重组质粒pchIL-18-MAGE转染树突状细胞疫苗体外杀伤肝癌细胞的研究

目的:探讨重组质粒pch IL-18-MAGE转染DC细胞在体外对肝癌细胞的杀伤作用。方法:构建共表达质粒pchIL-18-MAGE,体外培养树突状细胞,将以上重组质粒转染树突状细胞。RT-PCR和Western blot方法验证IL-18和MAGE-1基因在转染DC中的表达。应用流式细胞术检测转染后DC细胞的表型变化。以转染重组质粒DC刺激的淋巴细胞作为效应细胞,单纯淋巴细胞和未经转染DC刺激的淋巴细胞为对照,检测其对肝癌靶细胞的体外杀伤作用。ELISA法检测INF-γ的分泌。结果:pchIL-18-MAGE转染后DC细胞高表达CD83、CD1a、CD86、CD80、HLA-DR等抗原,表现为成熟DC表型特征。共表达质粒转染的DC细胞诱导的CTL对肝癌细胞杀伤作用最强(P<0.05)。结论:pchIL-18-MAGE转染DC细胞对MAGE+肝癌细胞杀伤作用明显。     

负载肝癌抗原的人树突状细胞生物学特性的研究

目的　探讨负载肝癌抗原的树突状细胞 (DC)对自身CIK细胞的诱导增殖能力和杀伤能力 .方法　从人外周血分离获得单核细胞 ,体外经重组细胞因子 (GM -CSF)、白细胞介素 - 4 (IL - 4 )、肿瘤坏死因子α(TNF -α)培养获得DC ,电镜观察其形态 ,流式细胞仪检测其表面抗原 ,混合淋巴细胞反应检测负载肝癌抗原DC诱导CIK细胞增殖活性 ,检测激活的CIK对肝癌细胞的杀伤作用 .结果　经体外培养 ,从外周血分离获得的大量成熟DC ,检测表明高表达DC的抗原标志 ,负载抗原的DC具有很强的激发同种CIK增殖的能力 ,激活的CIK对肝癌细胞系具有很强的杀伤作用.结论　实验结果为肝癌的临床免疫治疗提供了理论基础 .     

树突状细胞负载肝癌抗原肽疫苗体外诱导特异性免疫学反应的研究

目的：研究树突状细胞(dendritic cell，DC)负载肝癌抗原肽EPVTKAEML体外诱导特异性CTL的能力及其抑癌效果。方法：用顺序特异引物聚合酶链反应技术(PCR—SSP)选择HLA—B7表型供者，从脾组织中分离、培养DC-EPVTKAEML特异性CTL。用^51Cr释放法检测CTL的杀伤活性，并用抗HLA-1分子单抗(mAb)进行杀伤抑制实验。结果：找到4例HLA-B7杂合子供者，用DC负载HLA-B7限制的抗原肽EPVTKAEML可诱导特异性CTL反应，对肝癌细胞HHCC有较强的杀伤作用。结论：DC负载抗原肽EPVTKAEML在体外可诱发较强的特异性免疫反应。     

T-exo 负载DC 诱导抗肝癌细胞免疫效应研究

目的:观察肝癌细胞来源的外泌体(T-exo)负载DC体外诱导细胞毒T细胞(CTL)对肝癌细胞的杀伤作用。方法:采用超滤离心技术联合蔗糖密度梯度超速离心的方法从肝癌Huh-7细胞培养上清液中分离外泌体(T-exo),透射电镜鉴定形态,Western blot检测外泌体相关蛋白CD9、CD63、HSP70及肿瘤抗原分子AFP的表达;分离健康供者外周血单个核细胞(PBMC)培养DC,流式细胞术鉴定负载T-exo的DC细胞表型;用2-(4-碘苯)-3-(4硝基苯)-5-(2,4-磺苯基四氮唑)-2H-四唑单钠盐-1(WST-1)法检测负载T-exo的DC刺激T淋巴细胞增殖情况;流式细胞术Annexin-V/PI双染法检测负载T-exo的DC诱导CTL分别对AFP阳性Huh-7细胞及AFP阴性的SMMC7721细胞的杀伤作用。结果:透射电镜下可见T-exo为圆形或椭圆形双层膜囊泡状小体,大小不等,平均直径50~100 nm,表达外泌体膜相关分子及肿瘤抗原分子。负载T-exo的DC可促进初始T细胞增殖,T-exo致敏DC对AFP阳性的Huh-7肝癌细胞系杀伤活性明显高于AFP阴性的SMMC7721肝癌细胞组(P0.05)及未负载T-exo的对照组DC(P0.05)。结论:负载T-exo的DC能促进T细胞增殖,提高CTL细胞的细胞毒活性诱导特异性的抗肝癌效应。经T-exo抗原致敏DC诱导的CTL对肝癌细胞有明显的细胞毒作用,明显高于DC对照组(P0.05)。     

负载肝癌抗原的人树突状细胞生物学特性的研究

目的探讨负载肝癌抗原的树突状细胞(DC)对自身CIK细胞的诱导增殖能力和杀伤能力.方法从人外周血分离获得单核细胞,体外经重组细胞因子(GM-CSF)、白细胞介素-4(IL-4)、肿瘤坏死因子α(TNF-α)培养获得DC,电镜观察其形态,流式细胞仪检测其表面抗原,混合淋巴细胞反应检测负载肝癌抗原DC诱导CIK细胞增殖活性,检测激活的CIK对肝癌细胞的杀伤作用.结果经体外培养,从外周血分离获得的大量成熟DC,检测表明高表达DC的抗原标志,负载抗原的DC具有很强的激发同种CIK增殖的能力,激活的CIK对肝癌细胞系具有很强的杀伤作用.结论实验结果为肝癌的临床免疫治疗提供了理论基础.     

负载不同形式肝癌抗原的树突状细胞抑瘤功能的比较

目的：探讨不同形式的肝癌抗原修饰的树突状细胞(DC)的抑瘤功能。方法：分别用肝癌H22冻融抗原、H22小分子抗原肽和Hsp70-H22抗原肽复合物修饰DC；用MTT比色法分析DC激活的CTL对H22细胞的杀伤能力，并用RT-PCR法测定脾脏T细胞中IFN-γ mRNA的表达水平；用不同修饰的DC免疫小鼠，观察其对H22肝癌的生长抑制作用。结果：单独的H22肝癌抗原肽修饰的DC不能激活CTL。Hsp70-H22肽复合物修饰的DC激活CTL的能力强于H22肝癌冻融抗原修饰的DC，对H22细胞的杀伤率分别为47．3％和18．3％。各组T细胞中IFN-γ表达水平的变化与杀伤率的变化相一致。用H22肝癌冻融抗原和Hsp70-H22肽复合物修饰的DC免疫小鼠后，均可抑制H22细胞生长，但后者的抑制作用更强，成瘤率仅40％。其他各组的成瘤率均为100％。结论：Hsp70-H22肽复合物是一种DC的强致敏物．可通过激活CTL、诱导CD4^ T细胞分化成Th1型细胞而参与肝癌的免疫排斥。     

卵巢癌细胞株冻融抗原负载的树突状细胞诱导CTL抗卵巢癌免疫应答的体外研究

目的研究卵巢癌冻融抗原负载的树突状细胞(dendriticcells,DC)诱导细胞毒性T淋巴细胞(CTL)体外杀伤卵巢癌细胞的细胞毒性效应。方法利用免疫磁珠分离法(MACS)分离纯化脐血CD34 细胞并在体外诱导分化为DC,用反复冻融法从卵巢癌细胞系SKOV3中提取的可溶性相关抗原负载DC。流式细胞学检测负载抗原后DC表面各种分化相关抗原的表达,ELISA法检测DC上清中IL12的表达,混合淋巴细胞反应(MLR)测定DC体外刺激T细胞增殖的能力,MTT法检测抗原负载DC激活的抗原特异性CTL对卵巢癌细胞的杀伤作用。结果与未经抗原负载的DC相比,经卵巢癌抗原负载的DC不仅能更高地表达各种DC分化相关抗原CD1α(73.35%±2.94%vs34.1%±2.35%)、CD83(73.9%±8.46%vs54.68%±3.26%)、CD80(91.95%±2.48%vs52.53%±3.18%)、HLADR(70.05%±2.35%vs48.7%±2.07%)以及CD54(88.9%±5.52%vs71.45%±2.29%),同时具有更强的刺激同种异体T淋巴细胞增殖和IL12分泌的能力(P均<0.05)。此外,卵巢癌细胞SKOV3冻融抗原负载DC激活的CTL在体外对SKOV3的杀伤率为77.35%,显著高于未经抗原负载的DC(P=0.0001)。结论经卵巢癌细胞冻融抗原负载DC激活的CTL在体外具有更强的增殖能力和杀伤卵巢癌细胞的作用。     

树突状细胞负载肝癌可溶性抗原后的免疫应答

目的 用负载肝癌可溶性抗原的DC诱导肝癌特异性T细胞。方法 在体外用GM－CSF和IL－4诱导健康人外周血单核细胞，使其分化为高纯度树突状细胞（DC）。用负载人肝癌细胞株SMMC－7721可溶性抗原的DC诱导自身淋巴细胞。结果 诱导后淋巴细胞增殖指数大于1．5，表面CD56分子表达下降，CD3^ T/CD4^ T和CD3^ T/CD8^ T细胞比例增加，以CD3^ T/CD4^ T细胞比例增加最为明显。CD4／CD8比例由诱导前的0．84增加为1．04，活化前后γδ比例没有改变。活化后的淋巴细胞不但可杀伤SMMC－7721细胞，同时还可不同程度的杀伤其它3株肝癌细胞。另外，诱导7d的DC可不同程度的抑制4株肝癌细胞和胃癌细胞。结论 实验结果为肝癌DC疫苗的研究提供了理论基础。     

人乳头状瘤病毒11型E7抗原HLA-A*0201限制性细胞毒性T淋巴细胞表位的功能鉴定

目的 筛选和鉴定人乳头状瘤病毒11型E7抗原(HPVllE7)HLA-A*0201限制性细胞毒性T淋巴细胞(cytotoxic T lymphocyte,CTL)表位.方法 预测HPVllE7抗原HLA-A*0201限制性CTL表位并合成相对应的表位多肽和四聚体(tetramer),即HPVllE7 7-15(TLKDIVLDL)、15-23(LQPPDPVGL)、47-55(PLTQHYQIL)、81-89(DLLLGTLNI)和82-90(LLLGTLNIV).从健康HLA-A*0201成人外周血单一核细胞诱导树突状细胞(DC)并负载上述表位多肽,流式细胞技术检测DC成熟分化标记及ELISA法检测DC分泌的IL-12;成熟DC负载各组多肽后观察DC激活T淋巴细胞的效应,ELISA法检测T细胞分泌的IFN-γ;四聚体检测抗原特异性CD8+ T细胞及乳酸脱氢酶(LDH)释放法评价DC诱导的CTL对靶细胞的特异性体外杀伤效应.结果 预测的5条HPVllE7表位多肽均能诱导DC的成熟分化;E7 7-15、82-90和15-23多肽负载的DC能激活T淋巴细胞分泌高水平IFN-γ;E7 7-15多肽负载的DC能刺激特异性tetramer+CD8+细胞增殖且其诱导的CTL对HPVllE7/293细胞产生高效率的特异性杀伤作用(P<0.05).结论 筛选并鉴定出1条HPVllE7HLA-A*0201限制性CTL表位E7 7-15(TLKDIVLDL),负载该表位肽的DC体外可诱导高效、特异性的CTL效应,抗原性较强,有可能作为HPV感染治疗用肽疫苗的候选表位.     

肺癌细胞总RNA转染的DC疫苗体外诱导肺癌患者特异性抗肿瘤免疫的实验研究

目的：为了探讨肺癌细胞总RNA转染的DC疫苗体外诱导特异性抗肿瘤免疫的能力。方法：采用分离肺癌患者外周血单核细胞体外诱导DC细胞，Trizol法提取肺癌细胞系Calu-6总RNA，用脂质体包裹总RNA转染DC并诱导特异性CTL的扩增，LDH法和ELISA法检测CTL的杀伤活性和IFN-γ分泌。结果：经肺癌细胞总RNA转染的DC特异性表面标志及功能相关分子表达均上调，转染后的DC可显著刺激异体／自体T淋巴细胞增殖，诱导的特异性CTL对携带Calu-6抗原的靶细胞的杀伤率显著高于LAK细胞，再次接触相同抗原时其IFN-γ分泌量显著增高。结论：肺癌细胞总RNA转染的DC疫苗可在体外诱导出特异性抗肿瘤免疫。     

Early hepatocellular carcinoma macroscopically resembling adenomatous hyperplasia: Pathological resemblance to carcinoma-in-situ

The pathological features of 11 nodules of early hepatocellular carcinoma (EHCC) were studled. Their macroscopic features resembled those of adenomatous hyperplasia and differed from those of advanced hepatocellular carcinomas (AHCC). The EHCC extended along the hepatic lobular structure and lacked expansive growth. The endothelial cells in the dnusoids of EHCC did not react to Ulex europeeus aggiutinin 1 (UEA1) like adenomatous hyperplasla or other liver parenchyma, whereas the endothelial celis in the AHCC did react to UEA1. immunohistochemically, CD68-positlve Kupffer cells were noted in the alnusolds of EHCC, whereas in the AHCC Kupfter cails were not seen. Tumor emboli in the portal vein and intrahepatic metastases were not Identified In EHCC. which seemed to be carcinoma-in-situ or a microinvasive stage of hepatocareinogenesis.     

Liver cell atypias: a comparative study in cirrhosis with and without hepatocellular carcinoma

Various criteria have been proposed for the identification of early neoplastic changes in the setting of both small hepatocellular carcinomas and macroregenerative nodules. In this study we have applied those criteria to cases of liver cirrhosis without tumour (group I) and hepatocellular-carcinoma-associated cirrhosis (group II) to assess their discriminatory value in these two situations. Group I included 50 liver biopsies with uncomplicated cirrhosis while group II encompassed 48 liver biopsies of cirrhotic nodules adjacent to hepatocellular carcinomas. The histological changes sought were large cell dysplasia, small cell dysplasia, cytoplasmic basophilia, small microacinar structures, peripheral distribution of nuclei, nuclear irregularities and thickened liver cell plates. These changes were also assessed in macroregenerative nodules (nine in group I and seven in group II). None of these changes was useful to discriminate between group I and group II cirrhotic nodules when assessed separately. On the other hand, cirrhotic nodules showing three or fewer changes were never associated with malignancy, whereas those exhibiting four or more alterations were often located in the vicinity of a tumour. Acinar structures, thickened cell trabeculae, peripheral distribution of nuclei and nuclear irregularities seem to be the most specific indicators of proximity to a hepatocellular carcinoma. Similar results were obtained for macroregenerative nodules. These results may be helpful as guidelines to the probability of having a hepatocellular carcinoma elsewhere in livers containing atypical cirrhotic nodules, and may also prove valuable in the selection of appropriate material for investigating early molecular events in hepatic carcinogenesis.     

Clinicopathologic study on clear cell hepatocellular carcinoma

In order to study the clinicopathologic characteristics of the clear cell variant of hepatocellular carcinoma (HCC), 215 consecutive cases measuring less than 5 cm in diameter were reviewed. The cases were divided into clear cell HCC (20 cases); focal clear cell HCC (77 cases); and non-clear cell HCC (118 cases). Clinical and pathological findings were compared among these groups. Clear cell HCC was moderately differentiated in 80% of cases and the incidence was not related to tumor size. The male to female ratio was 2.3:1, lower than the 6.9:1 of non-clear cell HCC. The association rate with liver cirrhosis was 90%, higher than the 59.3% of non-clear cell HCC. Three- and five-year survival rates, and no recurrence time were 54.5%, 33.3%, and 564 days, respectively, lower than the findings of 74.3%, 46.1%, and 770 days for non-clear cell HCC. But there is no significant difference in prognosis between both groups. Ultrastructurally, clear cells showed abundant glycogen storage and a variable degree of fat vacuoles, with a marked reduction of the number and size of organelles in the 8 cases examined. Non-clear cells of focal clear cell and non-clear cell HCC showed a moderate degree of glycogen storage in 85.7% and 28.6% of the seven cases examined from each group, with significant difference. It was concluded that clear cell HCC occurs mostly in the moderately differentiated form and is characterized by high female prevalence, high rate of association with liver cirrhosis, and has no significant difference in prognosis compared with non-clear cell HCC.     

Challenge and Hope in Radiotherapy of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the most critical global health issues. With frequent association of viral liver disease, HCC is highly complex, harboring both cancer and chronic liver disease. The tumor stage and underlying liver function are both major determinants of the treatment selection as well as prognosis in HCC patients, thus allowing no more than a 20% chance for potentially curative therapies. Radiotherapy technology has been evolved remarkably during the past decade, and radiation can be precisely delivered, thereby permitting higher doses to the tumour and reduced doses to surrounding normal tissues. There has been increasing interest in the merits of radiotherapy in HCC over the past few years, as indicated by a Pub Med search. Radiotherapy has been used as the definitive therapy with curative intent in early stage tumours. It has been used also in combination with TACE for intermediate stage tumours. In locally advanced tumours, radiotherapy has been combined with systemic agents. Despite its efficacy, radiotherapy has not yet been incorporated into the standard management guidelines of HCC. The lack of high evidence level data, especially randomized controlled trials, has posed an obstacle in including radiotherapy into the routine treatment schema of HCC. Therefore, well-designed prospective studies are strongly recommended using developing technology for radiotherapy alone or combination therapies. Also, many issues such as the optimal dose-fractionation, intra- or extrahepatic metastasis after radiotherapy, and radiation-induced hepatic dysfunction remain to be solved. In this review, current status of radiotherapy for HCC will be discussed with regard to technical consideration and combination strategy. The limitation and future perspectives will also be discussed.     

Combined cytological and histological diagnosis of hepatocellular carcinoma in ultrasonically guided fine needle biopsy specimens

This study evaluates the usefulness of a combined cytological and histological approach to the diagnosis of hepatocellular carcinoma (HCC) when applied to fine needle biopsy specimens obtained under ultrasonic guidance. The material, aspirated from 51 focal liver lesions, was handled in such a way that there was sufficient material for both cytological and histological (cell block) assessment. Of the 29 cases of HCC studied, a confident cytological diagnosis was made in 23 (79%). In the remaining six cases, the cytological features were considered to be suspicious but not diagnostic of HCC. Examination of cell blocks in the six cases enabled a confident diagnosis of HCC to be made in all cases. This was due to the supplementary visual information provided by the histological features, particularly the pattern of arrangement of the tumour cells.     

Clinicopathological characteristics in combined hepatocellular-cholangiocarcinoma: a single center study in Korea

Purpose

Combined hepatocellular-cholangiocarcinoma (CHCC) is an uncommon form of cancer, and its clinicopathological features have rarely been reported in detail. This study was undertaken to evaluate the clinicopathological characteristics and prognostic factors of CHCC.

Materials and Methods

The clinicopathological features of patients diagnosed with CHCC at Severance Hospital between January 1996 and December 2007 were retrospectively studied by comparing them with the features of patients with hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) who had undergone a hepatic resection during the same period.

Results

Forty-three patients diagnosed with CHCC were included in this study (M : F=35 : 8, median age, 55 years). According to the parameters of the American Joint Committee on Cancer staging, there were 6 (14.0%), 9 (20.9%), 25 (58.1%), and 3 (7.0%) patients with stages I, II, III, and IV cancer, respectively. Thirty-two of the 43 patients underwent resection with curative intent. After resection, 27 patients (84.4%) had tumor recurrence during the follow-up period of 18 months (range: 6-106 months), and the median time to recurrence was 13 months. Overall median survival periods after hepatic resection of CHCC, HCC and CC were 34, 103 and 38.9 months, respectively (p<0.001). The median overall survival for all patients with CHCC was 21 months, and the 5-year survival rate was 18.1%. The presence of portal vein thrombosis and distant metastasis were independent prognostic factors of poor survival.

Conclusion

Even after curative hepatic resection, the presence of a cholangiocellular component appeared to be a poor prognostic indicator in patients with primary liver cancer.