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      • Long-term prognostic impact of osteopontin and Dickkopf-related protein 1 in patients with hepatocellular carcinoma after hepatectomy

        Byeon, Hyerim,Lee, Seung Duk,Hong, Eun-Kyung,Lee, Dong Eun,Kim, Bo Hyun,Seo, Yunsung,Joo, Jungnam,Han, Sung-Sik,Kim, Seong Hoon,Park, Sang-Jae Elsevier 2018 Pathology, research and practice Vol.214 No.6

        <P><B>Abstract</B></P> <P><B>Background</B></P> <P>New biomarkers are essential for improving the prediction of the survival and prognosis of patients with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the most widely used biomarker, but the low sensitivity and specificity limit its clinical applications. The diagnostic and prognostic capabilities of osteopontin (OPN), dickkopf-related protein 1 (DKK1), and a combination of these biomarkers are being studied.</P> <P><B>Methods</B></P> <P>From January 2006 to December 2008, patients undergoing hepatectomy for HCC were screened and their serum stored in tumor banks was analyzed. The serum was used to investigate OPN and DKK1 levels by enzyme-linked immunosorbent assay(ELISA). In the paraffin block, the status of OPN and DKK1 positivity was assessed using immunohistochemistry(IHC).</P> <P><B>Results</B></P> <P>A total of 60 patients were enrolled. The optimal cut-off level for survival was identified as 3.0 ng/mL and 5.2 ng/mL of OPN and DKK1, respectively. In multivariate analysis, a high OPN level was the only significant prognostic factor for overall survival [hazard ratio3.79, p = .017]. Considering a combination of AFP (cut-off level, 200 ng/mL) and OPN/DKK1, the patients with high AFP and OPN/DKK1 levels showed significantly lower overall survivals than those with low AFP, high AFP, and low OPN/DKK1 levels (p = .0091 for the AFP and OPN group, p = .0344 for the AFP and DKK1 group). Comparison between IHC and ELISA results for OPN and DKK1 levels did not reveal any significant correlation.</P> <P><B>Conclusions</B></P> <P>Serum OPN and DKK1 levels of HCC patients could be considered as novel biomarkers showing prognostic significance after hepatectomy based on long-term survival data.</P>

      • The Combined Effect of Stem Cell Factor and Granulocyte Macrophage Colony-stimulating Factor Administration after 90% Partial Hepatectomy in Rats

        ( Seung Duk Lee ),( Hyeong Min Park ),( Dasom Choi ),( Hyerim Byeon ),( Seong Hoon Kim ),( Young-kyu Kim ),( Sung-sik Han ),( Sang-jae Park ),( Eun Kyung Hong ),( Nam-joon Yi ),( Jin-young Jang ),( Ju 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

        Aims: The purpose of this study was to identify the impact of exogenous SCF and GM-CSF administration after 90% major hepatectomy in rats. Methods: Sprague Dawley rats underwent 90% major hepatectomy using a bile duct-sparing portal pedicle ligation technique under microscopy. The rats were divided into two groups: group 1 (phosphate-buffered saline) and group 2 (SCF+GM-CSF treatment, each 25 mcg/kg). Treatment was administrated immediately after operation through the inferior vena cava. Liver regeneration capacity and expression of cytokines and their downstream signaling molecules were evaluated at postoperative day 1, 2, 4, and 7. Results: The survival rate after 90% hepatectomy in rats using this technique were increased to 95% compared with 55% with conventional parenchymal ligation technique (p = 0.004). The combination effect of SCF and GM-CSF was evaluated in in vitro study. Group 2 exhibited a significantly increased liver regeneration index at early period after hepatectomy compared to group 1 (day 2: 287.5 ± 19.6 vs. 513.9 ± 67.1, p = 0.025 and day 4: 647.6 ± 108.8 vs. 941.7 ± 53.9, p = 0.046). Furthermore, serum liver enzyme levels including total bilirubin, aspartate aminotransferase, and alanine aminotransferase, were significantly lower in group 2 than in group 1 on postoperative days. The expression of Ki-67 and cyclin D1 were significantly higher in group 2 than in group 1 on postoperative days. Group 2 displayed significant increases of interleukin (IL)-6 and transforming growth factor (TGF)-β expression within 24 h after hepatectomy. Especially, C-X-C motif chemokine 12 (CXCL12)/C-X-C chemokine receptor type 4 (CXCR4) and matrix metalloproteinases 2 and 9 levels in the liver tissue of group 2 were also significantly upregulated according to quantitative polymerase chain reaction on postoperative days. Conclusions: Our data suggest that the administration of SCF+GM-CSF after major hepatectomy can enhance liver regeneration by liver cell proliferation and mobilization of stem cell modulating IL-6/TGF- β and CXCL12/CXCR4 pathway as well as by matrix remodeling. These findings suggest the possibility of therapeutic treatment using a combination of SCF and GM-CSF in the clinical setting to promote liver regeneration after extreme hepatectomy.

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