Pub Date : 2024-01-17DOI: 10.1186/s43066-024-00310-1
Kashif Asghar, Shaarif Bashir, Muhammad Hassan, Asim Farooq, Muhammad Abu Bakar, Sundus Bilal, Maryam Hameed, Shafqat Mehmood, Asif Loya
Hepatocellular carcinoma (HCC) is a highly aggressive and rapidly progressing form of cancer with a poor prognosis. Recent advances in the management of HCC focused on the novel immunotherapeutic modalities for patients with advanced disease. PD-L1 has emerged as a promising immunotherapeutic approach for HCC. The evaluation of PD-L1 expression aids in identifying patients who can derive maximum benefits from these therapies. This study aims to examine and compare the expression of PD-L1 using two clones (22C3 and 28-8) in HCC patients. Forty-six patients with HCC were selected between 2005 and 2022 from the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan. The patients' formalin-fixed paraffin-embedded (FFPE) tissue samples were retrieved from the department of pathology to conduct immunohistochemical analysis. Moreover, the clinicopathological data of these patients were gathered from the hospital information system (HIS). To assess the relationship between variables, bivariate analysis was carried out using either the chi-square test or Fisher exact test when necessary. Among the 46 tissue specimens analyzed, the presence of clone 22C3 was detected in 20 HCC patients, with 10 patients showing high expression (21.7%) and another 10 patients showing low expression (21.7%). 22C3 expression was not observed in 26 patients (56.5%). On the other hand, clone 28-8 was expressed in 10 patients, all of whom exhibited low expression (21.7%), while no expression of clone 28-8 was observed in 36 patients (78.3%). An association was found between the expression of 22C3 and 28-8 PD-L1 clones (p-value 0.01). Furthermore, upon closer examination, it was revealed that 12 cases exhibited positive results for 22C3 but negative results for 28-8. Interestingly, two cases displayed positive results for 28-8 but negative results for 22C3. We obserevd that the PD-L1 clones, 22C3 and 28-8, are comparable. If PD-L1 expression using 22C3 is negative, considering the use of 28-8 for evaluating expression in HCC patients may be beneficial. However, further validation in a larger cohort is necessary.
{"title":"Expression of PD-L1 clones (22C3 and 28-8) in hepatocellular carcinoma: a tertiary cancer care hospital experience","authors":"Kashif Asghar, Shaarif Bashir, Muhammad Hassan, Asim Farooq, Muhammad Abu Bakar, Sundus Bilal, Maryam Hameed, Shafqat Mehmood, Asif Loya","doi":"10.1186/s43066-024-00310-1","DOIUrl":"https://doi.org/10.1186/s43066-024-00310-1","url":null,"abstract":"Hepatocellular carcinoma (HCC) is a highly aggressive and rapidly progressing form of cancer with a poor prognosis. Recent advances in the management of HCC focused on the novel immunotherapeutic modalities for patients with advanced disease. PD-L1 has emerged as a promising immunotherapeutic approach for HCC. The evaluation of PD-L1 expression aids in identifying patients who can derive maximum benefits from these therapies. This study aims to examine and compare the expression of PD-L1 using two clones (22C3 and 28-8) in HCC patients. Forty-six patients with HCC were selected between 2005 and 2022 from the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan. The patients' formalin-fixed paraffin-embedded (FFPE) tissue samples were retrieved from the department of pathology to conduct immunohistochemical analysis. Moreover, the clinicopathological data of these patients were gathered from the hospital information system (HIS). To assess the relationship between variables, bivariate analysis was carried out using either the chi-square test or Fisher exact test when necessary. Among the 46 tissue specimens analyzed, the presence of clone 22C3 was detected in 20 HCC patients, with 10 patients showing high expression (21.7%) and another 10 patients showing low expression (21.7%). 22C3 expression was not observed in 26 patients (56.5%). On the other hand, clone 28-8 was expressed in 10 patients, all of whom exhibited low expression (21.7%), while no expression of clone 28-8 was observed in 36 patients (78.3%). An association was found between the expression of 22C3 and 28-8 PD-L1 clones (p-value 0.01). Furthermore, upon closer examination, it was revealed that 12 cases exhibited positive results for 22C3 but negative results for 28-8. Interestingly, two cases displayed positive results for 28-8 but negative results for 22C3. We obserevd that the PD-L1 clones, 22C3 and 28-8, are comparable. If PD-L1 expression using 22C3 is negative, considering the use of 28-8 for evaluating expression in HCC patients may be beneficial. However, further validation in a larger cohort is necessary.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"32 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139483022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-08DOI: 10.1186/s43066-024-00309-8
Khaled Mohamed Abdelwahab, Wesam Ahmed Ibrahim, Shereen Abou Bakr Saleh, Anas Abdelfattah Abdelaziz Elbarky, Ghada Abdelrahman Mohamed
Hepatocellular carcinoma (HCC) is one of the most prevalent and fatal malignancies worldwide. Following an increase in reactive oxygen species (ROS), cancer cells enter an oxidative stress state. As a result, these cells experience an increase in antioxidant activity to counteract oxidative stress. The thioredoxin (TRX) system is a ubiquitous mammalian antioxidant system that neutralizes ROS and maintains intracellular reduction oxidation (redox) balance, which is essential for HCC growth. However, the role of TRX protein in HCC remains largely unknown. Hence, we aimed to assess the diagnostic utility of serum TRX in patients with HCC. A total of 50 patients were consecutively recruited in this observational study. They were classified into three groups: an HCC group (25 patients), a cirrhosis group (15 patients with liver cirrhosis on top of chronic HCV infection), and a control group (10 healthy individuals). Serum TRX levels were measured using ELISA. Higher serum TRX levels were detected in the HCC group than in the cirrhosis and control groups (140.96 ± 12.70 vs 88.33 ± 10.34 vs 73.10 ± 13.22 ng/mL, respectively; P < 0.001). TRX was independently associated with the presence of HCC (P < 0.001). Regarding the detection of HCC, TRX at a cut-off value of 114 ng/mL had superior diagnostic performance to AFP with an AUC of 1.000, sensitivity of 100%, and specificity of 100%, whereas AFP at a cut-off value of 20.5 ng/mL had an AUC of 1.000, sensitivity of 100%, and specificity of 47%. Thioredoxin has the potential to be an HCC diagnostic marker. The clinical significance of thioredoxin in HCC requires further investigation.
{"title":"Evaluation of serum thioredoxin as a hepatocellular carcinoma diagnostic marker","authors":"Khaled Mohamed Abdelwahab, Wesam Ahmed Ibrahim, Shereen Abou Bakr Saleh, Anas Abdelfattah Abdelaziz Elbarky, Ghada Abdelrahman Mohamed","doi":"10.1186/s43066-024-00309-8","DOIUrl":"https://doi.org/10.1186/s43066-024-00309-8","url":null,"abstract":"Hepatocellular carcinoma (HCC) is one of the most prevalent and fatal malignancies worldwide. Following an increase in reactive oxygen species (ROS), cancer cells enter an oxidative stress state. As a result, these cells experience an increase in antioxidant activity to counteract oxidative stress. The thioredoxin (TRX) system is a ubiquitous mammalian antioxidant system that neutralizes ROS and maintains intracellular reduction oxidation (redox) balance, which is essential for HCC growth. However, the role of TRX protein in HCC remains largely unknown. Hence, we aimed to assess the diagnostic utility of serum TRX in patients with HCC. A total of 50 patients were consecutively recruited in this observational study. They were classified into three groups: an HCC group (25 patients), a cirrhosis group (15 patients with liver cirrhosis on top of chronic HCV infection), and a control group (10 healthy individuals). Serum TRX levels were measured using ELISA. Higher serum TRX levels were detected in the HCC group than in the cirrhosis and control groups (140.96 ± 12.70 vs 88.33 ± 10.34 vs 73.10 ± 13.22 ng/mL, respectively; P < 0.001). TRX was independently associated with the presence of HCC (P < 0.001). Regarding the detection of HCC, TRX at a cut-off value of 114 ng/mL had superior diagnostic performance to AFP with an AUC of 1.000, sensitivity of 100%, and specificity of 100%, whereas AFP at a cut-off value of 20.5 ng/mL had an AUC of 1.000, sensitivity of 100%, and specificity of 47%. Thioredoxin has the potential to be an HCC diagnostic marker. The clinical significance of thioredoxin in HCC requires further investigation.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"110 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139398107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-02DOI: 10.1186/s43066-023-00306-3
Tamer A. Addissouky, Ibrahim El Tantawy El Sayed, Majeed M. A. Ali, Yuliang Wang, Ayman El Baz, Ahmed A. Khalil, Naglaa Elarabany
Hepatocellular carcinoma (HCC) is a common type of liver cancer, with a high mortality rate. Hepatocellular carcinoma is a type of liver cancer that can be effectively managed through early detection and accurate diagnosis, followed by a personalized treatment plan that may include surgical resection, liver transplantation, minimally-invasive techniques, immunotherapy, or targeted therapy depending on the stage and severity of the cancer. This paper discusses recent advances in the early detection, management, and prevention of HCC. The use of newer imaging techniques, such as Magnetic resonance imaging (MRI) and contrast-enhanced ultrasound, along with image segmentation technology and deep learning models, have greatly enhanced the accuracy of HCC detection and diagnosis. Minimally-invasive techniques, such as thermal ablation and radiofrequency ablation, have allowed for more precise and targeted destruction of tumors, while Nanoparticles, immunotherapy and targeted therapy have shown promise in the management of advanced stage HCC. The use of Artificial intelligence (AI) and machine learning has revolutionized HCC research, aiding in the identification of high-risk patients and predicting outcomes. Lifestyle modifications, such as weight management, alcohol avoidance, and hepatitis B vaccinations, can play a critical role in preventing HCC development. Recent advances in early detection, management, and prevention of HCC have shown promise in improving patient outcomes. The use of newer imaging techniques, minimally-invasive techniques, immunotherapy, targeted therapy, and AI and machine learning have greatly enhanced HCC research and management, while lifestyle modifications can play a critical role in prevention. However, further research is required to fully understand the potential benefits of nanoparticles, traditional Chinese medicine and herbal medicines in HCC treatment. • Early detection and diagnosis: The advent of newer imaging techniques, such as MRI, contrast-enhanced ultrasound, and image segmentation technology, has allowed for earlier and more accurate detection of HCC, with higher sensitivity and specificity than previous techniques. Advances in radiomics and deep learning models have greatly enhanced the accuracy of HCC diagnosis. • AI and machine learning: The use of AI and machine learning has revolutionized HCC research, with greater accuracy and an ability to analyze large volumes of data. AI-based predictive models have been shown to be helpful in identifying high-risk patients and predicting outcomes. • Management: While surgical resection and liver transplantation remain effective treatments for early-stage HCC, advances in minimally-invasive techniques, such as thermal ablation and radiofrequency ablation, have allowed for more precise and targeted destruction of tumors. Additionally, nanoparticles, immunotherapy and targeted therapy have shown significant promise in the management of advanced stage HCC. • Prevention
{"title":"Latest advances in hepatocellular carcinoma management and prevention through advanced technologies","authors":"Tamer A. Addissouky, Ibrahim El Tantawy El Sayed, Majeed M. A. Ali, Yuliang Wang, Ayman El Baz, Ahmed A. Khalil, Naglaa Elarabany","doi":"10.1186/s43066-023-00306-3","DOIUrl":"https://doi.org/10.1186/s43066-023-00306-3","url":null,"abstract":"Hepatocellular carcinoma (HCC) is a common type of liver cancer, with a high mortality rate. Hepatocellular carcinoma is a type of liver cancer that can be effectively managed through early detection and accurate diagnosis, followed by a personalized treatment plan that may include surgical resection, liver transplantation, minimally-invasive techniques, immunotherapy, or targeted therapy depending on the stage and severity of the cancer. This paper discusses recent advances in the early detection, management, and prevention of HCC. The use of newer imaging techniques, such as Magnetic resonance imaging (MRI) and contrast-enhanced ultrasound, along with image segmentation technology and deep learning models, have greatly enhanced the accuracy of HCC detection and diagnosis. Minimally-invasive techniques, such as thermal ablation and radiofrequency ablation, have allowed for more precise and targeted destruction of tumors, while Nanoparticles, immunotherapy and targeted therapy have shown promise in the management of advanced stage HCC. The use of Artificial intelligence (AI) and machine learning has revolutionized HCC research, aiding in the identification of high-risk patients and predicting outcomes. Lifestyle modifications, such as weight management, alcohol avoidance, and hepatitis B vaccinations, can play a critical role in preventing HCC development. Recent advances in early detection, management, and prevention of HCC have shown promise in improving patient outcomes. The use of newer imaging techniques, minimally-invasive techniques, immunotherapy, targeted therapy, and AI and machine learning have greatly enhanced HCC research and management, while lifestyle modifications can play a critical role in prevention. However, further research is required to fully understand the potential benefits of nanoparticles, traditional Chinese medicine and herbal medicines in HCC treatment. • Early detection and diagnosis: The advent of newer imaging techniques, such as MRI, contrast-enhanced ultrasound, and image segmentation technology, has allowed for earlier and more accurate detection of HCC, with higher sensitivity and specificity than previous techniques. Advances in radiomics and deep learning models have greatly enhanced the accuracy of HCC diagnosis. • AI and machine learning: The use of AI and machine learning has revolutionized HCC research, with greater accuracy and an ability to analyze large volumes of data. AI-based predictive models have been shown to be helpful in identifying high-risk patients and predicting outcomes. • Management: While surgical resection and liver transplantation remain effective treatments for early-stage HCC, advances in minimally-invasive techniques, such as thermal ablation and radiofrequency ablation, have allowed for more precise and targeted destruction of tumors. Additionally, nanoparticles, immunotherapy and targeted therapy have shown significant promise in the management of advanced stage HCC. • Prevention","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"175 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139083467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-02DOI: 10.1186/s43066-023-00304-5
Edite Sadiku, Liri Cuko, Ina Pasho, Orion Jucja, Stela Taci, Kliti Hoti, Bledar Kraja
Acute gastrointestinal bleeding (GIB) is a significant medical condition that poses a considerable burden on healthcare systems worldwide. To effectively manage and improve outcomes for patients, it is essential to have comprehensive epidemiologic data on GIB, including its various aspects such as upper and lower GIB, treatment modalities, and overall mortality rates. The objective of this study is to present the first epidemiological data on acute gastrointestinal bleeding in our country, which includes a comprehensive analysis of upper and lower AGIB, as well as the use of endoscopic and surgical treatments, and an assessment of overall mortality rates for the year 2015. A retrospective analysis of medical records and databases was conducted to gather epidemiologic data related to acute GIB cases during the specified period. Patient demographics, clinical characteristics, diagnostic findings, treatment approaches (including endoscopic and surgical interventions), and overall mortality rates were evaluated and analyzed. The study included a total of 926 patients with acute gastrointestinal bleeding during 2015. Among them, 70% presented with upper gastrointestinal bleeding (UGIB), while 30% had lower gastrointestinal bleeding (LGIB). The remaining cases involved both upper and lower GIB. Regarding treatment modalities, 80% of patients with UGIB underwent endoscopic interventions, which included various techniques such as endoscopic hemostasis, band ligation, and sclerotherapy. On the other hand, 60% of patients with LGIB required surgical intervention due to the severity or complexity of their bleeding. The overall mortality rate for acute GIB during the study period was calculated to be 8%. Subgroup analysis revealed that patients with UGIB had a mortality rate of 5%, while patients with LGIB had a mortality rate of 10%. This study provides important epidemiologic data on acute gastrointestinal bleeding, focusing on upper and lower GIB, endoscopic and surgical treatment approaches, and overall mortality rates during the year 2015 in Albania. It refers to the first data, not published and gathered on this therapeutic field, that can be used as a reference for comparison in the latest publications and reports. Our study results showed that the higher incidence of UGIB compared to LGIB highlights the need for focused attention on upper gastrointestinal pathologies as significant contributors to GIB cases. The utilization of endoscopic interventions as the primary treatment modality for UGIB indicates the effectiveness and importance of timely endoscopic evaluation and intervention in controlling bleeding and improving patient outcomes. Based on the findings of this initial study, our future research endeavors were primarily focused on investigating patients within the upper gastrointestinal bleeding (UGIB) cohort.
{"title":"Epidemiologic data on acute gastrointestinal bleeding in Albania: an overview of upper and lower GI bleeding","authors":"Edite Sadiku, Liri Cuko, Ina Pasho, Orion Jucja, Stela Taci, Kliti Hoti, Bledar Kraja","doi":"10.1186/s43066-023-00304-5","DOIUrl":"https://doi.org/10.1186/s43066-023-00304-5","url":null,"abstract":"Acute gastrointestinal bleeding (GIB) is a significant medical condition that poses a considerable burden on healthcare systems worldwide. To effectively manage and improve outcomes for patients, it is essential to have comprehensive epidemiologic data on GIB, including its various aspects such as upper and lower GIB, treatment modalities, and overall mortality rates. The objective of this study is to present the first epidemiological data on acute gastrointestinal bleeding in our country, which includes a comprehensive analysis of upper and lower AGIB, as well as the use of endoscopic and surgical treatments, and an assessment of overall mortality rates for the year 2015. A retrospective analysis of medical records and databases was conducted to gather epidemiologic data related to acute GIB cases during the specified period. Patient demographics, clinical characteristics, diagnostic findings, treatment approaches (including endoscopic and surgical interventions), and overall mortality rates were evaluated and analyzed. The study included a total of 926 patients with acute gastrointestinal bleeding during 2015. Among them, 70% presented with upper gastrointestinal bleeding (UGIB), while 30% had lower gastrointestinal bleeding (LGIB). The remaining cases involved both upper and lower GIB. Regarding treatment modalities, 80% of patients with UGIB underwent endoscopic interventions, which included various techniques such as endoscopic hemostasis, band ligation, and sclerotherapy. On the other hand, 60% of patients with LGIB required surgical intervention due to the severity or complexity of their bleeding. The overall mortality rate for acute GIB during the study period was calculated to be 8%. Subgroup analysis revealed that patients with UGIB had a mortality rate of 5%, while patients with LGIB had a mortality rate of 10%. This study provides important epidemiologic data on acute gastrointestinal bleeding, focusing on upper and lower GIB, endoscopic and surgical treatment approaches, and overall mortality rates during the year 2015 in Albania. It refers to the first data, not published and gathered on this therapeutic field, that can be used as a reference for comparison in the latest publications and reports. Our study results showed that the higher incidence of UGIB compared to LGIB highlights the need for focused attention on upper gastrointestinal pathologies as significant contributors to GIB cases. The utilization of endoscopic interventions as the primary treatment modality for UGIB indicates the effectiveness and importance of timely endoscopic evaluation and intervention in controlling bleeding and improving patient outcomes. Based on the findings of this initial study, our future research endeavors were primarily focused on investigating patients within the upper gastrointestinal bleeding (UGIB) cohort.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"81 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139079479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}