RESUMEN
BACKGROUND/AIMS: To investigate whether serum Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA+-M2BP) can predict the recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection. METHODS: Patients with chronic hepatitis B (CHB) who underwent curative resection for HCC between 2004 and 2015 were eligible for the study. Recurrence was sub-classified as early (<2 years) or late (≥2 years). RESULTS: A total of 170 patients with CHB were selected. During the follow-up period (median, 22.6 months), 64 (37.6%) patients developed recurrence. In multivariate analyses, WFA+-M2BP level was an independent predictor of overall (hazard ratio [HR]=1.490), early (HR=1.667), and late recurrence (HR=1.416), together with male sex, des-gamma carboxyprothrombin level, maximal tumor size, portal vein invasion, and satellite nodules (all P<0.05). However, WFA+- M2BP level was not predictive of grade B-C posthepatectomy liver failure. The cutoff value that maximized the sum of sensitivity (30.2%) and specificity (90.6%) was 2.14 (area under receiver operating characteristic curve=0.632, P=0.010). Patients with a WFA+-M2BP level >2.14 experienced recurrence more frequently than those with a WFA+-M2BP level ≤2.14 (P=0.011 by log-rank test), and had poorer postoperative outcomes than those with a WFA+-M2BP level ≤2.14 in terms of overall recurrence (56.0 vs. 34.5%, P=0.047) and early recurrence (52.0 vs. 20.7%, P=0.001). CONCLUSION: WFA+-M2BP level is an independent predictive factor of HBV-related HCC recurrence after curative resection. Further studies should investigate incorporation of WFA+-M2BP level into tailored postoperative surveillance strategies for patients with CHB.
Asunto(s)
Antígenos de Neoplasias/sangre , Carcinoma Hepatocelular/cirugía , Hepatitis B Crónica/complicaciones , Neoplasias Hepáticas/cirugía , Glicoproteínas de Membrana/sangre , Área Bajo la Curva , Biomarcadores de Tumor/sangre , Carcinoma Hepatocelular/etiología , Femenino , Estudios de Seguimiento , Hepatectomía/efectos adversos , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B Crónica/virología , Humanos , Fallo Hepático/etiología , Neoplasias Hepáticas/etiología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Lectinas de Plantas/metabolismo , Pronóstico , Modelos de Riesgos Proporcionales , Curva ROC , Receptores N-Acetilglucosamina/metabolismo , Wisteria/metabolismoRESUMEN
KEY MESSAGE: The semi-aquatic plant Water-Wisteria is suggested as a new model to study heterophylly due to its many advantages and typical leaf phenotypic plasticity in response to environmental factors and phytohormones. Water-Wisteria, Hygrophila difformis (Acanthaceae), is a fast growing semi-aquatic plant that exhibits a variety of leaf shapes, from simple leaves to highly branched compound leaves, depending on the environment. The phenomenon by which leaves change their morphology in response to environmental conditions is called heterophylly. In order to investigate the characteristics of heterophylly, we assessed the morphology and anatomy of Hygrophila difformis in different conditions. Subsequently, we verified that phytohormones and environmental factors can induce heterophylly and found that Hygrophila difformis is easily propagated vegetatively through either leaf cuttings or callus induction, and the callus can be easily transformed by Agrobacterium tumefaciens. These results suggested that Hygrophila difformis is a good model plant to study heterophylly in higher aquatic plants.
Asunto(s)
Hojas de la Planta/metabolismo , Wisteria/metabolismo , Agrobacterium tumefaciens/genética , Reguladores del Crecimiento de las Plantas/metabolismo , Hojas de la Planta/fisiología , Wisteria/fisiologíaRESUMEN
Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA+-M2BP) has been suggested to be useful for the assessment of disease severity in non-alcoholic fatty liver disease (NAFLD). Consecutive adult NAFLD patients who had a liver biopsy were included. Serum WFA+-M2BP level was measured using a lectin-antibody sandwich immunoassay using a chemiluminescence enzyme immunoassay machine (HISCL-5000, Sysmex, Kobe, Japan). The measured levels were indexed using the following equation: Cut-off index (COI) = ([WFA+-M2BP]sample-[WFA+-M2BP]NC) / ([WFA+-M2BP]PC-[WFA+-M2BP]NC), where PC = positive control and NC = negative control. Histopathological examination of liver biopsy specimen was reported according to Non-Alcoholic Steatohepatitis (NASH) Clinical Research Network Scoring System. Data for 220 cases were analyzed. The AUROC of the COI for the diagnosis of NASH was 0.65. The AUROC of the COI for the diagnosis of steatosis grade ≥2 and 3 was 0.64 and 0.53, respectively. The AUROC of the COI for the diagnosis of lobular inflammation grade ≥1, ≥2 and 3 was 0.57, 0.68 and 0.59, respectively. The AUROC of the COI for the diagnosis of hepatocyte ballooning grade ≥1 and 2 was 0.64 and 0.65, respectively. The AUROC of the COI for the diagnosis of fibrosis stage ≥1, ≥2, ≥3 and 4 was 0.61, 0.71, 0.74 and 0.84, respectively. Out of the 220 cases, 152 cases were the same 76 patients who had a repeat liver biopsy after 48 weeks of intervention. The AUROC of the change in the COI to detect improvement in steatosis, lobular inflammation, hepatocyte ballooning and fibrosis was 0.57, 0.54, 0.59 and 0.52, respectively. In conclusion, serum WFA+-M2BP was most useful for the diagnosis of significant fibrosis, advanced fibrosis and cirrhosis in NAFLD patients. However, it was less useful for differentiating NASH from non-NASH, and for diagnosis and follow-up of the individual histopathological components of NASH.
Asunto(s)
Antígenos de Neoplasias/sangre , Cirrosis Hepática/patología , Glicoproteínas de Membrana/sangre , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Lectinas de Plantas/metabolismo , Receptores N-Acetilglucosamina/metabolismo , Wisteria/metabolismo , Diagnóstico Diferencial , Femenino , Hepatocitos/patología , Humanos , Inmunoensayo , Inflamación/diagnóstico , Cirrosis Hepática/sangre , Luminiscencia , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/sangre , Enfermedad del Hígado Graso no Alcohólico/patología , Obesidad/patologíaRESUMEN
Specialized constructs of the extracellular matrix termed perineuronal nets surround the soma, primary dendrites and initial axon segment of some but not all neuronal populations in the central nervous system. In an effort to determine the cellular localization of perineuronal nets in the human cochlear nucleus (CN), we first performed a quantitative morphometric study of the human CN. We provide evidence for a laminar organization in the human dorsal cochlear nucleus (DCN; including molecular, granular and deep layers) as in other laboratory animals. Additionally, we find that the human ventral cochlear nucleus (VCN) contains distinct octopus, stellate, globular and spherical bushy cell populations, as described in other species. Using Wisteria floribunda histochemistry in five human brainstems, we identified perineuronal nets in the human cochlear nucleus. Perineuronal nets are associated with the vast majority of octopus and stellate cells in the caudal VCN. In the rostral VCN, dense perineuronal nets are associated with globular bushy cells and faint nets are associated with some spherical bushy cells and stellate cells. Few perineuronal nets are found in the DCN.