Haipeng Yu

Clinical prognostic value of CD4+CD25+FOXP3+regulatory T cells in peripheral blood of Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma patients

Abstract Background: CD4+CD25+ forkhead box P3 (FOXP3)+ regulatory T cells (Tregs) accumulate in malignant tumors and negatively regulate antitumor immunity. However, the clinical significance of Tregs in HCC remains unclear. To determine the prognostic value of Tregs, we conducted a retrospective study on 264 patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) who underwent transcatheter arterial chemoembolization (TACE). Methods: We measured the proportion of peripheral blood Tregs in 105 healthy donors and 264 HCC patients (stage B) prior to and following TACE between 2005 and 2007. All HCC patients were followed up until December 2012. The correlations between the proportion of Tregs and clinicopathologic factors were analyzed, and long-term survival rate after TACE according to the percentage of Tregs was assessed by univariate and multivariate analyses. Results: The 1-, 2-, 3-, 4- and 5-year cumulative survival rates were 62.1%, 32.6%, 16.5%, 10.4% and 6.9%, respectively, and the median survival time was 19.0 months. The cumulative survival rate was significantly lower in patients with higher levels of peripheral blood Treg cells compared to those with lower Treg levels (p<0.001). Furthermore, we found that both pre- and post-TACE peripheral blood Treg levels showed significant negative association with overall survival time (p<0.001). Conclusions: Elevated peripheral blood CD4+CD25+FOXP3+Treg levels are an independent predictive factor of poor survival after TACE for HCC (stage B) patients. These results suggest that targeting Tregs may improve patient outcomes, and provide a strong rationale for testing these approaches in future immunotherapy-based clinical trials.

Percutaneous cryoablation of ovarian cancer metastasis to the liver: initial experience in 13 patients.

Objective To evaluate the feasibility, safety, and effectiveness of percutaneous cryoablation for the treatment of liver metastases from ovarian cancer. Methods/Materials A retrospective review was performed on 13 patients with liver metastases from ovarian cancer who underwent percutaneous cryoablation with computed tomography (CT) guidance. The tumor response was assessed by enhanced computed tomography performed before treatment, 1 month after, and every 3 months after treatment. The Functional Assessment of Cancer Therapy–General quality of life (QOL) was used to assess the patients’ QOL before, 1 week, 1 month, and 3 months after cryoablation. Results A total of 27 procedures of cryoablation were performed on these patients, and 5 patients underwent repeat procedures. Complete ablation was achieved for all lesions. Months are counted from the time of cryoablation, and the median duration of follow-up was 15 months (4-22 months). At the 1-month follow-up, the primary technique effectiveness was 100%. At the 3-month follow-up, local tumor progression was observed in 2 (7.14%) of 28 lesions. The 1-year survival from the time of cryoablation was 92.3%. Two patients died after 9 and 14 months, respectively. The QOL symptoms and functioning scales were preserved in patients alive at 3 months after cryoablation. No major complications such as cryoshock, hepatic bleeding, liver abscess, biliary fistula, and renal insufficiency were encountered. Conclusions Our initial experience showed that cryoablation is a safe and effective ablative therapy, providing a high rate of local tumor control in ovarian cancer liver metastases.

Prostate stem cell antigen and cancer risk, mechanisms and therapeutic implications.

Prostate stem cell antigen (PSCA) was originally identified as a tumor antigen in prostate cancer. Recent studies indicated that PSCA was correlated with many cancer types. In this review, we will consider the origin of PSCA, discuss the expression of PSCA in normal and cancer tissue, describe PSCA polymorphisms and cancer risk, summarize potential mechanisms for PSCA involvement in cancer; and look into the therapeutic implications of PSCA. PSCA is upregulated in prostate cancer, pancreatic cancer and bladder cancer, as well as a number of others, making it an ideal clinical target for both diagnosis and therapy. Future studies will be required to explore its mechanisms on various cancer types, and to confirm its clinical utility for diagnosis and immunotherapy strategies. The study of PSCA regulation and expression may also provide information on normal prostate development and prostate carcinogenesis.

Advances in endovascular therapy to treat primary hepatocellular carcinoma

Transcatheter arterial chemoembolization (TACE) is a minimally invasive procedure to restrict a tumors blood supply, and TACE has an established role in cancer therapy. An embolic material in the form of microspheres (such as drug-eluting beads) and transarterial radioembolization is effective at treating hepatocellular carcinoma (HCC). Endovascular therapy offers promise for the treatment of tumor thrombi in the portal vein. Many researchers are anticipating an era of TACE with microspheres. This review aims to provide an overview of advances in endovascular therapy to treat primary HCC.

Cryoablation combined with TACE for treating large hepatocellular carcinoma: Tumor load and cellular immunity

ObjectiveTo study the effectiveness on the tumor load and cellular immune function of percutaneous cryoablation (argon-helium cryoablative system, AHCS) combined with transarterial chemoembolization (TACE) for treating large hepatocellular carcinomas (HCCs) with diameters over 10 cm.MethodsA total of 48 HCC patients were treated with AHCS after TACE. Tumor sizes ranged from 10 to 14 cm. All cases were a hypervascular type. There were 38 Child A cases and 10 Child B cases. Forty were AFP positive and 8 negative. The patients were randomized with therapy group consisting of 26 cases and the control group 22 cases. The therapy group received AHCS 4 weeks following TACE treatment. Reexamination included pathology, tumor markers, T-lymphocyte subgroup levels and computed tomography or MRI. The necrosis rate of the tumor load was calculated by Cavalieri’s theory. EORTC QLQ-C30 was used in quality of life evaluation.ResultsThe average tumor-load reduction rate (necrosis rate) was 8.07% after TACE, and 28.65% after AHCS. Coagulation necrosis was produced in the target area. The tumor markers deceased significantly after AHCS. Tumor-load reduction after AHCS was more significant than after TACE. Suppression of cellular immunity after TACE was significant. In contrast, CD3+, CD/ and NK increased after AHCS and an abnormal T-lymphocyte distribution was corrected. Quality of life after AHCS increased according to the EORTC QLQ-C30 evaluation. No severe complications occurred.ConclusionPercutaneous AHCS cryoablation after TACE reduced the tumor load in the short term. At the same time, cellular immune function was increased after AHCS. TACE was critical in increasing the therapeutic efficacy of AHCS because of its embolisation of blood vessels preventing a Flow Effect. Reduction of the tumor load in the short term may conduce to increase cellular immunity. Percutaneous AHCS cryoablation combined with TACE can reduce the tumor load, improve cellular immunity and increase quality of life of HCC patients. This type of therapy deserves to be studied further research.

TACE combined with PSE in treating hepatocelluar carcinoma with hypersplenism

ObjectiveTo observe the effectiveness and safety of transcatheter arterial chemoembolization (TACE) combined with partial splenic embolization (PSE) in treating primary hepatocelluar carcinoma (HCC) with hypersplenism.MethodsThirty HCC patients with liver cirrhosis, portal hypertension and hypersplenism were treated with TACE and PSE. The degree of tumor volume reduction and remission of hypersplenism were observed.ResultsThe tumor reduction rate of the HCC was 73.3%. Twenty-eight patients had hypersplenic remission with a rate of 93.3%. There were no severe complications such as hepatic abscesses.ConclusionTACE combined with PSE is a safe and effective method to treat HCC with liver cirrhosis, portal hypertension and hypersplenism.