Diagnosis Of Primary Liver Cancer Research Articles

Primary liver cancer classification from routine tumour biopsy using weakly supervised deep learning

The diagnosis of primary liver cancers (PLCs) can be challenging, especially on biopsies and for combined hepatocellular-cholangiocarcinoma (cHCC-CCA). We automatically classified PLCs on routine-stained biopsies using a weakly supervised learning method. We selected 166 PLC biopsies divided into training, internal and external validation sets: 90, 29 and 47 samples, respectively. Two liver pathologists reviewed each whole-slide hematein eosin saffron (HES)-stained image (WSI). After annotating the tumour/non-tumour areas, tiles of 256x256 pixels were extracted from the WSIs and used to train a ResNet18 neural network. The tumour/non-tumour annotations served as labels during training, and the network's last convolutional layer was used to extract new tumour tile features. Without knowledge of the precise labels of the malignancies, we then applied an unsupervised clustering algorithm. Pathological review classified the training and validation sets into hepatocellular carcinoma (HCC, 33/90, 11/29 and 26/47), intrahepatic cholangiocarcinoma (iCCA, 28/90, 9/29 and 15/47), and cHCC-CCA (29/90, 9/29 and 6/47). In the two-cluster model, Clusters 0 and 1 contained mainly HCC and iCCA histological features. The diagnostic agreement between the pathological diagnosis and the two-cluster model predictions (major contingent) in the internal and external validation sets was 100% (11/11) and 96% (25/26) for HCC and 78% (7/9) and 87% (13/15) for iCCA, respectively. For cHCC-CCA, we observed a highly variable proportion of tiles from each cluster (cluster 0: 5-97%; cluster 1: 2-94%). Our method applied to PLC HES biopsy could identify specific morphological features of HCC and iCCA. Although no specific features of cHCC-CCA were recognized, assessing the proportion of HCC and iCCA tiles within a slide could facilitate the identification of cHCC-CCA. The diagnosis of primary liver cancers can be challenging, especially on biopsies and for combined hepatocellular-cholangiocarcinoma (cHCC-CCA). We automatically classified primary liver cancers on routine-stained biopsies using a weakly supervised learning method. Our model identified specific features of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Despite no specific features of cHCC-CCA being recognized, the identification of hepatocellular carcinoma and intrahepatic cholangiocarcinoma tiles within a slide could facilitate the diagnosis of primary liver cancers, and particularly cHCC-CCA.

Beyond liver cancer, more application scenarios for alpha-fetoprotein in clinical practice.

Alpha-fetoprotein (AFP) is a commonly used clinical biomarker. Before 1970, the two-way agar diffusion method was mainly used, and the specificity of AFP in the diagnosis of primary liver cancer was satisfactory. However, its positivity rate was not very high. The diagnostic value of AFP is changing with the evolution of detection methods. Here, we performed a literature search to identify English-language publications. The search was performed from January 2015 to April 2023 using the PubMed database and the following terms in [Titles/Abstracts]: alpha-fetoprotein, clinical practice, detection, etc. The references of retrieved articles were also screened to broaden the search. Studies referring to liver cancer and AFP detection methods were excluded. In this review, several clinical application scenarios for AFP were systematically reviewed, and its potential detection value in the future was discussed.

Porphyrin precursors and risk of primary liver cancer in acute intermittent porphyria: A case-control study of 188 patients.

Acute intermittent porphyria (AIP) is a rare hereditary metabolic disease characterized by acute attacks and accumulation of the porphyrin precursors 5-aminolevulinic acid (ALA) and porphobilinogen (PBG). Patients with AIP have a high risk of primary liver cancer (PLC). We aimed to assess the association between porphyrin precursor excretion and the risk for PLC in patients with AIP. We studied 48 patients with AIP who developed PLC between 1987 - 2015 and 140 age and sex matched controls with AIP but no PLC. Data on all available urinary PBG and ALA samples collected from 1975 until one year before PLC diagnosis were analyzed and compared between cases and controls using logistic regression. Porphyrin precursor excretion was higher in patients with PLC (PBG median 7.9 (IQR 4.4-21.9) mmol/mol creatinine) than in controls (3.8 (1.2-9.8)) (adjusted odds ratio 1.07, 95% confidence interval: 1.02-1.12). None of the 28 patients with all registered samples below the upper limit of normal (ULN) developed PLC, and only one of the 45 patients with all samples <2x ULN developed PLC. Among non-PLC controls, ALA and PBG levels decreased after age 50-60 while an increasing trend was observed after age 65 among those who developed PLC. Increased urinary porphyrin precursors are associated with a high risk of developing PLC. Patients with normal levels appear to have a low risk while high or increasing ALA and PBG after age 65 indicates high risk, which should be considered in surveillance decisions. This article is protected by copyright. All rights reserved.

Diagnostic value of 18F-FDG PET/CT and 68Ga-FAPI PET/CT in primary liver cancer: A systematic review and meta-analysis.

To conduct a meta-analysis of the diagnostic efficacy of fluorine-18-fluorodeoxyglucose (18F-FDG) and gallium-68-labeled fibroblast-activation protein inhibitor (68Ga-FAPI) positron emission tomography/computed tomography (PET/CT) for primary liver cancer based on existing clinical evidence. Meta-analysis was carried out according to PRISMA reporting specification. The clinical studies in PubMed/Medline, Embase and the Cochrane Library database were retrieved from the establishment to September 2022. Two researchers independently conducted literature screening and data extraction, evaluated the risk of bias according to QUADAS-2, conducted meta-analysis using Meta Disc 1.4 and Stata15.1 software, and calculated the summarized sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and diagnostic odds ratio (DOR). The diagnostic performance of 18F-FDG PET/CT and 68Ga-FAPI PET/CT for primary liver cancer was compared using summarized receiver operating characteristic (SROC) curve and area under curve (AUC). Four original studies on 18F-FDG PET/CT and 68Ga-FAPI PET/CT in the diagnosis of primary liver cancer were included, including 159 intrahepatic lesions in 106 patients. Taking lesions as a unit, in four original studies, the pooled results of 18F-FDG PET/CT diagnosis of primary liver cancer were Sen=0.5 (95% CI:95% CI: 0.41-0.59), Spe=0.87 (95% CI: 0.52-0.98), AUC=0.58 (95% CI:0.53-0.62); The pooled results of 68Ga-FAPI PET/CT in the diagnosis of primary liver cancer, Sen=0.5 (95% CI: 0.41-0.59), Spe=0.87 (95%CI:0.52-0.98), AUC=0.58 (95% CI:0.53-0.62). Besides, the Sen of 68Ga-FAPI PET/CT in the diagnosis of primary liver cancer was higher than that of 18F-FDG PET/CT (Z=2.323, P=0.02), the difference was statistically significant. Gallium-68-FAPI PET/CT is a promising tool. Compared with 18F-FDG, 68Ga-FAPI has higher sensitivity to detect more lesions in primary liver cancer and metastatic lesions, and has high performance in the diagnosis of primary liver cancer.

A graphene-assisted electrochemical sensor for detection of alpha-fetoprotein in serum

Alpha fetoprotein (AFP) is a specific tumor marker for the diagnosis of primary liver cancer. In this work, a molecularly imprinted (MIP) electrochemical sensor for AFP was prepared by surface imprinting method. The MIP electrochemical biosensor uses polysulfide cordial and graphene-gold composite as electrode modified nanomaterials to effectively enhance the detection of electrical signals. Dopamine (DA) is the functional monomer and the PDA-AFP complex is obtained by electropolymerization. The eluent elutes the functional monomer and the specific cavity formed can adsorb the target molecule. Under optimal experimental conditions, differential pulse voltammetry (DPV) was used for detection. The current of the prepared biosensor decreases with increasing AFP concentration. The peak current value of DPV assay showed good linearity with the logarithm of AFP concentration in the range of 0.01 ng/mL-1000 ng/mL. The detection limit can reach 3.7 pg/mL.

Artificial intelligence in liver cancers: Decoding the impact of machine learning models in clinical diagnosis of primary liver cancers and liver cancer metastases

Liver cancers are the fourth leading cause of cancer-related mortality worldwide. In the past decade, breakthroughs in the field of artificial intelligence (AI) have inspired development of algorithms in the cancer setting. A growing body of recent studies have evaluated machine learning (ML) and deep learning (DL) algorithms for pre-screening, diagnosis and management of liver cancer patients through diagnostic image analysis, biomarker discovery and predicting personalized clinical outcomes. Despite the promise of these early AI tools, there is a significant need to explain the ‘black box’ of AI and work towards deployment to enable ultimate clinical translatability. Certain emerging fields such as RNA nanomedicine for targeted liver cancer therapy may also benefit from application of AI, specifically in nano-formulation research and development given that they are still largely reliant on lengthy trial-and-error experiments. In this paper, we put forward the current landscape of AI in liver cancers along with the challenges of AI in liver cancer diagnosis and management. Finally, we have discussed the future perspectives of AI application in liver cancer and how a multidisciplinary approach using AI in nanomedicine could accelerate the transition of personalized liver cancer medicine from bench side to the clinic.

Role of CA 19.9 and CEA in predicting diagnosis in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is responsible for 90% of cases of primary liver cancer and is also responsible for the fourth most common cause of cancer death worldwide. To improve the current scenario for the early diagnosis and management of HCC patients, a better understanding of HCC is required. Hence, serum tumor biomarkers such as CA 19-9 (cancer antigen), CEA (carcinoembryonic antigen), and AFP (alpha-fetoprotein) show promising future, when it comes to early diagnosis of primary liver cancer (PHC), liver cirrhosis, and metastasis. It was a retrospective cross-sectional analysis of patients diagnosed with primary hepatocellular carcinoma, data were collected from the hospital database and included a total of 245 patients of HCC attending the out-patient department and some were admitted for treatment at our institution. Out of 245 patients, 68 patients were selected for the study. We have collected information related to the patient's demographic profile, pathological diagnosis, biochemical profile, and even radiological diagnosis. The sensitivity and specificity of CA 19-9 and CEA were also done. Adenocarcinoma is the most common type of liver cancer followed by HCC. We have shown a weak correlation between tumor markers CA 19-9 and CEA for the diagnosis of liver carcinoma. Further our study shows that the sensitivity of tumor marker CA 19-9 for the diagnosis of liver carcinoma is 64.28% and that of CEA is 83.67%. The search for a novel biomarker of early liver carcinoma requires further research. The authors declare that they have no competing interests.

Machine learning-empowered cis-diol metabolic fingerprinting enables precise diagnosis of primary liver cancer.

Cis-diol metabolic reprogramming evolves during primary liver cancer (PLC) initiation and progression. However, owing to the low concentrations and highly structural heterogeneity of cis-diols in vivo, severe interference from complex biofluids and limited profiling coverage of existing methods, in-depth profiling of cis-diol metabolites and linking their specific changes with PLC remain challenging. Besides, due to the low specificity of widely used protein biomarkers, accurate classification of PLC from hepatitis still represents an unmet need in clinical diagnostics. Herein, to high-coverage profile cis-diols and explore the translational potential of them as biomarkers, a machine learning-empowered boronate affinity extraction-solvent evaporation assisted enrichment-mass spectrometry (MLE-BESE-MS) was developed. A single analytical platform integrated with multiple complementary functions, including pH-controlled boronate affinity extraction, solvent evaporation-assisted enrichment and nanoelectrospray ionization-based cis-diol identification, was constructed, which significantly improved the metabolite coverage. Meanwhile, by virtue of machine learning (principal components analysis, orthogonal partial least-squares discrimination analysis and random forest), collected cis-diols were statistically screened to extract efficient features for precise PLC diagnosis, and the results outperform the routinely used protein biomarker-based methods both in sensitivity (87.5% vs. less than 70%) and specificity (85.7% vs. ca. 80%). This machine learning-empowered integrated MS platform advanced the targeted metabolic analysis for early cancer diagnosis, rendering great promise for clinical translation.

The clinical value of serum AFP, AFP-L3 and DCP alone and in combination in the diagnosis of primary liver cancer

Objective: To analyze the diagnostic value of AFP, AFP-L3 and DCP in primary liver cancer.

Development and validation of personalised risk prediction models for early detection and diagnosis of primary liver cancer among the English primary care population using the QResearch® database: research protocol and statistical analysis plan

Background and research aimThe incidence and mortality of liver cancer have been increasing in the UK in recent years. However, liver cancer is still under-studied. The Early Detection of Hepatocellular Liver Cancer (DeLIVER-QResearch) project aims to address the research gap and generate new knowledge to improve early detection and diagnosis of primary liver cancer from general practice and at the population level. There are three research objectives: (1) to understand the current epidemiology of primary liver cancer in England, (2) to identify and quantify the symptoms and comorbidities associated with liver cancer, and (3) to develop and validate prediction models for early detection of liver cancer suitable for implementation in clinical settings.MethodsThis population-based study uses the QResearch® database (version 46) and includes adult patients aged 25–84 years old and without a diagnosis of liver cancer at the cohort entry (study period: 1 January 2008–30 June 2021). The team conducted a literature review (with additional clinical input) to inform the inclusion of variables for data extraction from the QResearch database. A wide range of statistical techniques will be used for the three research objectives, including descriptive statistics, multiple imputation for missing data, conditional logistic regression to investigate the association between the clinical features (symptoms and comorbidities) and the outcome, fractional polynomial terms to explore the non-linear relationship between continuous variables and the outcome, and Cox/competing risk regression for the prediction model. We have a specific focus on the 1-year, 5-year, and 10-year absolute risks of developing liver cancer, as risks at different time points have different clinical implications. The internal–external cross-validation approach will be used, and the discrimination and calibration of the prediction model will be evaluated.DiscussionThe DeLIVER-QResearch project uses large-scale representative population-based data to address the most relevant research questions for early detection and diagnosis of primary liver cancer in England. This project has great potential to inform the national cancer strategic plan and yield substantial public and societal benefits.

Ethanolic extract of Coleus aromaticus leaves impedes the proliferation and instigates apoptotic cell death in liver cancer HepG2 cells through repressing JAK/STAT cascade.

Liver cancer or hepatocellular carcinoma (HCC) has become a leading cause for cancer burden across the globe, and incidences have tripled since the last two decades. Poor diagnosis of primary liver cancer and limited treatment strategies aggravate the challenges. Researchers globally have shown a steep inclination toward the exploration of plant-based compounds for their nutraceutical and anticancer potential to fit into the role of novel chemotherapeutics. Coleus aromaticus is a well-known culinary herb that earlier has been reported for several medicinal attributes. The current investigation deals with exploring the anticancer potential of ethanolic leaf extract of C. aromaticus (CoL-EtOH) against hepatocellular carcinoma HepG2 cell line. The observations made it evident that CoL-EtOH extract impeded the viability of HepG2 at 400 μg/ml (p< .01). Additionally, the extract also succeeded in escalating ROS production (p< .01) which aided dissipation of mitochondrial membrane potential and disruption of nuclear morphology. CoL-EtOH further activated caspase-8, -9, and -3 which was reaffirmed by increase in apoptosis at 400 μg/ml (p< .01). Moreover, post treatment with CaLEt-OH extract significantly reduced the expression of JAK-1 & STAT-3 genes (p< .01) along with regulated expression of Mcl1, Bcl-2, cyclinD1, p21, and p27 within HepG2 cells. This evidence portrays the promising anticancer potential of CoL-EtOH projecting it as a novel chemotherapeutic agent against HCC. PRACTICAL APPLICATIONS: The herb Coleus aromaticus belonging to Lamiaceae family and Coleus genus is known by various names in different regions of the world and several language-specific vernacular names. The herb has been used in therapeutic and medicinal applications as well as in culinary preparations. Various attributes of the nutritional strength and functional characteristics of the leaves in terms of carotenoids, minerals, phenols, dietary fiber, and antioxidant activity have been reported by several researchers. Carvacrol and thymol are majorly found in the plant, while chlorogenic acid and rosmarinic acid etc. as the phenolic components. The herb has been used in therapeutic and medicinal implications as well as in culinary preparations.

Contrast-Enhanced Ultrasound and Magnetic Resonance Enhancement Based on Machine Learning in Cancer Diagnosis in the Context of the Internet of Things Medical System.

As an accurate, safe, and effective noninvasive examination method, imaging examination has been widely used in the diagnosis and differential diagnosis of focal liver lesions. Enhanced ultrasonography (CEUS), enhanced CT (CECT), and enhanced magnetic resonance imaging (CEMRI) are the most commonly used enhanced imaging methods in clinical practice, all of which can accurately determine the nature of liver lesions. The purpose of this paper is to study the application of contrast-enhanced ultrasound and magnetic resonance enhancement in cancer diagnosis based on the Internet of Things medical system. The basic clinical data, CEUS, and enhanced CT/MRI findings of 120 CHC patients were retrospectively analyzed. The clinicopathological features of CHC patients were investigated by contrast-enhanced ultrasonography and CT/MRI enhanced mode. The diagnostic value of contrast-enhanced ultrasound and enhanced CT/MRI combined with tumor markers in CHC was analyzed. The experimental results showed that the sensitivities of CEUS, enhanced MRI, and their combination in diagnosing CHC were 72.44%, 81.56%, and 93.78%, respectively. This experiment has an important value in the diagnosis of primary liver cancer.

Imaging Diagnosis of Primary Liver Cancer Using Magnetic Resonance Dilated Weighted Imaging and the Treatment Effect of Sorafenib.

Objective This work explores the application value of dilated weighted imaging (DWI) in the diagnosis of primary liver cancer (PLC) and the effect of sorafenib in the treatment of PLC. Methods 88 patients with PLC who were treated in The First Affiliated Hospital of Northwest University from March 2019 to March 2021 were selected and randomly rolled into an experimental group and a control group, with 44 cases in each group. Patients in both groups were treated with transcatheter arterial chemoembolization (TACE), and the patients in the experimental group were treated with oral sorafenib on the basis of TACE. The indicators of complications, short-term efficacy (STE), and long-term efficacy (LTE) of the two groups were observed. All patients received DWI and magnetic resonance (MR) plain scan. The diagnostic accuracy and misdiagnosis rate of the two methods in diagnosing the PLC were compared. Results The accuracy, specificity, and sensitivity of MR plain scan were 68%, 88%, and 89%, respectively, while those of DWI were 96%, 95%, and 94.2%, respectively. It indicated that the accuracy, specificity, and sensitivity of DWI in diagnosing lesions were better than those of MR plain scan, especially the diagnostic accuracy (P < 0.05). The objective response rate (ORR) and disease control rate (DCR) of the STE in the experimental group were 30% and 97%, respectively, and those in the control group were 6% and 54.5%, respectively. The experimental group's mean progression-free survival (mPFS) and mean overall survival (mOS) were 12 and 25 months, respectively, while the control group's were 8 and 19 months, respectively. It was concluded that the mPFS and mOS of patients receiving TACE combined with oral sorafenib were much higher than those receiving TACE only (P < 0.05). Conclusion DWI and TACE combined with sorafenib had high application value in the diagnosis and treatment of PLC.

N-Cadherin Distinguishes Intrahepatic Cholangiocarcinoma from Liver Metastases of Ductal Adenocarcinoma of the Pancreas.

Simple SummaryThe differential diagnosis of primary liver cancer versus liver metastases of an extrahepatic primary tumor may be challenging, especially in carcinoma of the pancreatobiliary phenotype, as in intrahepatic cholangiocarcinoma or metastases of ductal adenocarcinoma of the pancreas. Nevertheless, the distinction is of fundamental importance for therapy planning. In the frame of this study, we focus on the differential expression and localization of the cell–cell contact-proteins E-cadherin and N-cadherin, markers for cell differentiation in normal epithelia of the pancreaticobiliary tract as well as in derived tumors, and demonstrate that N-cadherin positivity distinguishes intrahepatic cholangiocarcinoma from liver metastases of ductal adenocarcinoma of the pancreas. We propose that N-cadherin-positivity together with other biliary markers may be used for this important histopathological differential diagnosis and may thus improve the accuracy of cholangiocarcinoma diagnosis.Carcinomas of the pancreatobiliary system confer an especially unfavorable prognosis. The differential diagnosis of intrahepatic cholangiocarcinoma (iCCA) and its subtypes versus liver metastasis of ductal adenocarcinoma of the pancreas (PDAC) is clinically important to allow the best possible therapy. We could previously show that E-cadherin and N-cadherin, transmembrane glycoproteins of adherens junctions, are characteristic features of hepatocytes and cholangiocytes. We therefore analyzed E-cadherin and N-cadherin in the embryonally related epithelia of the bile duct and pancreas, as well as in 312 iCCAs, 513 carcinomas of the extrahepatic bile ducts, 228 gallbladder carcinomas, 131 PDACs, and precursor lesions, with immunohistochemistry combined with image analysis, fluorescence microscopy, and immunoblots. In the physiological liver, N-cadherin colocalizes with E-cadherin in small intrahepatic bile ducts, whereas larger bile ducts and pancreatic ducts are positive for E-cadherin but contain decreasing amounts of N-cadherin. N-cadherin was highly expressed in most iCCAs, whereas in PDACs, N-cadherin was negative or only faintly expressed. E- and N-cadherin expression in tumors of the pancreaticobiliary tract recapitulate their expression in their normal tissue counterparts. N-cadherin is a helpful marker for the differential diagnosis between iCCA and PDAC, with a specificity of 96% and a sensitivity of 67% for small duct iCCAs and 50% for large duct iCCAs.

Diagnostic Value of Multislice Spiral Computed Tomography Combined with Serum AFP, TSGF, and GP73 Assay in the Diagnosis of Primary Liver Cancer.

Objective To explore the diagnostic value of multislice spiral computed tomography (MSCT) scan combined with serum alpha-fetoprotein (AFP), tumor-specific growth factor (TSGF), and Golgi protein73 (GP73) assays in the diagnosis of primary liver cancer (PLC). Methods Totally, 60 patients with PLC admitted to The Second Hospital of Dalian Medical University from January 2019 to January 2020 were included in group A, 60 patients with liver cirrhosis were included in group B, and 60 healthy subjects were included in group C. The serum AFP, TSGF, and GP73 levels were determined, and all participants received MSCT scanning. The diagnostic efficacy of MSCT, assays of serum AFP, TSGF, and GP73, and their combined detection was analyzed. Results Group A had the highest levels of AFP, TSGF, and GP73, followed by group B, and then group C. The sensitivity, specificity, positive predictive value, and negative predictive value of MSCT for PLC were 80.0%,91.7%, 82.8%, and 90.2%, respectively, while those of combined detection of MSCT plus serum AFP, TSGF, and GP73 for PLC were 100.0%, 93.3%, 88.2%, and 100.0%. The combined detection was associated with significantly a higher detection rate of PLC versus stand-alone detection. Conclusion MSCT plus serum AFP, TSGF, and GP73 has a higher detection rate versus stand-alone detection, which shows great potential in the diagnosis of PLC.

Correlation analysis of intestinal flora and immune function in patients with primary hepatocellular carcinoma.

This study applied metagenomic sequencing technology to analyze the intestinal flora distribution and immune function of patients with primary liver cancer. Stool samples were collected from 10 patients with primary liver cancer (primary liver cancer group) and 10 healthy subjects (healthy control group) who were admitted to The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from March to June 2021. The general data of the patients were recorded. Metagenomic sequencing was performed, and principal component analysis and diversity analysis were used to analyze the structure of the two groups and compare the differences in species abundance. United States Employment Service (USES) Spearman correlation analysis was applied to examine vice Streptococcus blood, saliva, Streptococcus, Streptococcus mutans, Streptococcus thermophilus, and vice Haemophilus influenzae, WeiRong aureus, existing different WeiRong bacteria, Eosinophilic mucins Ekman bacteria, responding to bacteria, the other branch bacteria abundance and in alanine aminotransferase (ALT), aspartate aminotransferase (AST), valley correlation between levels of amyltranspeptidase (GGT), total protein, total bilirubin and alpha-fetoprotein (AFP). Beta diversity analysis based on Bray and Jensen-Shannon Divergence (JSD) distance measurement showed that the heterogeneity of fecal flora in the hepatic cell carcinoma (HCC) group was significantly lower than that in the healthy control group (P<0.001. At the species level of bacterial taxonomy, there was a statistically significant difference in the distribution of 137 bacteria in the healthy control and primary liver cancer groups (P<0.05). Correlation analysis showed that Streptococcus salivarius (P=0.020), Streptococcus thermophilus (P=0.002), and Haemophilus parainfluenzae (P=0.023) were significantly positively correlated with the serum ALT level. There were also notable correlations with AST (P=0.049), GGT (P=0.037), and total protein (P=0.010). The diversity of intestinal flora in patients with primary liver cancer is significantly reduced, species abundance is altered, and there is a marked imbalance of intestinal flora. Therefore, specific bacterial species with different intestinal flora may be used as biomarkers for the early diagnosis of primary liver cancer.

Magnetic Resonance Imaging and Serum AFP-L3 and GP-73 in the Diagnosis of Primary Liver Cancer.

Objective To investigate the combined application value of magnetic resonance imaging (MRI) combined with serum alpha-fetoprotein (AFP)-L3 and Golgi protein (GP)-73 in the diagnosis of primary liver cancer. Methods The data of 200 patients with suspected liver cancer admitted to our hospital from February 2020 to February 2021 were retrospectively analyzed, and they were randomly divided into an experimental group and a control group, with 100 cases in each group. The experimental group received a combined detection of MRI with serum AFP-L3 and GP-73, and the control group adopted traditional diagnostic methods (spiral computed tomography and serum AFP). The diagnostic yields of the two groups were compared. Surgical resection was performed after the diagnosis of primary liver cancer, and the correlation between the efficacy and combined detection of MRI with serum AFP-L3 and GP-73 levels was analyzed. Results The two groups presented comparable general information (P >0.05). The surgical results showed 160 cases of primary liver cancer, including 75 cases in the experimental group and 85 cases in the control group, and 40 cases of benign liver lesions. The diagnostic accuracy of the experimental group (73/75, 95%) was significantly higher than that of the control group (76/85, 86%) (P < 0.05). The serum levels of AFP-L3, GP-73, and AFP in patients with primary liver cancer were remarkably decreased after surgery (P < 0.001). The preoperative and postoperative AFP-L3, GP-73, and AFP levels of patients with primary liver cancer were significantly higher than those of patients with benign liver lesions. The AUC (95% CI) for the combined detection of MRI and serum AFP-L3 and GP-73 levels in patients with surgically confirmed primary liver cancer was 0.747 (0.619-0.874). Conclusion MRI combined with serum AFP-L3 and GP-73 presents favorable diagnostic efficiency in the diagnosis of primary liver cancer, which is worthy of clinical application.

Serum TERT C228T is an important predictor of non-viral liver cancer with fatty liver disease

BackgroundMolecular therapies and precision medicine are expected to be developed for liver cancer based on the diagnosis of DNA somatic alterations. However, it remains unclear whether TERT promoter mutation (TERT C228T) in serum cfDNA is useful for the diagnosis of liver cancer with non-viral fatty liver disease (FLD).MethodsThis retrospective cohort study examined 258 Japanese patients who had a confirmed diagnosis of primary liver cancer. We investigated the factors associated with TERT C228T and abnormal levels of liver cancer-specific tumor markers (AFP and PIVKAII) in serum samples.ResultsMultivariate analysis identified the etiology of FLD, vascular invasion, and non-cirrhosis as determinants of TERT C228T-positive liver cancer. Rates of positive TERT C228T in FLD were significantly higher than those of HBV and HCV. Conversely, rates of abnormal AFP in FLD were significantly lower than those of HBV and HCV. Viral suppression of HBV/HCV and alcohol intake did not affect TERT C228T, but AFP was significantly reduced by viral suppression. The rates of positive TERT C228T were significantly lower in HCV patients with viral clearance than those of FLD patients.ConclusionOur results highlight the importance of serum TERT C228T for the detection of non-viral FLD-related liver cancer. TERT C228T is a tumor marker that might not be influenced by inflammation.

Comparative the clinical value of contrast-enhanced ultrasonography, enhancement CT and MRI for diagnosing of liver lesions.

To investigate the accuracy of contrast-enhanced ultrasonography, CT-enhancement and MRI in the diagnosis of liver-occupying lesions. 176 patients with suspected liver lesions in our hospital were retrospectively studied from July 2014 to July 2016. All of the 176 patients were diagnosed by contrast-enhanced ultrasonography, enhanced CT and MRI, and the pathological examination was performed. The results of pathological examination were regarded as the results of the diagnosis. The diagnostic accuracywas then compared among contrast-enhanced ultrasound, enhanced CT and MRI of these patients. The results of contrast-enhanced ultrasonography showed that 164 of the 176 patients had liver-occupying lesions, and the accuracy of the diagnosis was 95.35%, which was significantly higher than that of CT enhancement and MRI (80.23% 84.30%). The accuracy of contrast-enhanced ultrasonography, in the diagnosis of primary liver cancer was significantly higher than that of CT enhancement and MRI (P < 0.05), and the difference was significant difference (P < 0.05). The examination of contrast-enhanced ultrasonography is relatively simple, and the patients can get duplicateexamination, so we should choose the contrast-enhanced ultrasonography as the preferred method of diagnosis in liver mass, especially primary liver cancer.

Clinical Value of Helical CT, Energy Spectrum CT, and MRI in the Diagnosis of Primary Liver Cancer

Clinical Value of Helical CT, Energy Spectrum CT, and MRI in the Diagnosis of Primary Liver Cancer