1.Changes in contrast-enhanced computed tomography quantitative parameters and their relationships with pathological grades in patients with clear cell renal cell carcinoma
Gang ZHOU ; Rong HUANG ; Qian CHENG
Chinese Journal of Radiological Health 2026;35(1):49-55
Objective To explore the change pattern of quantitative parameters in contrast-enhanced computed tomography (CECT) scans during the cortical and nephrographic phases in patients with clear cell renal cell carcinoma (ccRCC), evaluate the diagnostic efficiency of these quantitative parameters in predicting the pathological grade of ccRCC preoperatively, and provide imaging reference for clinically evaluating preoperative disease severity and formulating individualized therapeutic regimens. Methods A retrospective analysis was performed on the clinical data of 84 patients with ccRCC treated in our hospital between September 2022 and September 2024. According to the World Health Organization/International Society of Urological Pathology (WHO/ISUP) pathological grading system, patients were divided into a high-grade group (n = 32) and a low-grade group (n = 52). CECT features and quantitative parameters were compared between the two groups. The relationships between CECT quantitative parameters and pathological grading in ccRCC patients were analyzed using Spearman correlation. The diagnostic value of these parameters for preoperative pathological grading was evaluated using receiver operating characteristic curves. Results The maximum tumor diameter and the proportion of tumors with blurred margins were higher in the high-grade group than in the low-grade group (P<0.05). The CT values, net enhancement values, and enhancement rates during both the cortical and nephrographic phases were lower in the high-grade group than in the low-grade group (P<0.05). Spearman correlation analysis showed that the CT values, net enhancement values, and enhancement rates during both the cortical and nephrographic phases were negatively correlated with preoperative pathological grades in ccRCC patients (P<0.05). Receiver operating characteristic curve analysis revealed that the area under the curve for preoperative pathological grading using the combination of cortical phase CT value, cortical phase net enhancement value, cortical phase enhancement rate, nephrographic phase CT value, nephrographic phase net enhancement value, and nephrographic phase enhancement rate was 0.912, which was higher than the areas for any individual parameter used alone (0.770, 0.748, 0.763, 0.751, 0.739, and 0.718, respectively; P<0.05). The sensitivity, specificity, and 95% confidence interval for the parameters used in combination were 96.88%, 69.23%, and 0.853-0.970, respectively. Conclusion CECT quantitative parameters were negatively correlated with pathological grades in patients with single ccRCC and demonstrated high diagnostic efficiency for pathological grading, providing a reference for clinical treatment planning.
2.Mechanisms of Gegen Qinlian Tang-containing Serum in Improving 5-FU Sensitivity by Inhibiting Glycolysis in Colorectal Cancer Cells Based on CDK16/MYC Pathway
Rong CAI ; Shang WANG ; Fuqing CHENG ; Yanping ZHOU ; Zuowei HU ; Yunhai LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):1-9
ObjectiveTo explore the molecular mechanisms by which serum containing Gegen Qinlian Tang (GQT) inhibits glycolysis and enhances chemotherapy sensitivity in 5-fluorouracil (5-FU)-resistant colorectal cancer (CRC) cells based on the cyclin-dependent kinase 16 (CDK16)/MYC proto-oncogene (MYC) pathway. MethodsHCT-116/5-FU cells were treated with different concentrations (5%, 10%, 20%, 30%) of GQT-containing serum. Cell viability and 5-FU sensitivity were assessed using the cell counting kit-8 (CCK-8) assay, and the experimental concentrations of 5-FU and GQT for subsequent experiments were determined. Cell proliferation and apoptosis under individual 5-FU, GQT, and combined 5-FU + GQT treatments were evaluated using 5-ethynyl-2′-deoxyuridine (EDU) staining and annexin V-FITC/PI double staining, respectively. Glucose consumption, adenosine triphosphate (ATP) production, and lactate levels were measured by colorimetric assays. Expression levels of glycolysis-related proteins, CDK16, MYC, and phosphorylated MYC were detected by Western blot. Co-immunoprecipitation (CoIP) was used to examine the protein interaction between CDK16 and MYC, and cycloheximide (CHX) treatment was applied to assess the effect of CDK16 overexpression on MYC protein stability. ResultsCCK-8 assays showed that 2.5 mg·L-1 5-FU significantly inhibited HCT-116 cell viability in a dose-dependent manner. In HCT-116/5-FU cells, significant inhibition was observed only at 5 mg·L-1 5-FU (P<0.05), which was used for model establishment. Compared with 5-FU alone, addition of 5% GQT-containing serum significantly suppressed HCT-116/5-FU cell viability (P<0.05), with stronger inhibition at higher serum concentrations. Thus, 5% GQT-containing serum was used in subsequent experiments. Compared with the control group, 5-FU, GQT, and 5-FU + GQT treatments all significantly reduced cell proliferation (P<0.05) and increased apoptosis (P<0.01). The 5-FU + GQT combination showed superior inhibition of proliferation compared with 5-FU or GQT alone (P<0.01), accompanied by more pronounced reductions in glucose consumption, ATP production, and lactate generation (P<0.01). Additionally, compared with control, 5-FU, and GQT groups, the 5-FU + GQT group exhibited stronger suppression of MYC and its phosphorylated forms (P<0.01) and greater inhibition of glycolytic enzymes, including hexokinase 2 (HK2), 3-phosphoinositide-dependent protein kinase 1 (PDK1), lactate dehydrogenase A (LDHA), and pyruvate kinase M2 (PKM2) (P<0.01). CDK16, MYC, and MYC phosphorylation expression levels were significantly downregulated in the 5-FU + GQT group compared with the 5-FU group (all P<0.01). MYC protein stability decreased in a time-dependent manner in the 5-FU + GQT group (P<0.05), which was rescued by CDK16 overexpression (P<0.05). ConclusionGQT significantly enhances the sensitivity of HCT-116/5-FU cells to 5-FU, potentially by inhibiting CDK16 and thereby reducing MYC-mediated glycolysis.
3.Mechanisms of Gegen Qinlian Tang-containing Serum in Improving 5-FU Sensitivity by Inhibiting Glycolysis in Colorectal Cancer Cells Based on CDK16/MYC Pathway
Rong CAI ; Shang WANG ; Fuqing CHENG ; Yanping ZHOU ; Zuowei HU ; Yunhai LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):1-9
ObjectiveTo explore the molecular mechanisms by which serum containing Gegen Qinlian Tang (GQT) inhibits glycolysis and enhances chemotherapy sensitivity in 5-fluorouracil (5-FU)-resistant colorectal cancer (CRC) cells based on the cyclin-dependent kinase 16 (CDK16)/MYC proto-oncogene (MYC) pathway. MethodsHCT-116/5-FU cells were treated with different concentrations (5%, 10%, 20%, 30%) of GQT-containing serum. Cell viability and 5-FU sensitivity were assessed using the cell counting kit-8 (CCK-8) assay, and the experimental concentrations of 5-FU and GQT for subsequent experiments were determined. Cell proliferation and apoptosis under individual 5-FU, GQT, and combined 5-FU + GQT treatments were evaluated using 5-ethynyl-2′-deoxyuridine (EDU) staining and annexin V-FITC/PI double staining, respectively. Glucose consumption, adenosine triphosphate (ATP) production, and lactate levels were measured by colorimetric assays. Expression levels of glycolysis-related proteins, CDK16, MYC, and phosphorylated MYC were detected by Western blot. Co-immunoprecipitation (CoIP) was used to examine the protein interaction between CDK16 and MYC, and cycloheximide (CHX) treatment was applied to assess the effect of CDK16 overexpression on MYC protein stability. ResultsCCK-8 assays showed that 2.5 mg·L-1 5-FU significantly inhibited HCT-116 cell viability in a dose-dependent manner. In HCT-116/5-FU cells, significant inhibition was observed only at 5 mg·L-1 5-FU (P<0.05), which was used for model establishment. Compared with 5-FU alone, addition of 5% GQT-containing serum significantly suppressed HCT-116/5-FU cell viability (P<0.05), with stronger inhibition at higher serum concentrations. Thus, 5% GQT-containing serum was used in subsequent experiments. Compared with the control group, 5-FU, GQT, and 5-FU + GQT treatments all significantly reduced cell proliferation (P<0.05) and increased apoptosis (P<0.01). The 5-FU + GQT combination showed superior inhibition of proliferation compared with 5-FU or GQT alone (P<0.01), accompanied by more pronounced reductions in glucose consumption, ATP production, and lactate generation (P<0.01). Additionally, compared with control, 5-FU, and GQT groups, the 5-FU + GQT group exhibited stronger suppression of MYC and its phosphorylated forms (P<0.01) and greater inhibition of glycolytic enzymes, including hexokinase 2 (HK2), 3-phosphoinositide-dependent protein kinase 1 (PDK1), lactate dehydrogenase A (LDHA), and pyruvate kinase M2 (PKM2) (P<0.01). CDK16, MYC, and MYC phosphorylation expression levels were significantly downregulated in the 5-FU + GQT group compared with the 5-FU group (all P<0.01). MYC protein stability decreased in a time-dependent manner in the 5-FU + GQT group (P<0.05), which was rescued by CDK16 overexpression (P<0.05). ConclusionGQT significantly enhances the sensitivity of HCT-116/5-FU cells to 5-FU, potentially by inhibiting CDK16 and thereby reducing MYC-mediated glycolysis.
4.Evaluation of long-term efficacy of plasma exchange and double-filtration plasmapheresis preprocessing in high-titer ABO-incompatible kidney transplantation
Lifei LIANG ; Guisheng QI ; Rong ZHOU ; Ruirui SANG ; Cheng YANG
Organ Transplantation 2026;17(1):68-76
Objective To explore the clinical efficacy of plasma exchange (PE) and double-filtration plasmapheresis (DFPP) pretreatment regimens for high-titer ABO-incompatible kidney transplantation (ABOi-KT). Methods A retrospective analysis was conducted on 31 cases of ABOi-KT with a follow-up period ≥1 year admitted to Zhongshan Hospital Affiliated to Fudan University from April 2016 to August 2025. The efficacy differences between the PE combined with rituximab (RTX) + oral triple immunosuppressive regimen and the DFPP combined with RTX + oral triple immunosuppressive regimen were compared and analyzed. The titers of blood group antibodies and serum creatinine levels before and after the operation were monitored. The survival curves and cumulative risk occurrence curves were plotted using the Kaplan-Meier method. The survival rates of recipients and transplanted kidneys and the occurrence of complications were analyzed. Results Both the PE regimen and the DFPP regimen may effectively reduce the preoperative blood group antibody titer of the recipients to ≤1∶16. The one-year survival rate of the recipients and the transplanted kidneys both reached 100% after the operation. The postoperative serum creatinine levels of recipients who received the DFPP regimen were lower and more stable. There was no statistically significant difference in the incidence of complications between the two regimens during the same follow-up period. Conclusions Both the PE and DFPP regimens are effective pretreatment regimens for ABOi-KT. The DFPP regimen has more advantages in reducing treatment operations, lowering drug dosage and maintaining the stability of postoperative renal function. For recipients with a high initial antibody titer (≥ 1∶32), individualized determination of the number and frequency of plasma processing for pretreatment may achieve ideal therapeutic effects.
5.Mechanism of benzoapyrene-induced mitochondrial DNA damage mediated by PDX-1/TFAM pathway
Rong CUI ; Yi CHENG ; Li WANG ; Xiaohe ZHAI
Journal of Environmental and Occupational Medicine 2026;43(5):575-581
Background Previous studies have found that exposure to benzo[a]pyrene (BaP) can lead to functional impairment of the human pancreas. Pancreatic and duodenal homeobox factor 1 (PDX-1) may play a role in regulating mitochondrial function. It is hypothesized that BaP exposure may interfere with PDX-1 expression in human pancreatic ductal epithelial cells (H6C7), thereby affecting mitochondrial transcription factor A (TFAM). This process could induce mitochondrial DNA (mtDNA) damage, disrupt pancreatic development and function, and elevate the risk of diabetes onset. Objective To investigate the mechanism of BaP-induced mtDNA damage through disruption of the PDX-1/TFAM pathway in a H6C7 cell model. Methods A H6C7 cell injury model was established using different concentrations of BaP. Cell viability was determined using cell counting kit-8 (CCK-8). After 24 h of BaP exposure (5,10, and 20 μmol·L−1), cell morphological and mitochondrial membrane potential (MMP) changes were observed via confocalmicroscopy, and PDX-1/TFAM protein expression levels were assessed. Bioinformatics analysis combined with dual-luciferase reporter assays was used to confirm PDX-1 directly targeting the TFAM promoter. Following PDX-1 overexpression or silencing in BaP treated cells, flow cytometry was used to evaluate viability and apoptosis, while Western blot and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) measured PDX-1/TFAM expression and mitochondrial DNA copy number (mtDNA-cn). Results The cell injury model demonstrated that, compared with the control group, BaP exposure reduced cell viability, disrupted membrane integrity, induced nuclear fragmentation, and decreased MMP. Protein expression levels of PDX-1 and TFAM were significantly downregulated in the 10 and 20 μmol·L−1 groups (P<0.05). Dual-luciferase reporter assays confirmed that PDX-1 overexpression upregulated TFAM levels. Flow cytometry revealed that PDX-1 overexpression significantly reduced apoptosis rate (P<0.001), whereas PDX-1 silencing increased apoptosis rate (P<0.001). Compared with the BaP-only group, BaP+PDX-1 overexpression elevated TFAM protein and mRNA expression as well as mtDNA-cn (P<0.01), while BaP+siRNA-PDX-1 suppressed these parameters (P<0.001). Conclusion BaP exposure promotes apoptosis in human pancreatic cells. PDX-1, a key gene in pancreatic development, regulates the expression of TFAM, a core regulator of mitochondrial function. This interaction triggers changes in MMP and mtDNA-cn, activates the PDX-1/TFAM/mtDNA axis, and ultimately leads to pancreatic cell injury.
6.Mechanism of benzoapyrene-induced mitochondrial DNA damage mediated by PDX-1/TFAM pathway
Rong CUI ; Yi CHENG ; Li WANG ; Xiaohe ZHAI
Journal of Environmental and Occupational Medicine 2026;43(5):575-581
Background Previous studies have found that exposure to benzo[a]pyrene (BaP) can lead to functional impairment of the human pancreas. Pancreatic and duodenal homeobox factor 1 (PDX-1) may play a role in regulating mitochondrial function. It is hypothesized that BaP exposure may interfere with PDX-1 expression in human pancreatic ductal epithelial cells (H6C7), thereby affecting mitochondrial transcription factor A (TFAM). This process could induce mitochondrial DNA (mtDNA) damage, disrupt pancreatic development and function, and elevate the risk of diabetes onset. Objective To investigate the mechanism of BaP-induced mtDNA damage through disruption of the PDX-1/TFAM pathway in a H6C7 cell model. Methods A H6C7 cell injury model was established using different concentrations of BaP. Cell viability was determined using cell counting kit-8 (CCK-8). After 24 h of BaP exposure (5,10, and 20 μmol·L−1), cell morphological and mitochondrial membrane potential (MMP) changes were observed via confocalmicroscopy, and PDX-1/TFAM protein expression levels were assessed. Bioinformatics analysis combined with dual-luciferase reporter assays was used to confirm PDX-1 directly targeting the TFAM promoter. Following PDX-1 overexpression or silencing in BaP treated cells, flow cytometry was used to evaluate viability and apoptosis, while Western blot and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) measured PDX-1/TFAM expression and mitochondrial DNA copy number (mtDNA-cn). Results The cell injury model demonstrated that, compared with the control group, BaP exposure reduced cell viability, disrupted membrane integrity, induced nuclear fragmentation, and decreased MMP. Protein expression levels of PDX-1 and TFAM were significantly downregulated in the 10 and 20 μmol·L−1 groups (P<0.05). Dual-luciferase reporter assays confirmed that PDX-1 overexpression upregulated TFAM levels. Flow cytometry revealed that PDX-1 overexpression significantly reduced apoptosis rate (P<0.001), whereas PDX-1 silencing increased apoptosis rate (P<0.001). Compared with the BaP-only group, BaP+PDX-1 overexpression elevated TFAM protein and mRNA expression as well as mtDNA-cn (P<0.01), while BaP+siRNA-PDX-1 suppressed these parameters (P<0.001). Conclusion BaP exposure promotes apoptosis in human pancreatic cells. PDX-1, a key gene in pancreatic development, regulates the expression of TFAM, a core regulator of mitochondrial function. This interaction triggers changes in MMP and mtDNA-cn, activates the PDX-1/TFAM/mtDNA axis, and ultimately leads to pancreatic cell injury.
7.Current situation and development strategy of the construction of traditional Chinese medicine digital herbarium
LIU Junling ; HAO Dajun ; CHENG Shiyun ; SU Chang ; GENG Chao ; LIU Bingxin ; RONG Yu ; KANG Shuai
Drug Standards of China 2026;27(1):0049-0057
This study aims to review the current status and development trends of digital TCM (Traditional Chinese Medicine) specimen museums, providing a theoretical basis for their future construction. By systematically organizing literature and materials, practical experiences in platform architecture design, content planning, and technical implementation were summarized. The research results show that digital technology has significant application value in the TCM field. Currently, some Food and Drug Control Institutes have formed diverse construction achievements by integrating regional characteristics with technological innovation. However, current TCM specimen museums generally still face many challenges, such as insufficient digitalization. In conclusion, the digitalization of TCM specimen museums has become an inevitable trend in the industry. Targeted measures are urgently needed to solve existing problems and promote the sustainable development of digital TCM specimen museums. It is suggested to strengthen the standardization of data collection and storage, deepen the integration of technologies such as 3D, AR, and AI into the construction of specimen museums, and at the same time promote the spatial design combining regional culture with TCM. This will help create "one museum with one feature for one region" digital TCM specimen museums, further promoting their sustainable development and facilitating the digital inheritance of TCM.
8.Diagnostic value of serum lncRNA H19 and miR-22-3p in patients with acute myocardial infarction
Sheng ZHAO ; Dinghong LIU ; Mengyu ZHU ; Li RONG ; Wei CHENG ; Yanlin GAO
Acta Universitatis Medicinalis Anhui 2026;61(5):855-860
ObjectiveTo explore the expression levels of long non-coding RNA (lncRNA) H19 and microRNA-22-3p (miR-22-3p) in the serum of patients with acute myocardial infarction (AMI) and their diagnostic value for AMI. MethodsA total of 176 AMI patients were selected as the experimental group and were divided into ST-segment elevation myocardial infarction (STEMI) group (n=95) and non-ST-segment elevation myocardial infarction (NSTEMI) group (n=81) based on their medical history and electrocardiogram. Meanwhile, 156 patients with negative angiography during the same period were selected as the control group (CON group). The relative expression levels of lncRNA H19 and miR-22-3p in the serum of the two groups were detected by real-time fluorescence quantitative polymerase chain reaction. The diagnostic value of miR-22-3p and lncRNA H19 in AMI was evaluated by receiver operating characteristic curve (ROC) analysis. The levels of serum cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase MB isoenzyme (CK-MB), and high-sensitivity C-reactive protein (CRP) were detected in all study subjects. Spearman correlation analyses were used to evaluate the correlations between lncRNA H19 and miR-22-3p and cTnI, CK, CK-MB and CRP. ResultsCompared with the control group, the expression level of lncRNA H19 was upregulated and the expression level of miR-22-3p was downregulated in the AMI group (all P<0.01); compared with the NSTEMI group, the expression level of lncRNA H19 was upregulated and the expression level of miR-22-3p was downregulated in the STEMI group (P<0.01). The areas under the ROC curves (AUC) for the diagnosis of AMI by miR-22-3p, lncRNA H19 and their combination were 0.555, 0.977, and 0.983, respectively. lncRNA H19 was positively correlated with cTnI, CK, CK-MB and CRP (P<0.05), and negatively correlated with left ventricular ejection fraction (LVEF) (P<0.001); miR-22-3p was negatively correlated with cTnI, CK and CRP, and positively correlated with LVEF (P<0.05). ConclusionThe expression level of lncRNA H19 is elevated and the expression level of miR-22-3p decreased in AMI patients, and their levels may have potential value as an auxiliary biomarker for AMI diagnosis and cardiac function assessment.
9.Fluorescence Suppression Method of Raman Spectroscopy and Its Application in Skin and Cosmetics Analysis
Yun-Xia CHEN ; Jia-Rong WANG ; Jian-Yu ZHU ; Shi-Wen LIN ; Ya-Nan LIU ; Xiao-Yue MA ; Guang-Cheng XI ; Juan LIU
Progress in Biochemistry and Biophysics 2026;53(7):1914-1926
Owing to its inherent advantages—such as being non-destructive, rapid, highly molecule-specific, and minimally interfered with by moisture—Raman spectroscopy has been widely adopted in the fields of skin barrier function assessment, monitoring the transdermal penetration of active cosmetic ingredients, and the identification and quality control of cosmetic products. Despite these strengths, the practical application of this technique faces a significant bottleneck: the strong fluorescence background generated by endogenous skin components and exogenous cosmetic additives. Endogenous skin substances, such as structural proteins (e.g., collagen and elastin), metabolic coenzymes (e.g., nicotinamide adenine dinucleotide), and pigments (e.g., melanin), together with exogenous cosmetic constituents like organic colorants, chemical sunscreens, and fragrances, often possess strong absorption and emission characteristics. When excited by lasers, these components produce a fluorescence background that can be 106 to 108 times stronger than the Raman scattering signals, effectively masking the inherently weak vibrational fingerprint information. In recent years, driven by the rapid development of optoelectronic hardware and artificial intelligence algorithms, fluorescence suppression strategies have evolved from isolated, single-method approaches into comprehensive, multi-level synergistic systems. These systems are categorized into three distinct tiers: sample preparation, signal acquisition, and data processing. At the sample preparation level, techniques such as photobleaching and surface-enhanced Raman spectroscopy (SERS) are employed to eliminate or bypass the generation of fluorescence at the source. At the signal acquisition level, instrumental improvements—including the use of long-wavelength near-infrared excitation (typically 785 nm or 1 064 nm), confocal spatial filtering, and shifted excitation Raman difference spectroscopy (SERDS)— are utilized to physically isolate Raman signals from the fluorescence background. Furthermore, at the data processing level, numerical baseline correction methods such as polynomial fitting, penalized least squares (e.g., airPLS, arPLS), wavelet transform, and derivative algorithms are increasingly integrated into the analytical pipeline to extract Raman spectral features from mixed signals without increasing hardware costs or acquisition time. This review provides a systematic categorization and critical evaluation of these fluorescence suppression methods, detailing their underlying principles, technical advantages, and inherent limitations in diverse experimental setups. By focusing on critical application scenarios—including skin barrier assessment, percutaneous absorption monitoring, the routine quality control of cosmetics, and the emerging field of portable on-site detection—this paper explores the current state of technique selection and optimization. Finally, the article discusses future development trends, emphasizing the necessity of constructing adaptive, tiered suppression strategies, developing intelligent and automated data processing algorithms, and promoting the integration of portable, multi-modal diagnostic devices. The objective of this review is to provide a comprehensive technical reference to facilitate the transition of Raman spectroscopy from a specialized laboratory tool into a routine, robust analytical platform for advancements in skin science and cosmetic research.
10.Integrated molecular characterization of sarcomatoid hepatocellular carcinoma
Rong-Qi SUN ; Yu-Hang YE ; Ye XU ; Bo WANG ; Si-Yuan PAN ; Ning LI ; Long CHEN ; Jing-Yue PAN ; Zhi-Qiang HU ; Jia FAN ; Zheng-Jun ZHOU ; Jian ZHOU ; Cheng-Li SONG ; Shao-Lai ZHOU
Clinical and Molecular Hepatology 2025;31(2):426-444
Background:
s/Aims: Sarcomatoid hepatocellular carcinoma (HCC) is a rare histological subtype of HCC characterized by extremely poor prognosis; however, its molecular characterization has not been elucidated.
Methods:
In this study, we conducted an integrated multiomics study of whole-exome sequencing, RNA-seq, spatial transcriptome, and immunohistochemical analyses of 28 paired sarcomatoid tumor components and conventional HCC components from 10 patients with sarcomatoid HCC, in order to identify frequently altered genes, infer the tumor subclonal architectures, track the genomic evolution, and delineate the transcriptional characteristics of sarcomatoid HCCs.
Results:
Our results showed that the sarcomatoid HCCs had poor prognosis. The sarcomatoid tumor components and the conventional HCC components were derived from common ancestors, mostly accessing similar mutational processes. Clonal phylogenies demonstrated branched tumor evolution during sarcomatoid HCC development and progression. TP53 mutation commonly occurred at tumor initiation, whereas ARID2 mutation often occurred later. Transcriptome analyses revealed the epithelial–mesenchymal transition (EMT) and hypoxic phenotype in sarcomatoid tumor components, which were confirmed by immunohistochemical staining. Moreover, we identified ARID2 mutations in 70% (7/10) of patients with sarcomatoid HCC but only 1–5% of patients with non-sarcomatoid HCC. Biofunctional investigations revealed that inactivating mutation of ARID2 contributes to HCC growth and metastasis and induces EMT in a hypoxic microenvironment.
Conclusions
We offer a comprehensive description of the molecular basis for sarcomatoid HCC, and identify genomic alteration (ARID2 mutation) together with the tumor microenvironment (hypoxic microenvironment), that may contribute to the formation of the sarcomatoid tumor component through EMT, leading to sarcomatoid HCC development and progression.

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