1.Primary intracranial DICER1-mutant sarcoma: a clinicopathological analysis of seven cases
Liqiong OU ; Shaoyan XI ; Lingyi FU ; Wenguang ZHANG ; Xinyi XIAN ; Yanhui LIU ; Jingping YUN ; Jing ZENG ; Wanming HU
Chinese Journal of Pathology 2024;53(12):1231-1237
Objective:To investigate the clinicopathological features, immunophenotype, molecular characteristics, and differential diagnosis of primary intracranial DICER1-mutant sarcoma in order to better understand this tumor type.Methods:A retrospective analysis was conducted on 7 cases of primary intracranial DICER1-mutant sarcoma diagnosed in the Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China between 2021 and 2023 using next-generation sequencing. At the same time, 10 gliosarcomas, 4 intracranial FET::CREB fusion-positive mesenchymal tumors, 4 malignant meningiomas, 3 malignant solitary fibrous tumors, 3 malignant peripheral nerve sheath tumors, 3 synovial sarcomas and 3 rhabdomyosarcomas (total 30 cases) were selected as control.Results:Among the 7 patients with primary intracranial DICER1-mutant sarcoma, 6 were male and 1 was female, aged 10-32 years (median, 23 years). The tissue morphology was predominantly spindle or pleomorphic sarcoma-like, with 6 cases exhibiting eosinophilic globules, and 3 cases showing rhabdomyoblastic or rhabdomyosarcoma-like cell differentiation. Immunohistochemistry revealed focal desmin expression in 3 cases (3/7), ATRX loss in 3 cases (3/7), and p53 mutant pattern in 4 cases (4/7). Additionally, 4 cases (4/7) showed focal or diffuse SALL4 expression, whereas the control cases (30 cases) did not exhibit SALL4 protein expression, suggesting that SALL4 may possess certain auxiliary diagnostic value. Next-generation sequencing confirmed that all 7 cases of primary intracranial DICER1-mutant sarcoma harbored mutations in the DICER1 gene, with 5 cases having the mutation site at p.E1813D. Until May 2024, all 7 patients were alive.Conclusions:Primary intracranial DICER1-mutant sarcoma is a rare tumor. Understanding its morphological characteristics, immunohistochemical and molecular markers and differential diagnosis is crucial to avoid misdiagnosis and to improve diagnostic accuracy of this tumor.
2.Effect and mechanism of safranal in a mouse model of sepsis-related liver injury induced by lipopolysaccharide
Yi CHEN ; Yifan CHEN ; Yichao DU ; Peng TAN ; Tongxi LI ; Junjie BAI ; Wenguang FU
Journal of Clinical Hepatology 2023;39(11):2643-2650
ObjectiveTo investigate the protective effect of safranal against sepsis-related liver injury (SRLI) induced by lipopolysaccharide (LPS) in mice and its mechanism. MethodsA total of 32 experimental male C57BL/6 mice were divided into control group, single drug group, model group, and treatment group using the simple random method, with 8 mice in each group. The mice in the single drug group and the treatment group were intraperitoneally injected with safranal (60 mg/kg) for 7 days of pretreatment, and the mice in the model group and the treatment group were intraperitoneally injected with LPS (10 mg/kg) to induce acute liver injury. The activities of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured; HE staining was used to observe liver tissue sections; immunohistochemistry was used to analyze the expression of the downstream protein heme oxygenase-1 (HO-1) in the signal pathway; TUNEL was used to analyze the apoptosis of hepatocytes; Western blot was used to measure the expression of total proteins (nuclear factor erythroid 2-related factor 2 [Nrf-2] and HO-1) in liver tissue. The human liver cell line L02 was pretreated with safranal (100 μmol/L), followed by induction of acute hepatocellular injury with LPS (100 ng/mL), and DCFH-DA fluorescent labeling was used to detect reactive oxygen species (ROS). ResultsAfter safranal pretreatment, the treatment group had significantly lower levels of ALT and AST than the model group (both P<0.001), with a relatively intact pseudolobular structure and a smaller necrotic area in the liver. Compared with the model group, the treatment group had significant increases in the expression levels of Nrf2 and HO-1 in liver tissue after safranal+LPS treatment (both P<0.001), and immunohistochemistry showed that safranal pretreatment increased the number of HO-1-positive cells. In the cell model of LPS-induced acute liver injury, the treatment group had a significant reduction in the production of ROS compared with the model group. ConclusionSafranal can exert a protective effect against SRLI induced by LPS in mice through the Nrf2/HO-1 pathway.
3.Value of the nomogram based on HALP score in predicting the prognosis of patients with hepatocellular carcinoma after hepatectomy
Zhuoran LIU ; Jing LI ; Yu ZHOU ; Pingfu XIONG ; Li YANG ; Wenguang FU
Journal of Clinical Hepatology 2023;39(7):1600-1608
Objective To investigate the value of HALP score in evaluating the prognosis of patients with hepatocellular carcinoma (HCC) after hepatectomy and whether the nomogram based on HALP score could effectively predict the postoperative survival of patients. Methods A retrospective study was performed for the clinical data of 253 HCC patients who underwent surgical treatment in Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, from July 2013 to March 2020. The receiver operating characteristic (ROC) curve was plotted to calculate the optimal cut-off values of HALP score and other related indicators; the chi-square test was used to investigate the association between HALP score and clinicopathological features; the Kaplan-Meier method was used to plot survival curves, and the Log-rank test method was used for comparison. The univariate and multivariate Cox regression analyses were used to investigate the association of HALP score and other clinical parameters with the prognosis of patients. R3.6 was used to establish a nomogram; C-index and calibration curve were used to evaluate the predictive ability of the nomogram, and net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to compare predictive ability between the nomogram model and the conventional model. Results The Kaplan-Meier analysis showed that the high HALP group had significantly better overall survival (OS) and recurrence-free survival (RFS) than the low HALP group ( P < 0.001). The univariate Cox regression analysis showed that white blood cell count, gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), alpha-fetoprotein (AFP), surgical approach, microvascular invasion, TNM stage, degree of tumor differentiation, HALP, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR) were significantly associated with OS (all P < 0.05). The variables with statistical significance in the univariate Cox regression analysis were included in the multivariate Cox regression analysis, and the results showed that ALP, AST/ALT ratio, ALP, AFP, degree of tumor differentiation, and TNM stage were independent influencing factors for OS after surgery in HCC patients (all P < 0.05). The univariate Cox regression analysis showed that GGT, ALP, AFP, microvascular invasion, TNM stage, degree of tumor differentiation, HALP, AST/ALT ratio, NLR, and MLR were significantly associated with RFS (all P < 0.05), and the multivariate Cox regression analysis showed that HALP, AST/ALT ratio, NLR, ALP, AFP, and TNM stage were independent influencing factors for RFS after surgery in HCC patients (all P < 0.05). The nomograms for OS and RFS of HCC patients were established based on the multivariate analysis. The nomogram for OS had a C-index of 0.732 (95% confidence interval [ CI ]: 0.691-0.774) and an area under the ROC curve of 0.795, 0.791, and 0.775, respectively, in predicting 1-, 3-, and 5-year survival rates, and the nomogram for RFS had a C-index of 0.677 (95% CI : 0.637-0.717) and an area under the ROC curve of 0.742, 0.733, and 0.716, respectively, in predicting 1-, 3-, and 5-year survival rates. The calibration curves of 1-, 3-, and 5-year OS were well fitted to those of 1-, 3-, and 5-year RFS. Conclusion A low level of HALP before surgery is a predictive factor for poor long-term prognosis in HCC patients undergoing surgical treatment, and the nomogram model based on HALP score is superior to the BCLC staging model and can better predict the prognosis of HCC.
4.Research advances in the role of
Boyuan GU ; Shengyou XIAO ; Chen LIU ; Yonglang CHENG ; Wenguang FU
Journal of Clinical Hepatology 2023;39(7):1696-1702
Alcoholic liver disease (ALD) is one of the most common chronic liver diseases worldwide and includes the different stages of steatosis, steatohepatitis, fibrosis, and liver cirrhosis. Enterococcus faecalis is a common bacterium for nosocomial infection and has a significant impact on the prognosis of patients with alcoholic hepatitis. This review mainly introduces the pathogenesis of ALD and the pathogenic mechanism of E. faecalis , summarizes the research advances in E. faecalis in ALD, and briefly describes the detection and treatment methods for E. faecalis infection in clinical practice. Since there is an extremely high mortality rate in ALD patients with lytic E. faecalis infection, an in-depth understanding of E. faecalis has become an important issue nowadays.
5.Research progress on AMPK activation in nonalcoholic fatty liver disease
Xinyu YE ; Tongxi LI ; Zhiwei HUANG ; Wenguang FU ; Qiu LI
Chinese Journal of Hepatology 2023;31(11):1220-1223
Nonalcoholic fatty liver disease (NAFLD) occurrence and progression are associated with lipid accumulation, insulin resistance, inflammation, liver damage, fibrosis, and other factors. AMP-dependent protein kinase (AMPK) is a key molecule that regulates bioenergy metabolism and participates in multiple biological processes, including lipid metabolism, autophagy, inflammation, and cell apoptosis. Promoting AMPK activation can reduce hepatic lipid accumulation and insulin resistance, alleviate the development of NAFLD, reduce liver inflammation and fibrosis, and inhibit the progression of NAFLD to nonalcoholic steatohepatitis.
6.Protective effect of tanshinone I in a mouse model of hepatic ischemia-reperfusion injury
Xiaokang YI ; Yichao DU ; Baolin QIAN ; Zhiwei HUANG ; Qiu LI ; Wenguang FU ; Jian WEN
Journal of Clinical Hepatology 2021;37(1):105-109
ObjectiveTo investigate the protective effect of tanshinone I (T-I) on hepatic ischemia-reperfusion injury (HIRI) in mice. MethodsA total of 36 C57BL/6J mice were randomly divided into sham-operation group, ischemia-reperfusion (IR) group, IR+T-I (5 mg/kg) group, IR+T-I (10 mg/kg) group, IR+T-I (20 mg/kg) group, and IR+T-I (40 mg/kg) group, with 6 mice in each group. Each group was given intraperitoneal injection. The mice in the sham-operation group and the IR group were injected with an equal volume of the solvent olive oil; the mice in the IR+T-I groups were administered once a day for 7 consecutive days, a model of 70% HIRI was established at 2 hours after the last administration, and serum and liver samples were collected after 6 hours of reperfusion. Related kits were used to measure the serum level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and the content of superoxide dismutase (SOD), malondialdehyde (MDA), caspase-3, and reduced glutathione (GSH) in liver tissue; HE staining was used to observe liver histopathology; the TUNEL method was used to measure the level of hepatocyte apoptosis; immunohistochemistry was used to measure the protein expression of caspase-3 and heme oxygenase-1 (HO-1). A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the IR group, the IR+T-I (20mg/kg) group had significant reductions in the serum levels of ALT (192.48±23.67 U/L vs 336.90±41.52 U/L, P<0.01) and AST (123.19±9.16 U/L vs 206.90±18.81 U/L, P<0.01), and thus 20 mg/kg was determined as the optimal concentration. Compared with the IR group, the IR+T-I (20 mg/kg) group had significant reductions in MDA (1.34±0.21 μmol/mg vs 3.48±0.95 μmol/mg, P<0.05) and caspase-3 (0.69±0.97 μmol/mg vs 1.04±0.35 μmol/mg, P<0.05) and significant increases in SOD (274.47±30.53 U/mg vs 160.29±27.37 U/mg, P<0.05) and GSH (2.12±0.27 μmol/mg vs 1.03±0.42 μmol/mg, P<0.05). HE staining showed that the IR group had disordered structure of hepatic lobules and focal or extensive degeneration and necrosis of hepatocytes; compared with the IR group, the IR+T-I (20 mg/kg) group had a reduction in the area of hepatocyte necrosis and a basically complete structure of the liver. Immunohistochemistry showed that compared with the IR group, the IR+T-I (20 mg/kg) group had significant reductions in the number of apoptotic hepatocytes and the protein expression of caspase-3 and a significant increase in the protein expression of HO-1. ConclusionT-I exerts a protective effect against HIRI in mice by inhibiting liver oxidative stress response and hepatocyte apoptosis.
7.Research advances in Kupffer cells participating in the regulation of hepatocellular carcinoma
Pingfu XIONG ; Hao CHEN ; Wenguang FU ; Peng TAN ; Yonglang CHENG ; Jing LI
Journal of Clinical Hepatology 2021;37(10):2448-2451
Hepatocellular carcinoma (HCC) is a common type of primary liver cancer with high mortality worldwide. Among the common malignant tumors in China, HCC ranks fourth in terms of incidence rate and ranks second in terms of mortality, which seriously threatens the health and life safety of the Chinese people. This article mainly introduces the dual role of Kupffer cells (KCs) in HCC and briefly describes its interaction with liver parenchymal cells and nonparenchymal cells and related targeted treatment methods. The analysis shows that in-depth research on KCs in the regulation of HCC helps to provide new ideas for further treatment of HCC.
8.Research progress of mitochondrial dysfunction in pancreatic diseases
Yonglang CHENG ; Meizhou HUANG ; Hao CHEN ; Baolin QIAN ; Zhiwei HUANG ; Wenguang FU
Chinese Journal of Hepatobiliary Surgery 2021;27(8):637-640
Mitochondrial dysfunction is closely related to the occurrence and development of benign and malignant diseases of the pancreas. Mitochondrial membrane of the respiratory chain electron transfer and energy transfer plays an important role in maintaining normal cellular function. When the respiratory chain was disrupted, the oxidative stress was increased in the cell, and produced a large number of oxide intermediate products which target mitochondrial protein, DNA, etc, lead to mitochondrial dysfunction finally induced acute pancreatitis, pancreatic cancer and other diseases. In addition, mitochondrial homeostasis plays an indispensable role in maintaining the normal function of islet cells. This paper reviewed the research status of mitochondrial dysfunction in pancreatic diseases.
9.Research progress of hepatic non-parenchymal cells in nonalcoholic steatohepatitis
Tianxiang ZHENG ; Rong LI ; Peng TAN ; Meizhou HUANG ; Baolin QIAN ; Hao CHEN ; Wenguang FU
Chinese Journal of Hepatology 2021;29(7):711-715
Non-alcoholic steatohepatitis (NASH) is an important link for the progression of metabolic-related fatty liver disease to end-stage liver disease such as cirrhosis and hepatocellular carcinoma, which seriously endangers human health. NASH pathogenesis is complex, and involves the interaction between hepatic parenchymal and non-parenchymal cells (NPCs), sinusoidal endothelial cells, Kupffer cells, hepatic stellate cells, and so on. Herein, the relevant research progress of NPCs in the pathogenesis of NASH is reviewed in order to further understand the role of NPCs in NASH.
10.Research progress of interleukin-6 in pancreatic diseases
Rong LI ; Hao SHI ; Hao CHEN ; Ankang WANG ; Zhengming LEI ; Wenguang FU
Chinese Journal of Hepatobiliary Surgery 2020;26(6):476-480
Acute pancreatitis, chronic pancreatitis and pancreatic ductal adenocarcinoma are common pancreatic diseases. Interleukin-6 (IL-6) is a multipotent cytokine, which plays an important role in the differentiation of the severity of pancreatic diseases, prognosis and treatment of pancreatic diseases. This article reviews recent studies on the role of IL-6 in pancreatic diseases.

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