AimTo study predictive factors for hepatic decompensation after transarterial chemoembolisation (TACE) for hepatocellular carcinoma (HCC).MethodsBetween November 2009 and August 2010, of 254 patients with HCC who presented to our multidisciplinary HCC clinic for evaluation, 102 (40%) were amenable for TACE. In this prospective study, there were 102 patients with compensated cirrhosis with HCC and Child-Pugh Class A cirrhosis who underwent TACE at the National Liver Institute, Menoufiya University, Egypt. We excluded all patients with prior locoregional therapy, systemic therapy and/or surgical intervention. At baseline and at 1 month postprocedure, laboratory criteria, tumour criteria (size, number) and Child-Pugh score were recorded. Patients were classified into group 1 (no Child-Pugh point increase after TACE) and group 2 (one or more added Child-Pugh points after TACE, defining hepatic decompensation). Univariate and multivariate analyses were performed to identify factors predictive of hepatic decompensation.ResultsPatients were mostly males (82.4%) of mean age 58.4±8.1 years. The only significant changes in laboratory findings at 1 month after TACE were increased international normalised ratio, serum total bilirubin, alanine transaminase and aspartate transaminase and decreased serum albumin and α-fetoprotein (AFP). The statistically significant predictive factors for hepatic decompensation using univariate analysis were found to be baseline lower serum albumin, higher serum α-fetoprotein, more advanced Barcelona Clinic Liver Cancer (BCLC) stage, larger tumour size and a greater number of tumour nodules; with logistic regression, multivariate analysis found that at baseline larger tumour size (p=0.004 at 95% CI), higher serum AFP (p=0.046 at 95% CI) and lower serum albumin (p=0.033 at 95% CI) predicted decompensation; BCLC stage, number of tumour nodules and pre-TACE bilirubin did not predict changes in liver function.ConclusionsLower serum albumin and increased tumour burden (larger tumour size/more nodules and higher α-fetoprotein) at baseline may help predict post-TACE decompensation.
Aberrant expression of miRNAs has a link with tumorgenesis and their deregulation is reported in biological fluids of cancer patients. Authors aimed to investigate the diagnostic role of miRNA-17-5p, miR-155 and miRNA-222 in serum samples from breast cancer patients (n = 80), benign breast patients (n = 40) and healthy individuals (n = 30) using quantitative real-time PCR technique. Median levels of investigated markers revealed significant increase in primary breast cancer followed by benign and control groups. Investigated miRNAs reported significant relation with clinical stages and histological grading, while only miRNA-17-5p showed significant relation with hormone receptors. When considering investigated miRNAs as compared to tumor marker, their sensitivities were superior over tumor markers for early diagnosis of breast cancer, detection of early stages and low grades breast cancer patients. In conclusion, detection of the miRNA-17-5p, miR-155 and miRNA-222 expression levels in serum samples is significant promising molecular markers for early breast cancer diagnosis.
Aim: Transforming growth factor (TGF) is overexpressed by tumor cells like other proteins and growth factors. TGF-β1 is then activated in the extracellular compartment but is unable to control cell proliferation because of the absence or low level of TGF-β1 receptors on the plasma membrane of malignant hepatocytes. This potential mechanism might interrupt the autocrine regulation loop of TGF-β1 and its blocking effect on cell proliferation. TGF-β1 is a multifunctional cytokine involved in the regulation of growth and differentiation of both normal and transformed cells. This study aimed to evaluate the association of serum levels of TGF-β1 with disease severity. Methods: A total of 180 subjects were classified into 6 groups according to Barcelona clinic liver cancer (BCLC) classification, 30 patients each: early (BCLC 0 and A), intermediate (BCLC B), advanced stage (BCLC C), and terminal stage (BCLC D) of hepatocellular carcinoma as well as 1 group of patients with cirrhosis only and 1 control group. Serum levels of TGF β1 were measured. Results: Serum levels of TGF-β1 were significantly higher in patients with HCC (1,687.47 ± 1,462.81 pg/mL) than cirrhotics (487.98 ± 344.23 pg/mL, P < 0.001) and controls (250.16 ± 284.61 pg/mL, P < 0.001). Conclusion: TGF-β1 may have a role in tumor growth and progression.
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