model with the total cohort. An AgI > 4 had a HR for mortality of 2.26(95%CI: 1.184-4.327, P < 0.016). GGTP had a HR of 1.003(95%CI: 1.001-1.004, P < 0.001).CONCLUSION Our study validates the AgI in a new population with un-resectable HCC patients undergoing TACE. The analysis establishes a correlation between GGTP and the AgI.展开更多
AIM: To investigate Glyoxalase Ⅰ and fructosamine-3-kinase (FN3K) activity in red blood cells from patients with colorectal adenomas and cancer. METHODS: Thirty three consecutive subjects with one or more histologica...AIM: To investigate Glyoxalase Ⅰ and fructosamine-3-kinase (FN3K) activity in red blood cells from patients with colorectal adenomas and cancer. METHODS: Thirty three consecutive subjects with one or more histologically confirmed colorectal adenomatous polyps, 16 colorectal cancer patients and a group of 11 control subjects with normal colonoscopy were included in the study. Glyoxalase Ⅰ and FN3K activities were measured in red blood cells using a spectrophotometric and radiometric assay, respectively. RESULTS: A significant reduction in both Glyoxalase Ⅰ and FN3K activity was detected in patients with tumors compared to patients with adenomas and the controls. Erythrocyte Glyoxalase Ⅰ activity in colorectal cancer was approximately 6 times lower than that detected in patients with adenoma (0.022 ± 0.01 mmol/min per milliliter vs 0.128 ± 0.19 mmol/min per milliliter of red blood cells, P = 0.003, Tukey's test). FN3K activity in red blood cells from patients with colon cancer was approximately 2 times lower than that detected in adenoma patients (19.55 ± 6.4 pmol/min per milliliter vs 38.6 ± 31.7 pmol/min per milliliter of red blood cells, P = 0.04, Tukey's test). CONCLUSION: These findings suggest that deglycating enzymes may be involved in the malignant transformation of colon mucosa.展开更多
Background and aims:Hepatocellular carcinoma(HCC)is characterized by several clinically important prognostic parameters,including portal vein thrombosis(PVT),tumor multifocality,and serum alphafetoprotein(AFP)levels,i...Background and aims:Hepatocellular carcinoma(HCC)is characterized by several clinically important prognostic parameters,including portal vein thrombosis(PVT),tumor multifocality,and serum alphafetoprotein(AFP)levels,in addition to maximum tumor diameter(MTD).However,associations among these parameters have not been thoroughly examined.Thus,the study aimed to investigate the correlations among these HCC characteristics in a prospectively collected database.Methods:An 8080 HCC patient database derived from our weekly HCC council meeting was examined with respect to the correlations at baseline patient presentation between increases in MTD and changes in the percentage of patients with PVT,multifocality,or AFP levels.Results:The percentage of patients with PVT and with multifocality(tumor nodule numbers≥3)significantly increased with enlarging MTD,regardless of the serum AFP level,showing the independence of PVT and multifocality on AFP.The percentage of patients with multifocality increased with enlarging MTD,in the presence or absence of PVT,showing the independence of multifocality from PVT.Therefore,discordance was found between different tumor parameters.Conclusions:A statistically significant association was found between PVT and MTD and between multifocality and MTD,all three of which are independent of AFP.PVT and multifocality appeared to be independent of each other.Although PVT and multifocality were independent of AFP,they were also augmented with high serum AFP levels.The results suggest the possibility of multiple pathways of tumor progression in the later stages of HCC development.展开更多
文摘AIM To investigate novel predictors of survival in hepatocellular carcinoma(HCC) patients following transarterial chemoembolization(TACE).METHODS One hundred sixty seven patients with un-resectable HCC were retrospectively analyzed to identify factors that might contribute to their HCC biology and aggressiveness. We correlated routine laboratory results(total bilirubin, AST, ALKP, GGTP, albumin etc.) to maximum tumor diameter, number of tumor nodules, portal vein thrombosis and blood alpha-fetoprotein levels. These 4 parameters were previously combined to form an aggressiveness index(AgI). We used The Wilcoxon ranksum(Mann-Whitney), to test the correlation between the AgI categories and liver function parameters. The Cox proportional hazards model was applied to evaluate the categories of AgI associated with overall survival. RESULTS The AgI was strongly correlated with survival in this novel patient population. Three year survival probability for AgI > or < 4 was 42.4% vs 61.8%; P < 0.0863 respectively. Several factors independently correlated with AgI using univariate multiple logistic regression of AgI with 8 laboratory parameters. Lower albumin levels had an OR of 2.56(95%CI: 1.120-5.863 P < 0.026), elevated Alkaline phosphatase and gamma glutamyl transpeptidase(GGTP) had ORs of 1.01(95%CI: 1.003-1.026, P < 0.017) and 0.99(95%CI: 0.99-1.00, P < 0.053) respectively. In a Cox proportional hazard model combining mortality for AgI score and liver function parameters, only GGTP levels and the AgI were independently associated with survival. An AgI > 4 had HR for mortality of 2.18(95%CI: 1.108-4.310, P < 0.024). GGTP's single unit change had a HR for mortality of 1.003(95%CI: 1.001-1.006, P < 0.016). These were considered in the final multivariate model with the total cohort. An AgI > 4 had a HR for mortality of 2.26(95%CI: 1.184-4.327, P < 0.016). GGTP had a HR of 1.003(95%CI: 1.001-1.004, P < 0.001).CONCLUSION Our study validates the AgI in a new population with un-resectable HCC patients undergoing TACE. The analysis establishes a correlation between GGTP and the AgI.
文摘AIM: To investigate Glyoxalase Ⅰ and fructosamine-3-kinase (FN3K) activity in red blood cells from patients with colorectal adenomas and cancer. METHODS: Thirty three consecutive subjects with one or more histologically confirmed colorectal adenomatous polyps, 16 colorectal cancer patients and a group of 11 control subjects with normal colonoscopy were included in the study. Glyoxalase Ⅰ and FN3K activities were measured in red blood cells using a spectrophotometric and radiometric assay, respectively. RESULTS: A significant reduction in both Glyoxalase Ⅰ and FN3K activity was detected in patients with tumors compared to patients with adenomas and the controls. Erythrocyte Glyoxalase Ⅰ activity in colorectal cancer was approximately 6 times lower than that detected in patients with adenoma (0.022 ± 0.01 mmol/min per milliliter vs 0.128 ± 0.19 mmol/min per milliliter of red blood cells, P = 0.003, Tukey's test). FN3K activity in red blood cells from patients with colon cancer was approximately 2 times lower than that detected in adenoma patients (19.55 ± 6.4 pmol/min per milliliter vs 38.6 ± 31.7 pmol/min per milliliter of red blood cells, P = 0.04, Tukey's test). CONCLUSION: These findings suggest that deglycating enzymes may be involved in the malignant transformation of colon mucosa.
基金supported in part by NIH grant CA 82723(Brian I.Carr).
文摘Background and aims:Hepatocellular carcinoma(HCC)is characterized by several clinically important prognostic parameters,including portal vein thrombosis(PVT),tumor multifocality,and serum alphafetoprotein(AFP)levels,in addition to maximum tumor diameter(MTD).However,associations among these parameters have not been thoroughly examined.Thus,the study aimed to investigate the correlations among these HCC characteristics in a prospectively collected database.Methods:An 8080 HCC patient database derived from our weekly HCC council meeting was examined with respect to the correlations at baseline patient presentation between increases in MTD and changes in the percentage of patients with PVT,multifocality,or AFP levels.Results:The percentage of patients with PVT and with multifocality(tumor nodule numbers≥3)significantly increased with enlarging MTD,regardless of the serum AFP level,showing the independence of PVT and multifocality on AFP.The percentage of patients with multifocality increased with enlarging MTD,in the presence or absence of PVT,showing the independence of multifocality from PVT.Therefore,discordance was found between different tumor parameters.Conclusions:A statistically significant association was found between PVT and MTD and between multifocality and MTD,all three of which are independent of AFP.PVT and multifocality appeared to be independent of each other.Although PVT and multifocality were independent of AFP,they were also augmented with high serum AFP levels.The results suggest the possibility of multiple pathways of tumor progression in the later stages of HCC development.
