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Gastric Metastasis from Hepatocellular Carcinoma: A Rare Manifestation

Abdul Hakim MS, Azmi AN, Jayalakshmi P, Mahadeva S

J Gastrointest Cancer, 2018 Sep;49(3):346-348.
PMID: 28066868 DOI: 10.1007/s12029-016-9913-6
Matched MeSH terms: Carcinoma, Hepatocellular/secondary*
Sulforaphane is superior to glucoraphanin in modulating carcinogen-metabolising enzymes in Hep G2 cells

Abdull Razis AF, Noor NM

Asian Pac J Cancer Prev, 2013;14(7):4235-8.
PMID: 23991982

Glucoraphanin is the main glucosinolate found in broccoli and other cruciferous vegetables (Brassicaceae). The objective of the study was to evaluate whether glucoraphanin and its breakdown product sulforaphane, are potent modulators of various phase I and phase II enzymes involved in carcinogen-metabolising enzyme systems in vitro. The glucosinolate glucoraphanin was isolated from cruciferous vegetables and exposed to human hepatoma cell line HepG2 at various concentrations (0-25 μM) for 24 hours. Glucoraphanin at higher concentration (25 μM) decreased dealkylation of methoxyresorufin, a marker for cytochrome P4501 activity; supplementation of the incubation medium with myrosinase (0.018 U), the enzyme that converts glucosinolate to its corresponding isothiocyanate, showed minimal induction in this enzyme activity at concentration 10 μM. Quinone reductase and glutathione S-transferase activities were unaffected by this glucosinolate; however, supplementation of the incubation medium with myrosinase elevated quinone reductase activity. It may be inferred that the breakdown product of glucoraphanin, in this case sulforaphane, is superior than its precursor in modulating carcinogen- metabolising enzyme systems in vitro and this is likely to impact on the chemopreventive activity linked to cruciferous vegetable consumption.

Matched MeSH terms: Carcinoma, Hepatocellular/drug therapy; Carcinoma, Hepatocellular/enzymology*
Cellular assessment of the extract of bambangan (Mangifera pajang) as a potential cytoprotective agent for the human hepatocellular HepG2 cell line

Abu Bakar MF, Mohamed M, Rahmat A, Burr SA, Fry JR

Food Chem, 2013 Jan 1;136(1):18-25.
PMID: 23017387 DOI: 10.1016/j.foodchem.2012.07.099

This study was conducted to investigate the potential of bambangan (Mangifera pajang) fruit extracts in the protection against oxidative damage caused by tert-butyl hydroperoxide in the human hepatocellular HepG2 cell line. Proteins which might be involved in the cytoprotective mechanism were investigated using western blotting technique. Quercetin was used as a positive control. The results showed that only the kernel extract of M. pajang and quercetin displayed cytoprotective activity in HepG2 cells, with EC(50) values of 1.2 and 5.3μg/ml, respectively. Expression of quinone reductase, glutathione reductase and methionine sulfoxide reductase A proteins were significantly up-regulated by quercetin, suggesting their involvement in the cytoprotective activity of quercetin. However, expressions of only glutathione reductase and methionine sulfoxide reductase A proteins were significantly up-regulated by the kernel extract, again suggesting their involvement in the cytoprotective activity of bambangan kernel extract. Future study is needed to investigate the involvement of other cytoprotective proteins in the cytoprotection mechanism.

Matched MeSH terms: Carcinoma, Hepatocellular/enzymology*; Carcinoma, Hepatocellular/genetics; Carcinoma, Hepatocellular/metabolism
Fulltext Influence of immunology knowledge on healthcare and healthy lifestyle

Abu Kassim NL, Saleh Huddin AB, Daoud JI, Rahman MT

PLoS One, 2016;11(7):e0159767.
PMID: 27467083 DOI: 10.1371/journal.pone.0159767

Completing a course in Immunology is expected to improve health care knowledge (HCK), which in turn is anticipated to influence a healthy lifestyle (HLS), controlled use of health care services (HCS) and an awareness of emerging health care concerns (HCC). This cross-sectional study was designed to determine whether these interrelationships are empirically supported. Participants involved in this study were government servants from two ministries in Malaysia (n = 356) and university students from a local university (n = 147). Participants were selected using the non-random purposive sampling method. Data were collected using a self-developed questionnaire, which had been validated in a pilot study involving similar subjects. The questionnaire items were analyzed using Rasch analysis, SPSS version 21 and AMOS version 22. Results have shown that participants who followed a course in Immunology (CoI) had a higher primary HCK (Mean = 0.69 logit, SD = 1.29 logits) compared with those who had not (Mean = -0.27logit, SD = 1.26 logits). Overall, there were significant correlations among the HLS, the awareness of emerging HCC, and the controlled use of HCS (p <0.001). However, no significant correlations were observed between primary HCK and the other variables. However, significant positive correlation was observed between primary HCK and controlled use of HCS for the group without CoI. Path analysis showed that the awareness of emerging HCC exerted a positive influence on controlled use of HCS (β = 0.156, p < .001) and on HLS (β = 0.224, p < .001). These findings suggest that having CoI helps increase primary HCK which influences controlled use of HCS but does not necessarily influence HLS. Hence, introducing Immunology at various levels of education and increasing the public awareness of emerging HCC might help to improve population health en masse. In addition, further investigations on the factors affecting HLS is required to provide a better understanding on the relationship between primary HCK and HLS.

Matched MeSH terms: Carcinoma, Hepatocellular
CAHECA: computer aided hepatocellular carcinoma therapy planning

Adeshina AM, Hashim R, Khalid NE

Interdiscip Sci, 2014 Sep;6(3):222-34.
PMID: 25205500 DOI: 10.1007/s12539-013-0204-7

Hepatocellular Carcinoma is the most common type of liver cancer having a strong relation with cirrhosis. Undoubtedly, cirrhosis may be caused by the virus infection of hepatitis B (HBV) and hepatitis C (HBC) or through alchoholism. However, even when cirrhosis has not been developed, patients with hepatitis viral infections are still at the risk of liver cancer. Apparently, among the numerous medical imaging techniques, Computed Tomography (CT) is the best in defining liver tumor borders. Unfortunately, these imaging techniques, including the CT procedures, usually rely on an appended application to reconstruct the generated 2-D slices to 3-D model. This may involve high performance computation, may be time-consuming or costly. Moreover, even with the outstanding performances of CT in defining the liver tumor boundaries, contrast between tumor tissues and the surrounding liver parenchyma is too low in CT slices. With such a close proxity in the tumor and the surrounding liver tissues, accurate characterization of liver tumor is a challenge. Previously, algorithms were developed to reveal abnormalities in brain's MRI datasets and CT abdominal pelvic, however, introducing a framework that could accurately characterize liver tumor and its surrounding tissues in CT datasets would go a long way in contributing to medical diagnosis and therapy planning of Hepatocellular Carcinoma. This paper proposes an Hepatocellular Carcinoma framework by extending the functionalities of SurLens Visualization System with an automatic liver tumor localization technique using Compute Unified Device Architecture (CUDA). The study was evaluated with liver CT datasets from the Imaging Science and Information Systems (ISIS) Center, the Georgetown University Medical Center. Significantly, visualization of liver CT datasets and the localization of the entangled tumor was achieved without prior datasets segmentation. Interestingly, the framework achieved remarkably good processing speed at a reasonably cheaper cost with an immediate reconstruction of the datasets and mapping of the tumor tissues within the surrounding liver parenchyma.

Matched MeSH terms: Carcinoma, Hepatocellular/diagnosis*; Carcinoma, Hepatocellular/therapy
Fulltext Dynamic Hepatocellular Carcinoma Model Within a Liver Phantom for Multimodality Imaging

Ahmad MS, Suardi N, Shukri A, Nik Ab Razak NNA, Oglat AA, Makhamrah O, et al.

Eur J Radiol Open, 2020;7:100257.
PMID: 32944594 DOI: 10.1016/j.ejro.2020.100257

Introduction: Hepatocellular carcinoma (HCC) is one of the most common cancer in the world, and the effectiveness of its treatment lies in its detection in its early stages. The aim of this study is to mimic HCC dynamically through a liver phantom and apply it in multimodality medical imaging techniques including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound.
Methods and materials: The phantom is fabricated with two main parts, liver parenchyma and HCC inserts. The liver parenchyma was fabricated by adding 2.5 wt% of agarose powder combined with 2.6 wt% of wax powder while the basic material for the HCC samples was made from polyurethane solution combined with 5 wt% glycerol. Three HCC samples were inserted into the parenchyma by using three cylinders implanted inside the liver parenchyma. An automatic injector is attached to the input side of the cylinders and a suction device connected to the output side of the cylinders. After the phantom was prepared, the contrast materials were injected into the phantom and imaged using MRI, CT, and ultrasound.
Results: Both HCC samples and liver parenchyma were clearly distinguished using the three imaging modalities: MRI, CT, and ultrasound. Doppler ultrasound was also applied through the HCC samples and the flow pattern was observed through the samples.
Conclusion: A multimodal dynamic liver phantom, with HCC tumor models have been fabricated. This phantom helps to improve and develop different methods for detecting HCC in its early stages.

Matched MeSH terms: Carcinoma, Hepatocellular
Hepatitis C virus prevalence and genotyping among hepatocellular carcinoma patients in Baghdad

Al-Kubaisy WA, Obaid KJ, Noor NA, Ibrahim NS, Al-Azawi AA

Asian Pac J Cancer Prev, 2014;15(18):7725-30.
PMID: 25292053

Hepatocellular carcinoma (HCC) is the third most common cause for cancer death in the world, now being especially linked to chronic hepatitis C virus (HCV) infection. This case-control study consisting of 65 HCC patients and 82 patients with other malignant tumours as controls was conducted to determine the association of HCV markers with HCC. Serum of each participant was obtained for detection of HCV Ab and RNA by DNA enzyme immunoassay (DEIA). Twenty six per cent (26.0%) of HCC patients had positive anti-HCV which was significantly greater than the control group (p=0.001). HCC patients significantly have a risk of exposure to HCV infection almost 3 times than the control group (OR=2.87, 95% C.I=1.1-7). Anti-HCV seropositive rate was significantly (p=0.03) higher among old age HCC patients and increases with age. Males with HCC significantly showed to have more than 9 times risk of exposure to HCV infection (OR=9.375, 95 % CI=1.299-67.647) than females. HCV-RNA seropositive rate was (70.8%) significantly higher among HCC patients compared to (22.2%) the control group (p=0.019). The most prevalent genotype (as a single or mixed pattern of infection) was HCV- 1b. This study detected a significantly higher HCV seropositive rate of antibodies and RNA in HCC patients.

Matched MeSH terms: Carcinoma, Hepatocellular/genetics; Carcinoma, Hepatocellular/epidemiology; Carcinoma, Hepatocellular/virology*
Fulltext The association of coffee intake with liver cancer risk is mediated by biomarkers of inflammation and hepatocellular injury: data from the European Prospective Investigation into Cancer and Nutrition

Aleksandrova K, Bamia C, Drogan D, Lagiou P, Trichopoulou A, Jenab M, et al.

Am J Clin Nutr, 2015 Dec;102(6):1498-508.
PMID: 26561631 DOI: 10.3945/ajcn.115.116095

BACKGROUND: Higher coffee intake has been purportedly related to a lower risk of liver cancer. However, it remains unclear whether this association may be accounted for by specific biological mechanisms.
OBJECTIVE: We aimed to evaluate the potential mediating roles of inflammatory, metabolic, liver injury, and iron metabolism biomarkers on the association between coffee intake and the primary form of liver cancer-hepatocellular carcinoma (HCC).
DESIGN: We conducted a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition among 125 incident HCC cases matched to 250 controls using an incidence-density sampling procedure. The association of coffee intake with HCC risk was evaluated by using multivariable-adjusted conditional logistic regression that accounted for smoking, alcohol consumption, hepatitis infection, and other established liver cancer risk factors. The mediating effects of 21 biomarkers were evaluated on the basis of percentage changes and associated 95% CIs in the estimated regression coefficients of models with and without adjustment for biomarkers individually and in combination.
RESULTS: The multivariable-adjusted RR of having ≥4 cups (600 mL) coffee/d compared with <2 cups (300 mL)/d was 0.25 (95% CI: 0.11, 0.62; P-trend = 0.006). A statistically significant attenuation of the association between coffee intake and HCC risk and thereby suspected mediation was confirmed for the inflammatory biomarker IL-6 and for the biomarkers of hepatocellular injury glutamate dehydrogenase, alanine aminotransferase, aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), and total bilirubin, which-in combination-attenuated the regression coefficients by 72% (95% CI: 7%, 239%). Of the investigated biomarkers, IL-6, AST, and GGT produced the highest change in the regression coefficients: 40%, 56%, and 60%, respectively.
CONCLUSION: These data suggest that the inverse association of coffee intake with HCC risk was partly accounted for by biomarkers of inflammation and hepatocellular injury.

Matched MeSH terms: Carcinoma, Hepatocellular/blood; Carcinoma, Hepatocellular/immunology; Carcinoma, Hepatocellular/epidemiology; Carcinoma, Hepatocellular/prevention & control*
Development and physicochemical characterization of a biodegradable microspheres formulation loaded with samarium-153 and doxorubicin for chemo-radioembolization of liver tumours

Alregib AH, Tan HY, Wong YH, Kasbollah A, Wong EH, Abdullah BJJ, et al.

J Labelled Comp Radiopharm, 2023 Aug;66(10):308-320.
PMID: 37287213 DOI: 10.1002/jlcr.4046

Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are promising treatments for unresectable liver tumours. Some recent studies suggested that combining TACE and TARE in one treatment course might improve treatment efficacy through synergistic cytotoxicity effects. Nonetheless, current formulations do not facilitate a combination of chemo- and radio-embolic agents in one delivery system. Therefore, this study aimed to synthesise a hybrid biodegradable microsphere loaded with both radioactive agent, samarium-153 (153 Sm) and chemotherapeutic drug, doxorubicin (Dox) for potential radio-chemoembolization of advanced liver tumours. 152 Sm and Dox-loaded polyhydroxybutyrate-co-3-hydroxyvalerate (PHBV) microspheres were prepared using water-in-oil-in-water solvent evaporation method. The microspheres were then sent for neutron activation in a neutron flux of 2 × 1012 n/cm2 /s. The physicochemical properties, radioactivity, radionuclide purity, 153 Sm retention efficiency, and Dox release profile of the Dox-153 Sm-PHBV microspheres were analysed. In addition, in vitro cytotoxicity of the formulation was tested using MTT assay on HepG2 cell line at 24 and 72 h. The mean diameter of the Dox-153 Sm-PHBV microspheres was 30.08 ± 2.79 μm. The specific radioactivity was 8.68 ± 0.17 GBq/g, or 177.69 Bq per microsphere. The 153 Sm retention efficiency was more than 99%, tested in phosphate-buffered saline (PBS) and human blood plasma over 26 days. The cumulative release of Dox from the microspheres after 41 days was 65.21 ± 1.96% and 29.96 ± 0.03% in PBS solution of pH 7.4 and pH 5.5, respectively. The Dox-153 Sm-PHBV microspheres achieved a greater in vitro cytotoxicity effect on HepG2 cells (85.73 ± 3.63%) than 153 Sm-PHBV (70.03 ± 5.61%) and Dox-PHBV (74.06 ± 0.78%) microspheres at 300 μg/mL at 72 h. In conclusion, a novel biodegradable microspheres formulation loaded with chemotherapeutic drug (Dox) and radioactive agent (153 Sm) was successfully developed in this study. The formulation fulfilled all the desired physicochemical properties of a chemo-radioembolic agent and achieved better in vitro cytotoxicity on HepG2 cells. Further investigations are needed to evaluate the biosafety, radiation dosimetry, and synergetic anticancer properties of the formulation.

Matched MeSH terms: Carcinoma, Hepatocellular*
Fulltext Growth of Hepatocellular Carcinoma into the Right Atrium with Associated Pulmonary Tumour Emboli

Amran, A.R., Ranganathan, S.

International Medical Journal Malaysia, 2006;5(1):1-5.
MyJurnal

Hepatocellular carcinoma (HCC) presenting with right atrial metastases and pulmonary tumour embolism is rare . Intracavitary cardiac metastasis is uncommon and metastasis to the right atrium is even less common. The majority of such cases are believed to be due to advanced HCC such as Stage III or IV, in which the progression rate is high, and in infiltrative HCC it tends to be associated with vascular invasion. The diagnosis of pulmonary intravascular tumour emboli is difficult to establish both clinically and with conventional radiographic studies. We report a case hepatocellular carcinoma associated with tumour thrombus in the inferior vena cava (IVC), right atrium and pulmonary tumour embolism detected with multidetector helical computerized tomography (MDHCT).

Matched MeSH terms: Carcinoma, Hepatocellular
Fulltext Case Report-Staged brachytherapy achieving complete metabolic response in unresectable oligometastatic colorectal cancer to the liver

Appalanaido GK, Bahajjaj SIBZ, Shukor SA, Ahmad MZ, Francis HCH

Oxf Med Case Reports, 2021 Apr;2021(4):omab016.
PMID: 33948189 DOI: 10.1093/omcr/omab016

Liver is the most common site for metastasis from colorectal cancer (CRC). Non-surgical treatment options for oligometastatic CRC confined to the liver which represents an intermediate state in the metastatic cascade are fast expanding. Currently, several liver-directed local therapeutic options are available, such as hepatic arterial infusion (HAI) therapy, radio-frequency ablation (RFA), transarterial chemoembolization (TACE), stereotactic body radiotherapy and high dose rate brachytherapy (HDRBT). Many factors such as patient's fitness, liver function (LF), tumour size, location of the tumour in the liver and scheduling of systemic therapy need to be considered when selecting patients for surgery or local liver-directed therapy. This case report illustrates a successful local treatment with staged HDRBT for a large and unresectable, liver only oligometastatic disease from CRC. This patient underwent 4 cycles of chemotherapy (FOLFOX 4) followed by primary tumour resection and first stage of HDRBT to liver for a residual 14 cm tumour after the chemotherapy. After completing a further 4 cycles of chemotherapy with the same regimen, the tumour remained stable at 8 cm. She underwent a second stage of HDRBT to the same lesion and a repeat PET-CT scan done 8 weeks after the second HDRBT showed complete metabolic response. To our knowledge, this is the largest CRC metastatic liver lesion that has been successfully treated with HDRB.

Matched MeSH terms: Carcinoma, Hepatocellular
In silico analysis prediction of HepTH1-5 as a potential therapeutic agent by targeting tumour suppressor protein networks

Azemin WA, Alias N, Ali AM, Shamsir MS

J Biomol Struct Dyn, 2023 Mar;41(4):1141-1167.
PMID: 34935583 DOI: 10.1080/07391102.2021.2017349

Many studies reported that the activation of tumour suppressor protein, p53 induced the human hepcidin expression. However, its expression decreased when p53 was silenced in human hepatoma cells. Contrary to Tilapia hepcidin TH1-5, HepTH1-5 was previously reported to trigger the p53 activation through the molecular docking approach. The INhibitor of Growth (ING) family members are also shown to directly interact with p53 and promote cell cycle arrest, senescence, apoptosis and participate in DNA replication and DNA damage responses to suppress the tumour initiation and progression. However, the interrelation between INGs and HepTH1-5 remains unknown. Therefore, this study aims to identify the mechanism and their protein interactions using in silico approaches. The finding revealed that HepTH1-5 and its ligands had interacted mostly on hotspot residues of ING proteins which involved in histone modifications via acetylation, phosphorylation, and methylation. This proves that HepTH1-5 might implicate in an apoptosis signalling pathway and preserve the protein structure and function of INGs by reducing the perturbation of histone binding upon oxidative stress response. This study would provide theoretical guidance for the design and experimental studies to decipher the role of HepTH1-5 as a potential therapeutic agent for cancer therapy. Communicated by Ramaswamy H. Sarma.

Matched MeSH terms: Carcinoma, Hepatocellular*
Suppressing growth, migration, and invasion of human hepatocellular carcinoma HepG2 cells by Catharanthus roseus‑silver nanoparticles

Azhar NA, Ghozali SZ, Abu Bakar SA, Lim V, Ahmad NH

Toxicol In Vitro, 2020 Sep;67:104910.
PMID: 32526345 DOI: 10.1016/j.tiv.2020.104910

Application of silver nanoparticles serves as a new approach in cancer treatment due to its unique features. Biosynthesis of silver nanoparticles using plant is advantageous since they are easily accessible, nontoxic and produce quicker reaction compared to other methods. To evaluate the cytotoxicity, mechanism of cell death and DNA damage of biosynthesized Catharanthus roseus-silver nanoparticles on human liver cancer (HepG2) cells. The antiproliferative activity of Catharanthus roseus‑silver nanoparticles was measured using MTT assay. The cytotoxic effects were further evaluated by measuring nitric oxide and reactive oxygen species (ROS). The mechanism of cell death was determined by annexin-FITC/propidium iodide, mitochondrial membrane potential (MMP) and cell cycle assays. The assessment of DNA damage was evaluated using Comet assay method. The uptake of the nanoparticles were evaluated by Transmission Electron Microscopy (TEM). Catharanthus roseus‑silver nanoparticles has inhibited the proliferation of HepG2 cells in a time-dependent manner with a median IC50 value of 3.871 ± 0.18 μg/mL. The concentration of nitrite and ROS were significantly higher than control. The cell death was due to apoptosis associated with MMP loss, cell cycle arrest, and extensive DNA damage. TEM analysis indicated the presence of free nanoparticles and endosomes containing the nanoparticles. The findings show that Catharanthus roseus‑silver nanoparticles have produced cytotoxic effects on HepG2 cells and thus may have a potential to be used as an anticancer treatment, particularly for hepatocellular carcinoma.

Matched MeSH terms: Carcinoma, Hepatocellular/drug therapy
Fulltext Risk factors of hepatocellular carcinoma in type 2 diabetes patients: A two-centre study in a developing country

Azit NA, Sahran S, Voon Meng L, Subramaniam M, Mokhtar S, Mohammed Nawi A

PLoS One, 2021;16(12):e0260675.
PMID: 34882716 DOI: 10.1371/journal.pone.0260675

Type 2 diabetes mellitus (T2DM) is increasingly known as a risk factor of hepatocellular carcinoma (HCC). In this study, we determined the risk factors associated with HCC in T2DM patients. This was a matched case-control study conducted at two hepatobiliary referral centres in a developing country. Patients' sociodemographic, clinical, and biochemical characteristics between 1 January 2012 and 30 June 2018 were extracted from the electronic medical records and analysed using multivariate logistic regression analysis. A total of 212 case-control pairs were included. Significant risk factors included Chinese and Malay ethnicities that interacted with viral hepatitis (adjusted odds ratio [AOR] = 11.77, 95% confidence interval [CI]: 1.39-99.79) and (AOR = 37.94, 95% CI: 3.92-367.61) respectively, weight loss (AOR = 5.28, 95% CI: 2.29-12.19), abdominal pain/ discomfort (AOR = 6.73, 95% CI: 3.34-13.34), alcohol (AOR = 4.08, 95% CI: 1.81-9.22), fatty liver (AOR = 3.29, 95% CI: 1.40-7.76), low platelet (AOR = 4.03, 95% CI:1.90-8.55), raised alanine transaminase (AOR = 2.11, 95% CI: 1.16-3.86). and alkaline phosphatase (ALP) levels (AOR = 2.17, 95% CI: 1.17-4.00). Statins reduced the risk of HCC by 63% (AOR = 0.37, 95% CI: 0.21-0.65). The identification of these factors aids the risk stratification for HCC among T2DM patients for early detection and decision-making in patient management in the primary care setting.

Matched MeSH terms: Carcinoma, Hepatocellular/epidemiology*
Tissue microarray immunohistochemical profiles of p53 and pRB in hepatocellular carcinoma and hepatoblastoma

Azlin AH, Looi LM, Cheah PL

Asian Pac J Cancer Prev, 2014;15(9):3959-63.
PMID: 24935581

The tumour suppressor genes, p53 and pRb, are known to play important roles in neoplastic transformation. While molecular routes to the uncontrolled growth of hepatocytes, leading to primary liver cancer have generated considerable interest, the roles of p53 and pRb mutations in hepatocellular carcinoma (HCC) and hepatoblastoma (HB) remain to be clarified. We examined the immunohistochemical expression of p53 and pRb gene products in 26 HCC and 9 HB, sampled into tissue microarray blocks. 10 (38%) of 26 HCC showed > 10% tumour nuclear staining for p53 protein, 3 of these also being HbsAg positive. Conversely, none of 9 HB expressed nuclear p53 immunopositivity. Some 24 (92%) HCC and 8 (89%) HB showed loss of pRb nuclear expression. Two of the 26 HCC and one of the 9 HB showed >10% tumour nuclear staining for pRb protein. Our results suggest that p53 does not have an important role in the development of HB but may contribute in HCC. There is also loss of pRb expression in the majority of HCC and HB, supporting loss of pRb gene function in the hepatocarcinogenesis pathway. However, a comparison of the staining profiles of p53 and pRb proteins in HCC and HB did not reveal a consistent pattern to differentiate between the two types of tumours immunohistochemically. Hence the use of p53 and pRB protein expression has no contribution in the situation where there is a diagnostic difficulty in deciding between HCC and HB.

Matched MeSH terms: Carcinoma, Hepatocellular/genetics*; Carcinoma, Hepatocellular/pathology
Roles of ethnicity in survival of hepatocellular carcinoma patients in malaysia

Azmawati M, Krisnan R

Asian Pac J Cancer Prev, 2012;13(12):6023-6.
PMID: 23464397

The incidence of hepatocellular carcinoma (HCC) in Malaysia for the year 2001 was 2.8 per 100,000 people. The mortality rate is increasing. A retrospective cohort study measuring the survival of HCC patients who received treatment in Selayang Hospital was conducted from 1 January 2003 to 31 December 2006. The main objectives of the study were to measure the survival of the patients and to understand the influencing factors, especially ethnicity. The subjects were newly diagnosed cases of HCC by CT scan and histopathological assessment who underwent futher investigations and treatments in Hospital Selayang (inception cohort). The survival time was measured from the date of diagnosis until the subjects died, or failed to follow-up at the end of the study period (31 December 2007). A total of 299 patients were selected with 95 patients dying, the majority among Chinese (39.1%). Subgroup analysis according to ethnicity proved significantly that Chinese patients who had smaller tumor, less number of nodules, low AFP level, Child Pugh Class A and received surgical treatment had a better median survival rate compared to other ethnic groups. Malay (cHR: 1.3, 95%CI; 0.89-1.85) and Indian (cHR: 1.3, 95%CI; 0.74-2.26) patients had a poor survival compared to Chinese patients, but not in the final model. Therefore ethnicity may play a role in survival of HCC patients, but not as a main hazard prognostic factor.

Matched MeSH terms: Carcinoma, Hepatocellular*
Fulltext Antiproliferative and Apoptotic Effects of Cardamonin against Hepatocellular Carcinoma HepG2 Cells

Badroon NA, Abdul Majid N, Alshawsh MA

Nutrients, 2020 Jun 12;12(6).
PMID: 32545423 DOI: 10.3390/nu12061757

Liver cancer is the sixth most common cancer in terms of incidence and the fourth in terms of mortality. Hepatocellular carcinoma (HCC) represents almost 90% of primary liver cancer and has become a major health problem globally. Cardamonin (CADMN) is a natural bioactive chalcone found in several edible plants such as cardamom and Alpinia species. Previous studies have shown that CADMN possesses anticancer activities against breast, lung, prostate and colorectal cancer. In the present study, the mechanisms underlying the anti-hepatocellular carcinoma effects of CADMN were investigated against HepG2 cells. The results demonstrated that CADMN has anti-proliferative effects and apoptotic action on HepG2 cells. CADMN showed potent cytotoxicity against HepG2 cells with an IC50 of 17.1 ± 0.592 μM at 72 h. Flow cytometry analysis demonstrated that CADMN arrests HepG2 cells in G1 phase and induces a significant increase in early and late apoptosis in a time-dependent manner. The mechanism by which CADMN induces apoptotic action was via activation of both extrinsic and intrinsic pathways. Moreover, the findings of this study showed the involvement of reactive oxygen species (ROS), which inhibit the NF-κB pathway and further enhance the apoptotic process. Together, our findings further support the potential anticancer activity of CADMN as an alternative therapeutic agent against HCC.

Matched MeSH terms: Carcinoma, Hepatocellular
Hepatic resections 1964-1979: vignettes drawn from the Malaysian experience

Balasegaram M, Joishy SK

Jpn J Surg, 1980 Jun;10(2):94-9.
PMID: 6253701

We present a study of 288 hepatic resections carried out in Malaysia for the past fifteen years. First, we describe our indications for hepatic resectins which are not limited to hepatic trauma and hepatomas, but also include hepatic abscesses, cysts, intrahepatic calculi and hemangiomas. Second, we give a simplified classification of hepatic resections using accurate terminology. Third, we describe the safety of hepatic resections in our hands which we believe is due to specially designed surgical instruments and the accurate decision making process at surgery. We have had minimum postoperative mortality and no intraoperative deaths so far. Finally, while analysing each indication we have drawn vignettes from our experience for the past fifteen years.

Matched MeSH terms: Carcinoma, Hepatocellular/surgery
Hepatic resection. Pillars of success built on the foundation of 15 years of experience

Balasegaram M, Joishy SK

Am J Surg, 1981 Mar;141(3):360-5.
PMID: 6259961

Two hundred eight-eight hepatic resections performed over the past 15 years are discussed. The safety and success achieved are attributed to the original work in Malaysia on the anatomy of the liver and its anomalies, the use of surgical instruments specially designed for hepatic resection, various types of resections devised and studies on aids to liver regeneration after resection. The diversity of the principles and practice of surgery in the Western countries compared with those in Malaysia is illustrated.

Matched MeSH terms: Carcinoma, Hepatocellular/surgery
Management of primary liver cell carcinoma

Balasegaram M

Am J Surg, 1975 Jul;130(1):33-7.
PMID: 50750

A review of 352 patients with primary liver cell carcinoma treated by the author is presented. The poor rate of resectability (7 per cent) has necessitated various forms of treatment over the years. These are described in detail. Based on this experience, the current form of treatment for nonresectable carcinoma is summarized. Although it is too early to assess this form of treatment, initial results appear to be promising. A second report in the near future is planned.

Matched MeSH terms: Carcinoma, Hepatocellular/therapy*

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