Carcinoma, Hepatocellular ; virology ; Genome, Viral ; Hepatitis B virus ; genetics ; Humans ; Liver Neoplasms ; virology ; Mutation

Hepatocellular carcinoma(HCC),one of the most common malignant tumors,is the main cause of cancer death in China.Early diagnosis of the disease is of great importance.Serum tumor markers have been effective for detecting HCC for a long time.Among those markers,alpha fetoprotein(AFP)is the most widely used one in detecting patients with HCC,but it has limited utility for detecting HCC due to its limited sensitivity and specificity.Searching better markers for HCC has been a re- search focus in recent years.This review introduces many useful markers to supplement AFP for detecting HCC.

MicroRNAs(miRNAs) are endogenous non-coding RNAs,about 20 nucleotides in length.They play a pivotal role in the regulation of genes involved in diverse biology processes such as cell development,proliferation,differentiation and apoptosis by the translation repression or mRNA degradation.Recent evidence has suggested that miRNA alterations are involved in the initiation and progression of various human cancer including hepatocellular carcinoma(HCC),and miRNA-expression profiling of HCC has identified signatures associated with diagnosis,staging,progression and prognosis.As a novel molecular target,miRNAs holds great promise in diagnosis and biotherapy of HCC.

Circulating nucleic acids (CNAs) are extracellular nucleic acids found in cell-free serum,plasma and other body fluids from healthy subjects as well as in patients. The ability to detect and quantitate specific DNA and RNA sequences has opened up the possibility of diagnosis and monitoring of diseases,especially in the field of cancer. Furthermore,in some recent studies it has been suggested a kind of non-coding RNA-microRNA (miRNA),also exist in cell-free serum and plasma,highlighting the field of using CNAs to diagnose cancer. As a novel tumor marker,tumor-specific circulating miRNAs holds great promise in early diagnosis of cancer.

Objective To analyze the correlation of gamma-glutamyl transpeptidase (GGT)level with alpha-fetoprotein (AFP)level and to re-evaluate the diagnostic value of GGT for hepatocellular carcinoma (HCC).Methods Four hundred and seventy-two patients with HCC or liver cirrhosis,who were hospitalized in China-Japan Friendship Hospital from January 2003 to June 2009,were included in the study.The correlation between GGT and AFP was analyzed by Spearman nonparametric test.The cut-off values for the two parameters were determined based on their receiver operating characteristics (ROC)curves,areas under the ROC curve (AUCs),sensitivity,and specifici-ty,and the diagnostic values were presented using their sensitivity,specificity,and correct index.Statistical analysis was performed using SPSS 17.0.Normally distributed continuous data were analyzed by independent-samples t test,while non-normally distributed continuous data were analyzed by Mann -Whitney U test.Categorical data were analyzed by Pearson chi -square test,continuity-corrected chi -square test,or Fisher’s exact test.Results Among 472 patients,224 were diagnosed with HCC,and 248 with liver cirrhosis.Compared with cirrhotic patients,HCC patients had a significantly higher GGT level (113 (58-254)U/L vs 38 (22-72)U/L,Z=-11.037,P<0.001)and a significantly higher AFP level (429.5 (15.7-1210.0)ng/ml vs 5.7 (3.4-18.2)ng/ml,Z=-10.157,P<0.001).A significant correlation was found between GGT and AFP (r=0.449,P<0.001).The AUC was 0.784 for GGT and 0.788 for AFP.The cut-off value was 60 U/L for GGT and 20 ng/ml for AFP.The sensitivity was 74.1%for GGT,71.8%for AFP,and 90.7%for a combina-tion of the two parameters,the specificity was 70.2%,77.6%,and 58.7%,respectively,and the correct index was 0.443,0.494,and 0.494,respectively.Conclusion GGT may be regarded as one biomarker for HCC,and its level is significantly correlated with AFP level. The diagnostic value of AFP may not be improved when used in combination with GGT.

With the completion of human genome,we are entering the functional genomic age.To further reveal the nature of life,glycomics comes into being and becomes a research focus.This review gives a deep insight on the current research progress of glycomics,including the research target,the structural classification and metabolism of sugar chain,the biological significance,research approaches,and the correlation between glycomics and liver diseases.

Early diagnosis of hepatocellular carcinoma(HCC)is still a great challenge in clinical practice.Tumor markers such as alpha-fetoprotein(AFP),liver enzymes,cytokines,and some special glycoproteins,though helpful,are not sensitive and specific enough for early diagnosis of HCC.The establishment of several interesting predictive diagnostic models on liver fi- brosis/cirrhosis suggests that mathematic predictive model,which is developed based on large sample size and follow-up study, might be of higher sensitivity,specificity and feasibility in clinical application.Here we suggest that more attention should be paid to this kind of multi-parameter predictive diagnostic models clinically,so as to improve the early diagnosis of HCC in a more economical and feasible way.

Early diagnosis of hepatocellular carcinoma (HCC) is still a great challenge in clinical practice. Tumor markers such as alpha-fetoprotein(AFP), liver enmymes, cytokines, and some special glycoproteins, though helpful, are not sensitive and specific enough for early diagnosis of HCC. The establishment of several interesting predictive diagnostic models on liver fibrosis/cirrhosis suggests that mathematic predictive model, which is developed based on large sample size and follow up study, might be of higher sensitivity, specificity and feasibility in clinical application. Here we suggest that more attention should be paid to this kind of multi-parameter predictive diagnostic models clinically, so as to improve the early diagnosis of HCC in a more economical and feasible way.

Objective:To retrospectively analyze the routine clinical laboratory parameters for hepatocellular carcinoma,in an attempt to search for parameters for diagnosis of hepatocellular carcinoma(HCC).Methods:The pre-operation clinical labo- ratory data,such as tumor makers,and serological biochemical indices,hepatitis B virus(HBV)infection markers,and HBV DNA titers,were collected from 828 patients who were pathologically diagnosed as having HCC;then the correlation between these data with tumor size and the pathological grades of HCC was analyzed.Results:It was found that 97.9% of the 828 pa- tients were infected with HBV and 70.9% of them were accompanied by liver fibrosis.We also found that the tumor size was correlated with albumin(ALB),globulin(GLB),A/G,aspartate aminotransferase(AST),ratio of aspartate to alanine amin- otransferase(AST/ALT),gamma-glutamyl transferase(GGT),alkaline phosphatase(ALP),alpha-L-fucosidase(AFU),al- pha-fetoprotein(AFP)and tumor grades;meanwhile,the pathological grades of tumor was correlated to prealbumin(PALB), GGT and tumor size(all P

Objective To evaluate the mid- and long-term radiological outcomes of cerebral aneurysms with GDCs embolization.Methods One hundred and sixty-two patients with 173 aneurysms embolized with GDCs underwent angiographic follow-up from 1 to 54 months post-operatively and were retrospectively reviewed. Three neuro-radiologists reviewed each angiogram and made a comparison between initial and follow-up angiograms. Morphological outcomes were evaluated as follows: unchanged; progressive thrombosis; and re-opening or re-growth. Results Of 173 aneurysms with GDC embolization, 142 aneutysms had total or nearly total occlusion, 23 subtotal occlusion and 8 partial occlusion shown on initial angiograms. The incidence of re-opening was 17.1% (13/76) in less than 3 months, and 6.2% (6/97) between 3 and 6 months postoperatively. Four aneurysms showed recurrency(2.3%) on second follow-up angiography in one year after procedure and one-year cumulative recurrent rate was 13.3% of 56 aneurysms with the third follow-up angiography in the post-operation period of 12 to 54 months, four showed a little enlargement and the cmnulative recurrent rate so far was 20.2% (35/173). Conclusions The direct and main causes for aneurysmal recurrence are incomplete and loosening packing. The first angiographic follow-up is recommended to be performed at 3 months or earlier after the procedure, especially in aneurysms with initial incomplete occlusion. Re-treatment with balloon- or stent-assisted coil embolization is recommended in re-opening aneurysms. (J Intervent Radiol,2005,14:472-479)