人肝癌组织中CD34和血管内皮生长因子的表达及微血管密度的 …

目的 探讨ＣＤ３４和血管内皮生长因子（ＶＥＧＦ）在人肝癌组织中的表达及微血管密度（ＭＶＤ）的病理意义。方法 对３０例人肝细胞肝癌９ＨＣＣ）及相应癌旁组织,１０例肝硬化,５例轻度慢性肝炎和４例正常肝组织,进行了ＣＤ３４、ＶＥＧＦ免疫组织化学ＳＰ法检测,对ＣＤ３４阳性血管进行ＭＶＤ计数,对ＶＥＧＦ进行半定量计数,并结合肝癌的病理特征进行分析。结果 ＨＣＣ组织中ＣＤ３４呈广泛,窦隙状阳性表达,而在正常及     

c－erbB－2蛋白和表皮生长因子受体在肝脏病变中的表达

对１８４例乙型肝炎、肝硬变和肝细胞癌（ＨＣＣ）及２９例正常肝组织的标本作了ＡＢＣ法染色，观察其ｃ－ｅｒｂＢ－２蛋白和表皮生长因子受体（ＥＧＦＲ）的表达情况。３６％（４８／１３４）的慢性肝炎、肝硬变和ＨＣＣ组织中有ＥＧＦＲ表达，主要定位于血窦内皮。良、恶性病变肝组织之间在ＥＧＦＲ表达强度上无显著差别，提示ＥＧＦＲ可能与慢性肝脏病变中血窦内皮的增生有关。在正常肝，仅少数标本（５／２９）中见到ｃ－ｅｒｂＢ－２微弱表达；在ＨＢＶ相关的慢性肝脏病变，所有标本中均检测到ｃ－ｅｒｂＢ－２蛋白，主要定位于肝小多角细胞（ＳＰＬＣ）、小细胞性不典型增生（ＳＣＤ）及小管状化生（ＤＭ）的肝细胞；ＨＣＣ细胞中ｃ－ｅｒｂＢ－２蛋白阳性较弱。这提示ｃ－ｅｒｂＢ－２基因的活化与人ＨＣＣ发生有关。其作用机制可能是促进ＳＰＬＣ向ＳＣＤ的转化及促进ＳＣＤ的进展。ｃ－ｅｒｂＢ－２与ＨＢｘＡｇ表达的密切关联提示这种原癌基因的活化可能也与ＨＢＶＸ基因有关。     

肝细胞癌中血管内皮生长因子和cNOS与血管生成及细胞增殖的关系

目的　观察血管内皮生长因子 (VEGF)及含激酶插入区受体 (KDR)在原发性肝癌中的表达情况及其与cNOS表达的相关性 ,探讨它们在肝癌肿瘤性血管生成、肿瘤细胞增殖和转移过程中的作用。　方法　收集手术切除的 80例原发性肝癌、4 0例肝硬化、2 0例正常肝组织标本 ,应用免疫组织化学和原位杂交的方法观察VEGF及其KDR、cNOS在肝细胞癌中的表达情况 ,分析VEGF及其受体KDR、cNOS与微血管密度 (MVD)、肿瘤细胞增殖指数和转移的关系。　结果　肝癌组织中癌细胞VEGF的表达与MVD、细胞增殖指数明显相关 (P <0 0 1和P <0 0 5 ) ,与肝癌内皮细胞中cNOSmRNA的表达之间也有相关性 (Pearson列联系数 =0 2 984 ,P <0 0 5 )。内皮细胞中cNOSmRNA与VEGF均阳性者微血管密度、细胞增殖指数均明显高于cNOSmRNA阴性和VEGF阳性者 (P <0 0 1) ,也明显高于两者均阴性者 (P <0 0 1)。　结论　肝细胞癌中癌细胞VEGF的表达与血管生成、细胞增殖和肝癌转移密切相关 ,且内皮细胞cNOSmRNA的表达可能参与VEGF的促血管生成作用。     

Immunohistochemical expression of CD95 (Fas), c-myc and epidermal growth factor receptor in hepatitis C virus infection, cirrhotic liver disease and hepatocellular carcinoma

Gene product expression in normal and chronic hepatitis C virus infection was determined in an attempt to improve our understanding of the molecular events leading to the development of cirrhosis and liver carcinoma. Activation of CD95 (Fas) causes apoptosis of cells and liver failure in mice and has been associated with human liver disorders. c-myc is involved in cell proliferation and EGFR in regeneration of cells. The material of the current study included 50 cases of chronic hepatitis C (CHC) (and negative hepatitis B virus infection), 29 cases of liver cirrhosis and HCV (LC), and 19 cases of hepatocellular carcinoma and HCV (HCC) admitted to the Theodor Bilharz Research Institute (TBRI) during the years 2003-2004. Ten wedge liver biopsies - taken during laparoscopic cholecystectomy - were included in the study as normal controls. Laboratory investigations, including liver function tests, serological markers for viral hepatitis and serum alpha fetoprotein level (alpha-FP), were determined for all cases. Histopathological study and immunohistochemistry using monoclonal antibodies for CD95, c-myc and EGFR were also done. In CHC cases, the histological activity index (HAI) revealed more expression of Fas antigen in liver tissues with active inflammation than in those without active inflammation (p < 0.01). EGFR and c-myc act synergistically in liver tumorigenesis. Upregulation of Fas in chronic hepatitis C infection and of c-myc & EGFR in malignant transformation was concluded from this study. c-myc expression may obstruct the induction of apoptosis of HCC cells and lead to uncontrolled cell growth.     

原发性肝癌及慢性肝脏病变端粒酶活性的研究

目的比较原发性肝细胞癌（ＨＣＣ）及其癌旁不同慢性病变组织端粒酶活性的异同,探讨端粒酶活性在恶性肿瘤诊断中的意义。方法用ＴＲＡＰ方法检测３８例ＨＣＣ及其癌旁不同慢性病变肝组织的端粒酶活性。同时以４例正常肝组织为对照。结果３８例ＨＣＣ中３２例显示端粒酶活性（８６８％）。端粒酶活性与ＨＣＣ的细胞分化、类型、大小及有无乙型肝炎病毒（ＨＢＶ）感染无关,但与病人血清中甲胎蛋白（ＡＦＰ）水平相关。端粒酶活性阴性组ＡＦＰ水平明显低于各阳性组（Ｐ＜００１）。正常肝（４例）、先天性胆管闭锁（４例）、肝小叶间纤维增生（２例）、慢性病毒性肝炎（２例）及未见明显病变肝组织（７例）均未见有端粒酶活性。２５例肝硬化中４例端粒酶呈弱活性。结论端粒酶活性见于大多数ＨＣＣ及个别肝硬化组织,其活性可能在ＨＣＣ的发生、发展中起重要作用,有希望成为恶性肿瘤诊断的标记物。     

Significance of pSmad2/3 and Smad4 in hepatitis C virus‐related liver fibrosis and hepatocellular carcinoma

Chronic hepatitis C (CHC) is a major public health problem, especially in Egypt. Risk of hepatocellular carcinoma (HCC) development increases as hepatitis C virus (HCV)‐related liver diseases progress. Smads act as substrates for the transforming growth factor‐beta (TGF‐β) family of receptors. This study aims to assess hepatic expression of pSmad2/3 and Smad4 in CHC with different stages of fibrosis and grades of necro‐inflammation as well as in HCC on top of CHC. This study was done on 33 core liver biopsies from patients with CHC (15 with early fibrosis and 18 with late fibrosis), 15 liver specimens from HCC cases on top of CHC, as well as five normal controls. pSmad2/3 and Smad4 show more immunopositivity, higher percentage of positive hepatocytes and stronger staining intensity in CHC with late fibrosis compared to early fibrosis. pSmad2/3 shows increase of the previous parameters in CHC with high grade activity than those with low activity. Smad4 shows increase of the previous parameters in HCC compared to CHC cases. pSmad2/3 and Smad4 can be used as diagnostic and/or prognostic markers for progression of HCV‐related fibrosis to cirrhosis and further progression to HCC.     

Cyclooxygenase-2 and vascular endothelial growth factor in chronic hepatitis,cirrhosis and hepatocellular carcinoma

Background/Aims

Cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) are up-regulated in hepatocellular carcinoma (HCC). To investigate the levels of COX-2 and VEGF expression in chronic hepatitis (CH), cirrhosis, and HCC.

Methods

The immunohistochemical expressions of COX-2 and VEGF were evaluated in tissues from patients with CH (n=95), cirrhosis (n=38), low-grade HCC (LG-HCC; n=6), and high-grade HCC (HG-HCC; n=29).

Results

The COX-2 expression scores in CH, cirrhosis, LG-HCC, and HG-HCC were 3.3±1.9 (mean±SD), 4.2±1.7, 5.5±1.0, and 3.4±2.4, respectively (CH vs. cirrhosis, P=0.016; CH vs. LG-HCC, P=0.008; LG-HCC vs. HG-HCC, P=0.004), and the corresponding VEGF expression scores were 0.9±0.8, 1.5±0.7, 1.8±0.9, and 1.6±1.1 (CH vs. cirrhosis, P<0.001; CH vs. LG-HCC, P=0.011; LG-HCC vs. HG-HCC, P=0.075). Both factors were correlated with the fibrosis stage in CH and cirrhosis (COX-2: r=0.427, P<0.001; VEGF: r=0.491, P<0.001). There was a significant correlation between COX-2 and VEGF in all of the tissue samples (r=0.648, P<0.001), and between high COX-2 and VEGF expression scores and survival (COX-2: P=0.001; VEGF: P<0.001).

Conclusions

The expressions of both COX-2 and VEGF are significantly higher in cirrhosis and LG-HCC than in CH. High COX-2 and high VEGF expressions are associated with a high survival rate.     

Genomic instability in chronic viral hepatitis and hepatocellular carcinoma

Chronic hepatitis may progress to cirrhosis and hepatocellular carcinoma (HCC). Progressive accumulation of mutations and genomic instability in chronic viral hepatitis might flag an increased risk of HCC development. Genomic instability at dinucleotide microsatellite loci in chromosomes 2, 13, and 17 and at 2 mononucleotide repeat loci was examined in liver tissues from 41 patients, including 30 without HCC (18 patients with chronic hepatitis and 12 with cirrhosis) and 11 with HCC. Genomic instability was detected in 51% of the 41 cases. Allelic imbalance at informative dinucleotide loci occurred in 37% of the cases. In 14 cases (34%), allelic imbalance was detected in chronic hepatitis or cirrhosis without HCC. Allelic imbalance at the chromosome 13 locus was detected in 50% of the cases of chronic hepatitis C. Allelic imbalance at the TP53 chromosome locus and/or at the chromosome 13 locus was significantly more frequent than alterations at the chromosome 2 locus (P =.026). Low-level microsatellite instability was found in 20% of all cases examined and high-level microsatellite instability in 3 patients (7.5%), including 2 cases of chronic hepatitis and 1 case of cirrhosis. Our results show that allelic imbalance occurs frequently in hepatitis-related HCC as well as in chronic hepatitis in patients without HCC. Allelic imbalance at the D13S170 chromosome 13 locus (13q31.2) occurs frequently in chronic hepatitis, suggesting that genomic alterations affecting the long arm of chromosome 13 might be used to monitor the natural progression of chronic hepatitis-associated liver carcinogenesis.     

Dysregulation of blood lymphocyte subsets and natural killer cells in schistosomal liver cirrhosis and hepatocellular carcinoma

Abstract. Immunological factors are important in the pathogenesis of a wide spectrum of hepatobiliary diseases. Using flow cytometry, we determined the changes in lymphocyte subsets and natural killer cells in 123 individuals (81 patients with liver disease and 42 healthy volunteers). The liver diseases included periportal fibrosis (PPF, 10 patients), liver cirrhosis (LC, 31 patients), and hepatocellular carcinoma (HCC, 40 patients). Schistosomiasis and viral hepatitis B and C were the putative etiological agents of liver diseases. Immunophenotyping by indirect immunofluorescence was conducted using monoclonal antibodies to CD3 (T-lymphocytes), CD4 (helper/inducer T-cells), CD8 (suppressor/cytotoxic T-cells), and CD57 (natural killer cells) cell surface markers. Immunophenotyping of PPF patients showed no significant changes in all markers compared with the healthy controls. However, there was a significant decrease (P<0.01) in CD3 and CD4 T-cells, and a highly significant increase (P<0.001) in CD57 T-cells in patients with LC or HCC. In addition, LC and HCC patients showed no significant change in CD8 T-cells compared with controls. In conclusion, the progression of liver diseases is associated with a dysregulation of cellular immune responses. T-lymphocytes and natural killer cells may play a role in the immunopathogenesis of liver cirrhosis and HCC.     

Significant down-regulation of growth hormone receptor expression revealed as a new unfavorable prognostic factor in hepatitis C virus-related hepatocellular carcinoma

Background/AimsGrowth hormone (GH) is the main regulator of somatic growth, metabolism, and gender dimorphism in the liver. GH receptor (GHR) signaling in cancer is derived from a large body of evidence, although the GHR signaling pathway involved in the prognosis of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related HCC, remains unclear. We aimed to explore the expression of GHR and analyze its association with clinicopathologic features and prognosis of patients with chronic hepatitis C and HCC.MethodsThe expression of GHR mRNA was investigated by quantitative real-time polymerase chain reaction in paired tumors and adjacent non-tumorous (ANT) liver tissues of 200 patients with chronic hepatitis C and HCC. Western blotting and immunofluorescence assays using the HCV-infected Huh7.5.1 cell model was performed.ResultsGHR mRNA was significantly lower in HCV-HCC tissues than in corresponding ANT liver tissues. GHR mRNA and protein levels also decreased in the HCV-infected Huh7.5.1 cell model. Notably, lower GHR expression was associated with age of >60 years (P=0.0111) and worse clinicopathologic characteristics, including alpha-fetoprotein >100 ng/mL (P=0.0403), cirrhosis (P=0.0075), vascular invasion (P=0.0052), pathological stage II–IV (P=0.0002), and albumin ≤4.0 g/dL (P=0.0055), which were linked with poor prognosis of HCC. Most importantly, the high incidence of recurrence and poor survival rates in patients with a low ratio of tumor/ANT GHR (≤0.1) were observed, indicating that low expression levels of GHR had great risk for development of HCC in patients with chronic hepatitis C.ConclusionsOur study demonstrates a significant down-regulation of GHR expression as a new unfavorable independent prognostic factor in patients with chronic hepatitis C and HCC.     

婴儿慢性肝炎,肝硬化和肝细胞癌的病理研究

收集婴儿慢性肝炎（ＣＨ）、婴儿肝硬化（Ｃｉ）和婴儿肝细胞癌（ＨＣＣ）的标本，进行一般病理学、免疫病理学和超微结构研究。结果显示婴儿ＣＨ、Ｃｉ和ＨＣＣ具有乙型肝炎病毒（ＨＢＶ）感染、慢性活动性肝病和卵圆细胞增生的共同背景。并对婴儿ＨＢＶ感染途径，ＨＢｘＡｇ与ＨＣＣ的关系，卵圆细胞增生在婴儿ＣＨ、Ｃｉ演变为婴儿ＨＣＣ中的作用进行了探讨。     

Tumorigenic role of YAP in hepatocellular carcinogenesis is involved in SHP2 whose function is different in vitro and in vivo

Yes-associated protein (YAP) is a nuclear effector of the cell-density sensing Hippo pathway and interacts with Src homology phosphotyrosine phosphatase 2 (SHP2), which controls cell proliferation and survival. The tumor promoting/suppressing activities of YAP and SHP2 during liver tumorigenesis remain controversial. This study aimed to investigate the tumorigenic roles of YAP and SHP2 in hepatocellular carcinogenesis. Cell density associated subcellular distributions of YAP and SHP2 in normal human hepatocytes (THLE-2) and hepatocellular carcinoma (HCC) cells (SK-Hep1, SNU-182) were investigated by Western blotting and cell block immunohistochemistry. The effects of YAP knockdown on proliferation, migration and invasion were studied using YAP-specific siRNAs. The prognostic significance of YAP and SHP2 expressions was investigated immunohistochemically using a tissue microarray (TMA) from 50 HCC cases. High-cell density decreased the nuclear expression of YAP and SHP2 in normal hepatocytes as compared with low-cell density. However, in HCC cells, nuclear YAP and SHP2 were observed regardless of cell density. Nuclear YAP influenced SHP2 expression and cell proliferation. In particular, YAP knockdown impacted nuclear levels of SHP2 protein in SK-Hep1 cells. In HCC tissues, nuclear YAP expression was elevated and cytoplasmic SHP2 expression was diminished as compared with adjacent non-tumor tissues. Notably, these expressions were found to be significantly associated with poor recurrence-free and overall survival rate in patients with HCC. Consequently, the tumor promoting role of YAP is involved in SHP2 which functions as a tumor promoter in vitro but as a tumor suppressor in vivo. YAP and SHP2 can be unfavorable prognostic markers in HCC.     

The role of N-acetylglucosaminyltransferases V in the malignancy of human hepatocellular carcinoma

To investigate the role of N-acetylglucosaminyltransferases V (GnT-V) in the malignancy of human hepatocellular carcinoma (HCC), the GnT-V stably suppressed cell line HepG2 GnT-V/1564 was constructed from HepG2. The proliferation, migration, invasion, metastasis of HepG2 GnT-V/1564 was investigated both in vitro and in vivo. The clinical pathological significance of GnT-V expression was also studied in 140 cases of HCC tissues. This study showed that down-regulation of GnT-V inhibited the proliferation, migration and invasion of the HepG2 cells. In addition, GnT-V expression was shown in 138 cases of 140 (98.6%) HCC samples, in 3 cases of 31 (9.7%) in liver cirrhosis cases and in 1 cases of 20 (5.0%) in normal liver tissues. Besides, a higher level of GnT-V was observed more frequently in the advanced tumors with higher T stage and histological grade. These data suggested that GnT-V expression was positively related with malignancy in HCC and GnT-V may be both a differentiation marker and a potential target for the treatment of HCC.     

TOLL样受体-4和髓样分化蛋白-2在血吸虫病小鼠肝脏的表达及意义

目的:探讨血吸虫病小鼠肝脏TOLL样受体-4(TLR-4)和髓样分化蛋白-2(MD-2)的表达及其在肝脏损害中的作用。方法:将40只健康小鼠随机分成正常对照组(N组,20只)与模型组(M组,20只),M组采用腹部敷贴法制作血吸虫病模型,造模150天后处死动物,鲎试验法测定血清内毒素水平;免疫组化和RT-PCR方法检测肝脏中TLR-4和MD-2的表达。结果:M组血清内毒素水平高于N组(P<0.01);M组小鼠肝脏TLR-4/MD-2表达水平高于N组(P<0.01);M组小鼠肝脏TLR-4/MD-2高表达主要位于肝窦内皮细胞及肝窦区周围细胞。结论:血吸虫病肝硬化可发生肠源性内毒素易位、内毒素血症;脂多糖通过其信号转导蛋白TLR-4和MD-2在肝脏的高表达,激活一系列促炎基因的转录,可能是引起血吸虫病肝脏损害的原因之一。     

Subcellular shift of the hepatic growth hormone receptor with progression of hepatitis C virus-related chronic liver disease

AIMS: To evaluate the cytoplasmic and nuclear expression of hepatic growth hormone receptor (GHR) in different stages (S0, S1, S3 and S4, according to Knodell's classification) of chronic liver disease (CLD) and in hepatocellular carcinoma (HCC). METHODS AND RESULTS: Liver specimens from 31 patients with hepatitis C virus-related CLD, five patients with HCC and nine controls were examined for expression of hepatic GHR by immunohistochemistry with MAb 263. Cytoplasmic and nuclear staining were evaluated as a percentage of positively stained cells. The cytoplasmic expression of GHR was comparable between normal liver and S0 hepatitis, while it progressively decreased in S1, S3 and S4 CLD (P < 0.01). Conversely, nuclear GHR showed increased expression in S3 and S4 CLD (P < 0.05). No differences were observed between HCC and normal liver in terms of GHR immunoreactivity. CONCLUSIONS: This is the first study to show that the subcellular expression of hepatic GHR changes with the progression of CLD. The increase in nuclear expression of GHR with advanced stages of CLD suggests that GH may act directly at the nuclear level to promote hepatocyte proliferation/regeneration.     

Non-B hepatocellular carcinoma: influence of age, sex, alcohol, family clustering, blood transfusion and chronic liver disease

In 144 cases of hepatocellular carcinoma (HCC), 166 cases of cirrhosis without HCC and 142 cases of chronic hepatitis, we examined HBsAg, anti-HBs and anti-HBc in sera and compared the following factors between hepatitis B virus marker-negative and -positive patients: age, sex, alcohol consumption, family clustering of liver diseases, and histories of blood transfusion and post-transfusion hepatitis. Results of this study demonstrated several distinct differences in clinical backgrounds between non-B (negative for HBsAg, anti-HBs and anti-HBc) and B (positive for HBsAg) patients with HCC. Non-B patients were significantly older, had a lower frequency of familial tendencies for liver diseases, and more frequently had cancers other than HCC in their families. Some of these differences were also observed between non-B and B patients with cirrhosis and chronic hepatitis. Among patients with chronic hepatitis, the non-B patients had received blood transfusion or had post-transfusion hepatitis more frequently than the B patients. However, this difference was not apparent in patients with liver cirrhosis or HCC, suggesting that progression of non-A, non-B post-transfusion hepatitis to cirrhosis and HCC may not be as frequent as progression to chronic hepatitis.     

Clinical study on relationship between hepatocellular carcinoma and hepatitis C virus infection in patients with chronic liver disease]

The relationship between hepatocellular carcinoma (HCC) and hepatitis C virus (HCV) infection was investigated. Antibody to hepatitis C virus was detected in 88.8% and 87.0% of 240 patients with hepatocellular carcinoma and liver cirrhosis, respectively. A history of blood transfusion was shown in only 21.8% (21/96) of the HCV antibody positive HCC patients. Of 196 patients with chronic hepatitis type C and the HCV antibody positive liver cirrhosis, 10 developed HCC during the follow-up period of two years. A high prevalence of HCV antibody was also shown among 83 patients with alcoholic liver cirrhosis and HCC associated with alcoholic liver cirrhosis. HCV-RNA was detected in all patients with alcoholic HCC. These data support a causal association between hepatitis C virus and hepatocellular carcinoma.