Jiahong Dong

Perspectives on using des-γ-carboxyprothrombin (DCP) as a serum biomarker: facilitating early detection of hepatocellular carcinoma in China

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in China. Evidence has shown that surgical resection and liver transplantation may offer the best potential for treating HCC but are only available to patients whose tumors are detected early. Over the past few decades, although a series of measures for standardized management of HCC has been implemented in China, most patients with HCC in China still present with advanced-stage disease, thus strategies to screen for and diagnose HCC at an earlier stage are urgently needed in China when curable interventions can be offered to achieve long-term disease-free survival for patients with HCC. In China, the serum biomarker α-fetoprotein (AFP) is considered a useful and feasible tool for HCC screening and early diagnosis. However, the sensitivity and specificity of AFP vary widely, and the total AFP is not always specific, especially when HCC is in its early stages. Globally, numerous studies have reported that the combination of des-γ-carboxyprothrombin (DCP) and AFP may have a higher sensitivity than AFP alone, and suggested DCP could also be used to assess the progression of HCC. However, DCP has not been approved in China until now. Differ from most of Western countries, people with HBV infection are the largest population at risk of developing HCC China. In order to assess the screening and diagnostic value of DCP in Chinese patients with HCC, a first large-scale, multi-center study was launched in China in 2012, results showed that DCP can help to detect HCC in its early stages and facilitate definitive treatment. The clinical use of DCP is urgently needed to facilitate early detection of HCC in China.

Knowledge into action – Exploration of an appropriate approach for constructing evidence-based clinical practice guidelines for hepatocellular carcinoma

With the development of evidence-based medicine (EBM), the concept of transfer of current best evidence into clinical decision-making has garnered substantial attention worldwide. As such a good tool, many clinical practice guidelines (CPGs) for hepatocellular carcinoma (HCC) have been published worldwide under the guide of current best evidence. Our study did a systematic evaluation of the current 17 guidelines for HCC worldwide, which found that the appropriate constructing approach is the most important factor that influences guidelines implementation. Three factors of organizations or bodies drafting the guideline, exploration for achieving current best evidence, and purpose of constructing evidence-based CPGs for HCC should be paid close attention to. In order to achieve the current best evidence and promote evidence-based CPGs to be widely accepted and fully implemented, we recommend to conduct a systematic approach with 4 steps of global guidelines assessment, systematic literature review, experts consensus and draft implementation, as well as implementation evaluation and periodic update in constructing and implementing evidence-based CPGs for HCC.

Standardization of perioperative management on hepato-biliary-pancreatic surgery.

Japan-China Joint Medical Workshop (2012) on standardization of perioperative management on hepato-biliary-pancreatic surgery was held by the Center for Medical Standards Research, IRCA-BSSA Group in Japan on April 15-16, 2012. Experts in the fields of surgery, anesthesia, pharmacy, and public health from 21 health institutions from Japan and China presented their research achievements and shared their medical experience of perioperative management on hepato-biliary-pancreatic surgery, which should facilitate building of guidelines for hepatocellular carcinoma and be expected to promote standardized management of liver cancer in Asia.

Caffeoyl pyrrolidine derivative LY52 inhibits hepatocellular carcinoma invasion via suppressing matrix metalloproteinase-2

PurposeIn this study, we examined the effects of LY52, a caffeoyl pyrrolidine derivative designed to fit the S′1 active pocket of gelatinases, on the expressions of matrix metalloproteinases and invasion abilities of hepatocellular carcinoma cells.MethodsThe effects of LY52 on the proliferations of HepG2 (hepatitis B virus (HBV) negative) and HepG2.2.15 (HBV-producing) cells were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Gelatin zymography was used to detect the effects of LY52 on matrix metalloproteinases expressions and Western blot was used to detect matrix metalloproteinase-2 expressions. Transwell chamber assay was used to detect the effects of LY52 on invasion of the cells.ResultsGelatin zymography and Western blot showed that matrix metalloproteinase-2 expressions were inhibited by LY52 in a dose-dependent manner, and inhibitory rates of LY52 on HepG2 cells were higher than on HepG2.2.15 cells. Transwell chamber showed that LY52 could significantly inhibit the invasion of both cells, although the inhibitory effects of LY52 on HepG2.2.15 cells were was not as obvious as on HepG2 cells.ConclusionsThese results suggested that LY52 might inhibit the invasion of hepatocellular carcinoma cells by suppressing matrix metalloproteinase-2, although the inhibitory effects of LY52 on HBV-negative cells were more obvious than that of HBV-infected cells.

The defects of cholangiocyte primary cilia in patients with graft cholangiopathies

To observe the morphologic changes in intrahepatic bile ducts and the defects of cholangiocyte primary cilia in patients with graft cholangiopathies.