The Molecular Pathogenesis and Clinical Implications of Hepatocellular Carcinoma

The prognosis of hepatocellular carcinoma (HCC) is affected by tumoral factors and liver functions; therefore it is often difficult to select the appropriate therapeutic methods for HCC. Recently, two global phase III trials showed that sorafenib, which is a tyrosine kinase inhibitor, improved the prognosis of patients with advanced HCC. As a new therapeutic strategy for HCC, sorafenib is expected to expand the indication for HCC in the future. However, it alone is insufficient for the molecular-targeted treatment of HCC because the signaling pathway exists not only in cancer cells but also in normal cells. Recently, cancer stem cells (CSCs) have attracted attention as a novel therapeutic target for HCC. There is now much evidence that stem cell properties such as self-renewal, unlimited proliferation, and differentiation are highly relevant to cancer recurrence and the drug resistance of HCC. In this review, we describe the molecular pathogenesis and the current state and future development of molecular- and CSC-therapeutic targeted agents for HCC, citing various reports

Possible ΛcΛc\Lambda_c\Lambda_c molecular bound state

Possible $\Lambda_c\Lambda_c$ hadronic molecule is investigated in the one-pion-exchange potential model. In the study with this model, the heavier meson exchange effects are encoded into a phenomenological cutoff parameter and couplings to the nearby $\Sigma_c\Sigma_c$, $\Sigma_c\Sigma_c^*$, and $\Sigma_c^*\Sigma_c^*$ channels are essential. From the numerical results, we find that a molecular bound state of two $\Lambda_c$'s is possible, where the tensor force plays a crucial role, although the binding energies are sensitive to the cutoff parameter.Comment: 5 pages, 3 tables, 2 figures; publication versio

Prediction of postoperative liver failure and evaluation of modifi ed criteria for liver resection with computed volume analysis

Background/Aims: The exact resectable volume corresponding to liver function has never been elucidated for safe resection of a diseased liver. The aim of this study was to evaluate whether modifi ed criteria for safe liver resection could be used to predict postoperative liver failure/dysfunction.Methodology: Consecutive 86 patients who underwent liver resections were assessed. Clinical laboratory tests and liver volume were evaluated. The modifi ed criteria used to determine safe liver resection consisted of indocyanine green retention rate at 15 min (ICGR15), antithrombin III (ATIII), clearance index (HH15), and receptor index (LHL15). We compared clinical outcomes after liver resection using our modifi ed criteria and Makuuchi criteria. Results: There were 78 patients without liver failure and 8 with liver failure/dysfunction. ICGR15 (P < 0.001), ATIII (P = 0.036), operative time (P = 0.014), tumor type (P = 0.047), modifi ed criteria score (P = 0.037), lost liver volume (P = 0.006), and modifi ed criteria (P= 0.007) were signifi cantly different between the groups. Diagnostic probability of modifi ed criteria (P = 0.007) was better than the one of Makuuchi criteria (P = 0.271).Conclusions: Postoperative liver failure/dysfunction could be predicted using the modifi ed criteria. Furthermore, the criteria could be used to provide a putative liver volume for safe removal.departmental bulletin pape

Short-and Midterm Outcomes of Laparoscopy Assisted Colectomy for Colon and Rectosigmoid Cancer

Background: Laparoscopy-assisted colectomy (LAC) has gained acceptance for the treatment of colon cancer. Objective: To evaluate the use and outcomes of LAC. Patients: Patients who underwent LAC (n = 176) for colon and rectosigmoid cancer (2001-2008). Results: There were 97 men (55.1%) and 79 women(44.9%), whose median age was 67.5 years (range, 33-99 years). The median operating time for patients who underwent LAC was 216 minutes (range, 70-440). The median blood loss was 60 ml (range 10-610 ml). Intra- and postoperative complicacomplications occurred in 3 (1.7%) and 16 patients (9.1%), respectively. The morbidity rate of patients was 0%. The overall survival rates for 3 years were 100.0%, 97.5%, 95.9%, 90.1% and 77.9% for stages 0,Ⅰ,Ⅱ,Ⅲa and Ⅲb, respectively. The relapse-free survival rates for 3 years were 100.0%, 100.0%, 90.1%, 65.7% and 62.3% for stages 0, Ⅰ,Ⅱ,Ⅲa and Ⅲb, respectively. Conclusion: This study confirmed the favorable short-and midterm operative results in patients who underwent LAC

Postoperative Prognosis of Breast Cancer Patients Predicted by p53 Gene Mutation in Cancer Cells Obtained by Aspiration Biopsy

The method of cytological examination by fine needle aspiration biopsy (FNAB) was developed clinically in breast cancer and enabled us to prepare cancer cell nuclei for the detection of p53 gene mutation. In the expectation that this method would improve the prediction of postoperative prognosis, the observation of 10 year survival for breast cancer patients with p53 gene mutations was done. The DNA of the aspirated cells was examined preoperatively for gene alterations in 53 patients with breast cancer. The p53 protein accumulation, DNA ploidy pattern, estrogen receptor (ER) , and clinicopathological factors were examined postoperatively The postoperative follow up was conducted over 10 years and evaluated the status of p53 gene mutation. In 26 patients (49.1%) , 29 p53 gene mutations were shown. p53 protein accumulations and DNA aneuploidy patterns were detected in 33 (62.3%) and 42 (79.2%) cases, respectively, and both significantly correlated with p53 gene mutations. With regard to the postoperative prognosis, in over 10 years of observation, the patients who showed p53 mutations had a significantly worse prognosis in both disease free survival and overall survival than those showing negative p53 mutation. A similar tendency was also seen in patients with histologic grade 3. Using FNAB, the usefulness of the preoperative detection of p53 gene mutation was revealed, suggesting its clinical benefits for predicting a patient\u27s prognosis