Tumor Markers AFP Research Articles

Pathological features of primary extragonadal germ cell tumor of the prostate with small round blue cell morphology

Objective: To investigate the clinicopathological features and clinical management of primary extragonadal germ cell tumor of the prostate. Methods: Two cases of primary extragonadal germ cell tumor in the prostate were collected at Fudan University Shanghai Cancer Center, in January and September 2016, respectively. Their pathological features, clinical treatments and follow-up were retrospectively analyzed. Results: The two patients were 41 and 32 years old, respectively, and both presented with obstructive symptoms of the lower urinary tract. Histologically, both cases showed small round blue cells and an invasive growth pattern. The immunohistochemistry (IHC) stains of SALL4, OCT3/4, CD117 and PLAP were all positive, while those of PSA, AR and syn were negative. Moreover, case 1 demonstrated perinuclear dot-like staining for CKpan, which might be a diagnostic pitfall. There was no evidence of disease in other areas via physical examination or radiographic studies. Based on these IHC findings and the morphology, the two cases were diagnosed as primary seminoma of the prostate, which were consequently treated with six cycles of bleomycin, etoposide and cisplatin-based chemotherapy. A complete response was achieved in case 1. Case 2 was followed up and showed tumor recurrence, and progression with elevated tumor marker AFP. The subsequent radical removed specimens of case 2 were finally diagnosed as mixed germ cell tumor of the prostate. Conclusion: As a rare neoplastic entity, primary germ cell tumor of the prostate can show small blue round cell morphology. Pathologically, the morphology of small round blue cells combined with a perinuclear dot-like pattern of CKpan IHC staining may be a diagnostic pitfall. The clinical treatment strategy should be evaluated with consideration of the pathological diagnosis and comprehensive evaluation of the tumor markers.

Does Determining Tumor Markers from the Testicular Vein Enable Better Diagnosis and Prognosis?

Introduction: β-HCG has been the only tumor marker evaluated in testicular vein (VT) blood until now. Objective: To evaluate the correlation between the tumor markers β-HCG, AFP, PLAP, and LDH from the VT and peripheral blood as well as their significance in predicting tumor recurrence and tumor stage. Methods: Patients with testicular cancer undergoing orchiectomy were studied retrospectively over a period of 20 years. Tumor stage, tumor histology, time to tumor recurrence, and tumor markers from VT and peripheral blood were analyzed. Minimal follow-up was 2 years. Statistical analysis was performed by means of Cox- and logistic regression models and Spearman rank correlation coefficients. Results: A total of 172 patients with an average follow-up of 9.9 years were investigated. The overall recurrence rate was 18% (seminoma patients 20.8%, nonseminoma patients 14.5%). Marker values measured from VT blood were higher than in peripheral blood and correlated strongly with the peripherally measured values. AFP obtained from peripheral blood was the only tumor marker allowing a statement on the recurrence probability. Tumor markers from VT blood showed no correlation with tumor stage. Discussion/Conclusion: Tumor markers from VT blood are significantly higher than in peripheral blood. Tumor markers obtained from VT blood do not provide clinical advantage in terms of assessing tumor stage and recurrence probability.

Spirulina inhibits hepatocellular carcinoma through activating p53 and apoptosis and suppressing oxidative stress and angiogenesis

BackgroundMost hepatocellular carcinoma cases are diagnosed at late stages of the disease, which makes it the second cause of cancer mortality worldwide. For advanced-stage patients, chemotherapeutic drugs are the best treatment option; however, their adverse effects and high cost are still major obstacles for effective treatment. Spirulina microalga is a rich source of nutritional and bioactive elements and potential pharmaceuticals, which has an -proliferative effect against several cancer cell lines. It also has a prophylactic effect against the early stages of some cancer models, including hepatocellular carcinoma. AimsThe present study was carried out to evaluate the therapeutic anticarcinogenic effect of spirulina against advanced murine hepatocellular carcinoma. Main methodsHepatocarcinoma was induced by a single injection of diethylnitrosamine (100 mg/kg, intraperitoneally) followed by 22 weekly injections of carbon-tetrachloride (0.5 mg/kg, i.p). Spirulina (250 and 500 mg/kg bw) was given orally, from week 25 to 28, after the establishment of hepatocellular carcinoma. Key findingsSpirulina inhibited HCC structural and functional alterations, manifested by improving the survival rate, significantly decreasing the tumor marker AFP, and the count and size of the hepatic nodules, as well as downstaging HCC. This was accompanied with the augmentation of the endogenous antioxidant capacity, apoptosis (Bax) and the tumor suppressor protein (p53), as well as the suppression of tissue levels of the lipid peroxidation marker (MDA) and neoangiogenesis marker (VEGF). SignificanceIn conclusion, spirulina has an anticarcinogenic effect against advanced hepatocellular carcinoma exerted through activating the tumor suppressor protein p53 and apoptosis, and suppressing oxidative stress and angiogenesis.

Real impact of tumor marker AFP and PIVKA-II in detecting very small hepatocellular carcinoma (≤ 2 cm, Barcelona stage 0) - assessment with large number of cases.

BACKGROUNDIn hepatocellular carcinoma (HCC), detection and treatment prior to growth beyond 2 cm are relevant as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.AIMTo examine the impact of the tumor marker alpha-fetoprotein (AFP) or PIVKA-II in detecting very small HCC nodules (≤ 2 cm in maximum diameter, Barcelona stage 0) in the large number of very small HCC. The difference in the behavior of these tumor markers in HCC development was also examined.METHODSA total of 933 patients with single-nodule HCC were examined. They were subdivided into 394 patients with HCC nodules ≤ 2 cm in maximum diameter and 539 patients whose nodules were > 2 cm. The rates of patients whose AFP and PIVKA-II showed normal values were examined.RESULTSThe positive ratio of the marker PIVKA-II was significantly different (P < 0.0001) between patients with nodules ≤ 2 cm in diameter and those with nodules > 2 cm, but there was no significant difference in AFP (P = 0.4254). In the patients whose tumor was ≤ 2 cm, 50.5% showed normal levels in AFP and 68.8% showed normal levels in PIVKA-II. In 36.4% of those patients, both AFP and PIVKA-II showed normal levels. The PIVKA-II-positive ratio was markedly increased with an increase in the tumor size. In contrast, the positivity in AFP was increased gradually and slowly.CONCLUSIONIn the surveillance of very small HCC nodules (≤ 2 cm in diameter, Barcelona clinical stage 0) the tumor markers AFP and PIVKA-II are not so useful.

S2383 When Blood Meets Liver: An Interesting Case of Budd-Chiari Syndrome

INTRODUCTION: Budd-Chiari is a syndrome characterized by hepatic venous outflow obstruction. Primary Budd-Chiari is due to pro-coagulant states causing venous thrombosis. Secondary Budd-Chiari is due to compression or invasion of the hepatic veins, such as malignancy. Budd-Chiari is rare and has a high mortality if not properly identified and managed. CASE DESCRIPTION/METHODS: A 67-year-old Hispanic female with past medical history of chronic liver mass, liver cirrhosis secondary to NAFLD, type 2 diabetes mellitus, and obesity, presents with abdominal pain for several days. Physical exam was notable for right upper quadrant abdominal pain, anasarca, and abdominal wall cellulitis. Laboratory tests were remarkable for white blood cell count, 3.2; platelet count, 84; and AST 66. The remainder of laboratory data were unremarkable. CT abdomen pelvis showed enlarging right hepatic lobe lesion; expansion of the right hepatic vein into the suprahepatic IVC, concerning for tumor thrombus; and infrahepatic IVC prominent caliber suggestive of backflow pressure related to tumor thrombus. MRI abdomen showed 4.2 cm mass in the right hepatic lobe, possibly hepatocellular carcinoma. The location of the mass did not allow for safe percutaneous biopsy. Tumor marker AFP was noted to be 1,682. Hypercoagulable panel and immunologic work up were unremarkable. The patient was started on IV heparin and IV antibiotics. She was eventually transitioned to by mouth Eliquis. After a 14-day hospital stay, she was discharged home on continued Eliquis treatment and outpatient follow up appointments with Gastroenterology and Hematology. DISCUSSION: The presentation of Budd-Chiari is highly variable. When considering the diagnosis clinicians should be suspicious of patients with risk factors, such as malignancy, hypercoagulable states, and liver infections. Typical signs and symptoms of Budd-Chiari include acute liver failure patients with ascites, right upper quadrant abdominal pain, and hepatomegaly. The diagnosis is generally made with imaging. Abdominal ultrasound may show hypertrophied caudate liver lobe secondary to venous outflow channels distinct from the hepatic veins. CT or MRI abdomen can provide confirmatory imaging if ultrasound is unremarkable, but suspicion is high. Liver biopsy is not required to establish diagnosis and increases risk of bleeding. Although there are significant bleeding risks in patients, long term anticoagulation is required.

Incidental Hepatic Splenosis in a Male with Microhematuria

Hepatic splenosis is a rare entity which involves imbedding of native splenic tissue into liver parenchyma. This typically occurs after abdominal trauma, splenic laceration, or splenectomy. A 35 year old Russian male with history of obesity presented to Urology for evaluation given history of a solitary kidney. Urinalysis showed evidence of microhematuria and subsequent urine cytology showed a highly atypical cell. An abdominal MRI without contrast was done for further evaluation. A 3.4 cm x 5.0 cm T1 hypointense, T2 hyperintense mass in the right hepatic lobe was seen (figure 1). Additional history revealed splenectomy and nephrectomy after trauma in 1984. He denied blood transfusions, intravenous drug use, or sexual promiscuity. He admitted to a 6 year period of heavy alcohol use in his twenties. Labs revealed normal LFTs and negative viral hepatitis B and C serologies. Tumor markers CEA, AFP, and Ca 19-9 were not elevated. An abdominal MRI with contrast was done to better evaluate the lesion. It showed an unchanged lobulated 3.4 cm x 5.0 cm mass in hepatic segment 8 with arterial enhancement and patchy areas of washout (figure 1). The differential included hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma, focal nodular hyperplasia, sarcoma, and metastatic disease from testicular cancer. There was particular concern for HCC given arterial enhancement with washout. An ultrasound guided biopsy was done for diagnosis. Pathology of the mass showed red and white pulp of splenic tissue surrounded by normal appearing hepatocytes (figure 2). Approximately 80% of patients with hepatic splenosis have a history of splenectomy. The interval time between splenectomy and hepatic splenosis is 25 years. The pathogenesis is believed to be from hematogenous spread or direct seeding of splenic tissue onto exposed serosal surfaces at the time of trauma or splenectomy. Technetium-99m-labeled heat denatured red blood cell scintigraphy or supraparamagnetic iron oxide enhanced MRI are non-invasive tests that can confirm the diagnosis. Hepatic splenosis does not require resection unless the patient has evidence of idiopathic thrombocytopenic purpura or autoimmune hemolytic anemia. Although hepatic splenosis is a rare entity, it can mimic malignancy and lead to invasive testing and surgery. It is important to consider this diagnosis in patients with history of splenectomy and characteristic imaging in order to prevent unnecessary medical intervention.2423_A Figure 1 No Caption available.2423_B Figure 2 No Caption available.

Some increasing of the level of AFP before operation had relation to overall survival rates in rfa as first therapy for small HCC

Introduction: Radio frequency ablation (RFA) for hepatocellular carcinoma (HCC) were the importance therapeutic strategy. The gross classification by The General Rules of the Clinical and Pathological Study of Primary Liver Cancer and tumor size were very important for HCC therapy. For our surgical outcome and result of pathology based on the gross classification from 1990 to 1994, our RFA indication was less than 30 mm and simple nodular type (SN) or small nodular type with indistinct margin (SNIM). We presented that there were no significant difference of rate of disease-free (DFS) and overall survival rates (OS) between HR and RFA. This time, we studied relations between outcome of RFA and tumor marker AFP. Methods: 40 cases checked level of AFP two time before operation, undergoing first therapy by RFA from 2009 to 2012 were studied. We evaluated DSF, OS by a group with increasing of level of AFP (UP group) or not increasing (non-UP group). Results: In the group (n=22) and non-UP group (n=18), level of AFP at first time were 2-191 (median: 17) and 3-102 ng/ml (median: 7.5), level of AFP at second time were 3-298 (median: 18), 2-65 ng/ml (median: 7). The 5 years DSF of UP group or non-UP group were 18.8%, 27.3% (p=0.645), and the 5 OS were 48.1%, 84.2% (p=0.04). Conclusion: In RFA as first therapy for SN- or SNIM-type HCC (< 30 mm, single nodule), it was suggested :that some increasing of the level of AFP before operation had relation to OS.

Direct determination of the tumor marker AFP via silver nanoparticle enhanced SERS and AFP-modified gold nanoparticles as capturing substrate.

The authors describe a rapid and direct SERS-based immunoassay for the determination of AFP, an important marker for diagnosis of hepatocellular carcinoma. Silver nanoparticles (AgNPs; 36nm i.d.) serve as a support to immobilize antibody and as a SERS intensifier, and AFP-modified gold nanoparticles are employed as capturing substrate. Direct and quantitative detection of AFP is accomplished with a limit detection as low as 5ng·mL-1. Compared to assays based on the use of metal nanoparticles, the use of gold-silver nanoparticle heterodimers as an active SERS substrate can save costs because only a single antibody is required. Moreover, the high selectivity and good linear relationship of detecting AFP in fetal bovine serum indicates its potential applicability for the direct analysis of clinical samples. Graphical abstract Direct and quantitative determination of AFP antigen utilizing SERS has been was successfully presented and applied to detect alpha fetoprotein antigen in fetal bovine serum with detection limit of 2ng•mL-1.

Diagnostic performance of tumor markers AFP and PIVKA-II in Chinese hepatocellular carcinoma patients.

Alpha-fetoprotein is an effective biomarker as an aid in hepatocellular carcinoma detection in many countries. However, alpha-fetoprotein has its limitations, especially in early hepatocellular carcinoma diagnosis. Protein induced by vitamin K absence or antagonist-II is another biomarker that is used for hepatocellular carcinoma detection. The aim of this study is to compare the diagnostic performance of alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II alone and in combination to explore improving biomarker performance as an aid in early hepatocellular carcinoma detection. In this study a total of 582 serum samples including 132 hepatocellular carcinoma patients, 250 non-hepatocellular carcinoma patients, and 200 healthy volunteers were collected. Alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II levels were measured by both chemiluminescent enzyme immunoassay on LUMIPULSE platform and by chemiluminescent microparticle immunoassay on ARCHITECT platform. Receiver operation characteristic curve analyses were performed for each biomarker and in combination. The results showed that Alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II in combination have shown higher area under the curve compared to alpha-fetoprotein alone for diagnosis in whole patients (0.906 vs 0.870) in hepatocellular carcinoma early-stage patients (0.809 vs 0.77) and in hepatitis B virus-related hepatocellular carcinoma patients (0.851 vs 0.788) with ARCHITECT platform. Protein induced by vitamin K absence or antagonist-II showed higher area under the curve than alpha-fetoprotein for diagnosis of hepatitis B virus-related hepatocellular carcinoma patients (0.901 vs 0.788).We conclude that Combining alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II may improve the diagnostic value for early detection of hepatocellular carcinoma. Protein induced by vitamin K absence or antagonist-II performs better than alpha-fetoprotein in diagnosis of hepatitis B virus-related hepatocellular carcinoma patients.

Combination of serum tumor markers dickkopf-1, DCP and AFP for the diagnosis of primary hepatocellular carcinoma.

To evaluate the detection accuracy of the biomarkers dickkopf-1, DCP and AFP as a serum biomarker panel by comparing the sensitivity of the panel with those of the individual biomarkers. The study was composed of three groups, one with HCC patients, one with non-HCC liver diseases and one with healthy controls. Serum AFP was measured using a chemiluminescence assay and serum dickkopf-1 and DCP were measured with ELISA. The sensitivity and specificity of the biomarkers were analyzed as single parameters and as a serum panel. The HCC group showed higher levels of dickkopf-1, DCP and AFP than the other two groups (P<0.05). Dickkopf-1 showed better sensitivity (73.26% vs. 58.13%, P<0.05) and better specificity (44.0% vs. 29.0%, P<0.05) than AFP. DCP also had better sensitivity (74.42% vs. 58.13%, P<0.05) than AFP, but their specificity was similar (30.00% vs. 29.00%, P>0.05). The combination of the biomarkers as a serum panel produced much better sensitivity (93.02%) and specificity (78.00%) than each of the markers individually (P<0.05). The combination of AFP, DCP and dickkopf-1 as a biomarker panel can significantly improve the detection power with much higher sensitivity and specificity for HCC than any of the biomarkers alone. The tests are convenient and inexpensive, and may serve as a valuable addition to current options for the diagnosis of HCC.

Molecular evaluation of Hepatocyte Growth Factor (HGF) as a potential Biomarker to detect Hepatocellular Carcinoma

This study was carried out to investigate the noninvasive expression level of hepatocyte growth factor (HGF) in hepatocellular carcinoma patients and its relationship with diagnostic parameters.To active this goal we used thirty six patient divide to fourteen with HCC, twelve patients with HCV and ten healthy control patient matched in age and sex were investigated. HGF level wasdetected by quantitative polymerase chain reaction (qRT-PCR). The median age of the patients was 51 years (rang 44-58 years); where males constituted the majority of the group (69.4%). The entire patient had cirrhotic history. None of the patients were pretreated with local therapies. The baseline noninvasive HGF level wassignificantly higher in patient HCC than in the HCV and control groups (p=0.028), whereas HGF level was alsohigher in HCV patient than healthy patient. Further the correlation between the level of HGF and all laboratory parameters was tested. We found that there is a good positive relationship between HGF levels and SGPT (ALT), SOGT (AST), Platelets count.Finally we compared the predicative accuracy of HGF and a conventional tumor marker AFP by ROC curve; we found that the sensitivity of HGF (85.7%) to predict the HCC is higher than AFP (73%), and also the specificity.Overall, these results suggest that HGF could serve as a useful tumor biomarker for prediction of HCC in comparing with, HCV, and healthy control results.

Overexpression of Tyro3 and its implications on hepatocellular carcinoma progression.

While various tyrosine kinases have been associated with the pathogenesis of hepatocellular carcinoma (HCC), the identification of a dominant therapeutic target among them remains a challenge. Here, we investigated the role of Tyro3, a relatively uncharacterized member of the TAM (Tyro3, Axl and Mer) receptor family. The present study aimed to profile and identify potential association between Tyro3 expression in HCC and cancer phenotypes. RNAs obtained from 55 HCC patients were quantified for Tyro3 expression in both cancerous tissue and the adjacent normal tissue. Expression profile was correlated with clinical data. These observations were further substantiated with invitro HCC cell culture investigations.Tyro3 was strongly upregulated (>2-fold elevation) in the tumor tissue of ~42% of the patients. It was shown that higher expression level of Tyro3 was associated with the key tumor marker AFP, and the tumor diameter and liver injury marker ALT. Subsequent cell culture models indicated high expression in various HCC cell lines, in particular Hep3B. Gene silencing of Tyro3 in Hep3B effectively reduced cell proliferation, ERK phosphorylation and cyclinD1 expression, indicating a key in maintaining the proliferative state of these cells. Notably, silencing also suppressed the transcriptional and translational expression of HCC tumor marker AFP. Overall, these data suggest that Tyro3 contributes significantly to tumor growth, aggressiveness and liver dysfunction. Inhibition of Tyro3 and its aberrant signaling in tumors with high expression could present new opportunities for HCC treatment.

Histological features of tumor-bearing tissues formed by human fibroblasts after reprograming by Piwil2

To observe the histological features of tumor-bearing tissues formed by human fibroblasts after reprograming by spermatogonial stem cell self-renewal key regulating gene Piwil2 (Piwil2-iCSC). Piwil2-iCSC tumor spheroids-like colonies were selected for tumor formation assay in four nude mice. Pathological features of Piwil2-iCSC tumors were observed by histology. Stem cell markers and common triploblastic markers were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) assay and immunohistochemistry. Germ cell tumor markers were detected by immunohistochemical examination. Two weeks after inoculation, subcutaneous tumors were formed in all the four nude mice with a tumor formation rate of 100%. In the Piwil2-iCSC tumor tissues, Piwil2-GFP(+) cells showed high-density nuclear expression and were widely observed in DAPI-stained sections. Numerous mitotic figure of the neoplastic cells were seen (>10 cells/field of vision under high magnification) in HE-stained sections. Enlarged abnormal cell nuclei were observed. RT-PCR assay showed that Piwil2-iCSC tumors still expressed Piwil2 and some self-renewal and pluripotent markers of stem cells and some markers of triploblastic differentiation. Immunohistochemical staining showed that the tumors expressed stem cell markers, triploblastic markers and germ cell tumor markers AFP and HCG. Piwil2-iCSC tumors are probably undifferentiated embryonic small cell carcinoma, most likely to be immature teratoma, mixed with yolk sac tumor and choriocarcinoma components. It can be used as a useful model for the research of origin or genesis mechanism of cancer stem cells and the treatment of relevant tumors.

Biphenotypic hepatic tumors: imaging findings and review of literature.

To describe imaging findings in biphenotypic hepatic tumors (BPT) and a proposal for new imaging classification based on contrast-enhanced imaging. Retrospective review of CT, MRI, PET/CT, and ultrasound findings in 39 patients with histologically confirmed BPT was performed. Tumor markers including AFP, L3 fraction, CA 19.9, CA 125, and CEA were recorded. Based on the dynamic enhancement features, BPT were categorized into 4 enhancement patterns (Types 1-4). Enhancement patterns were correlated with other imaging findings and tumor markers. Imaging features and tumor markers that were not consistent with diagnosis of hepatocellular carcinoma or intrahepatic cholangiocarcinoma based on enhancement pattern were considered discordant findings. Enhancement patterns in 29 patients (CT/MR) included 23 Type 2 (continuous peripheral rim of late arterial hyperenhancement with washout or fade in portal venous and/or delayed phases, ±delayed central enhancement) and 2 of each Types 1, 2, and 3. Discordant imaging findings were present in two patients with Type 2 pattern and in one patient with Type 1 pattern. Both AFP and CA 19.9 were elevated in 15 of 33 of patients. Tumor markers AFP and CA 19.9 were discordant in 17 of 21 patients with Type 2 pattern, two of two patients with Type 3 pattern. Most BPTs were markedly PET avid with average SUV max of 8.2. Most frequent ultrasound appearance is peripheral hypoechogenicity and central hyperechogenicity. BPT most commonly present with imaging features similar to cholangiocarcinoma or metastases. BPT can be suggested when imaging findings or tumor markers are discordant with the most likely diagnosis based on enhancement pattern.

Porous platinum nanoparticles and PdPt nanocages for use in an ultrasensitive immunoelectrode for the simultaneous determination of the tumor markers CEA and AFP

We describe the use of porous platinum nanoparticles (pPt NPs) and PdPt nanocages (PdPt NCs) in an electrochemical immunoassay for two tumor markers (CEA and AFP) directly in serum and with enhanced detection performance. The pPt NPs possess a high specific surface area and electrical conductivity, while the PdPt NCs display excellent catalytic property and high loading capacity. The PdPt NCs were labeled with anti-CEA and thionine, and the PdPt NCs were labeled with anti-AFP and ferrocene. The resulting electrode displayed a large decrease of the anodic peak current and an increase of cathodic peak current for hydrogen peroxide (H2O2). The dual square wave voltammetric immunoassay was performed at −0.1 V (for CEA) and +0.6 V (for AFP) after exposure to a sample containing CEA and AFP and in the presence of H2O2. CEA can be detected in the 0.05 to 200 ng mL−1 concentration range and AFP between 0.03 and 100 ng mL−1. The limits of detection are 1.4 pg mL−1 for CEA and 1 pg mL−1 for AFP (at an SNR of 3). The sensitivity of the method (expressed as slope vs. concentration) is better by a factor of 4.6 to 100 compared to conventional electrochemical immunoassays. Analytical data obtained with diluted serum samples were in good agreement with reference values obtained via a standard ELISA. Negligible cross-reactivity is found between CEA and AFP. In our opinion, this approach paves the way for developing other kinds of electrochemical immunosensors based on the use of pPt NPs and PdPt NCs as materials for designing new electrode interfaces.

Proteins related to early changes in carcinogenesis of hepatic oval cells after treatment with methylnitronitrosoguanidine

Hepatic oval cells are considered as facultative progenitor/stem cells of liver and able to differentiate into either hepatocytes or biliary epithelial cells. The transformed oval cells by carcinogen possess potential to develop carcinomas in animal models. In order to better understand the molecular mechanism in carcinogenetic process, we used a proteomic approach to assess the early changes in protein expression of oval cells (OC3W3-15) initiated by methylnitronitrosoguanidine (MNNG). Meanwhile, we compared cell biologic characteristics of the MNNG treated OC3W3-15 cells and control oval cells by electron microscopy, flow cytometry, karyotype and soft agar assay. The mRNA levels of GGT and GSTP1 determined by real-time PCR were also detected in both cell lines. Our results showed that MNNG-treated OC3W3-15 cells exhibited characteristics of malignant transformation, including growth rate, chromosomal aberrations, abnormal DNA content, and the ability to form colonies. The cells expressed higher levels of the tumor marker AFP, GGT and GSTP1 mRNA than that of control cells. Significant changes of several proteins involved in the malignant transformation process, including cell cycle related proteins, proteins involved in organism development and cell differentiation, are found in OC3W3-15 cells. The proteins may provide early affection in malignant transformation of hepatic oval cells, and yield further insight into mechanism of carcinogenesis of hepatocellular carcinoma.

Serum Levels of CA15-3, AFP, CA19-9 and CEA Tumor Markers in Cancer Care and Treatment of Patients with Impaired Renal Function on Hemodialysis

Since renal failure causes decrease in tumor marker excretion, use of these markers in cancer care and treatment in patients with renal insufficiency or hemodialysis is controversial. The aim of this study was to investigate differences of serum levels of tumor markers CA15-3, AFP, CA19-9 and CEA in patients with impaired renal function. A total of 100 patients referred to the Tabriz Immam Reza and Amiralmomenin hospital from June 2010 to November 2011 were selected for study. Subjects were divided to 3 groups of healthy, dialysis and renal failure but non hemodialysis cases, the last category being re-grouped based on creatinine clearance. No significant relationship between different groups in serum levels of CEA (P=0.99) and CA19-9 (P=0.29) tumor markers was found. A significant correlation was observed between serum levels of AFP (P<0.001) and CA15-3 (P<0.001) and also a tendency between creatinine clearance and CEA (r=0.05, P=0.625). Creatinine clearance significantly correlated with AFP (P<0.001, r=0.53) and CA15-3 (p=0.00, r=-0.412), but not CA19-9 (P=0.089, r=-0.171). According to results of this study it appears that use of tumor markers in patients with impaired renal function should be performed with special precautions.

English

Abstract Introduction Primary extranodal lymphomas of the liver are notably rare. A proportion of cases are associated with infection with hepatitis C or B, HIV, EBV or primary biliary cirrhosis. We report the case of a 45-year-old man who presented with abdominal pain and weight loss. Case report Physical examination revealed an enlarged liver, but ascites, jaundice, splenomegaly and peripheral lymphadenopathy were absent. Laboratory studies showed elevated hepatic enzymes. Tumour markers CEA and AFP were normal. Abdominal computed tomography revealed multiple hypodense lesions in both lobes of the liver. Liver biopsy examination confirmed a diagnosis of non-Hodgkin’s anaplastic large-cell lymphoma of T phenotype. Immunohistochemically, the neoplastic cells were positive for CD43, CD4, CD2, CD3, CD30, CD5 and granzyme B and negative for CD20, CD79a, CD10, EBV, CD15, CEA, EMA, CD56, CD57 and ALK1. Bone marrow biopsy did not reveal lymphomatous involvement. The patient received combination chemotherapy, and he was alive 2 years after diagnosis. Conclusion Although primary lymphoma of liver is rare compared with secondary hepatic involvement by lymphoma, primary epithelial neoplasms and metastatic carcinoma, the diagnosis should be considered in certain clinical circumstances. The prognosis relates to the specific disease entity.

Magnetic resonance imaging findings of sclerosing Sertoli cell tumor of the testis

We present a case of sclerosing Sertoli cell tumor of the testis that was examined preoperatively by magnetic resonance imaging. A 28-year-old male presented to the urology department of our hospital complaining of a painless mass in the right testicle that had been present for the past 2 years. Levels of the tumor markers AFP, hCG, and LDH were all within the standard ranges. T2-weighted MR images showed a well-demarcated lobular hypointensity 15 mm in size in the right testis. Contrast enhancement of this mass after gadolinium administration was homogeneous, with slightly stronger enhancement than the normal testis tissue. Tumor enucleation was performed, and the tumor was diagnosed as a sclerosing Sertoli cell tumor.

Radiologic-pathologic comparison of undifferentiated embryonal sarcoma of the liver in a 61-year-old woman

Undifferentiated(embryonal) sarcoma;Liver;Adult;Anatomical/pathologicalcorrelationMrs. V, a 61-year-old woman with no particular history, was seen for impairment ofgeneral health and abdominal pain. The physical examination found a tender mass inthe right hypochondrium. The laboratory tests revealed presence of inflammation(CRP: 350mg/L, 15,000 neutrophils), cytolysis (ALT: 130IU/L, AST: 150IU/L: 4N), anictericcholestasis (alkaline phosphatase: 450IU/L); tumor markers AFP (8ng/mL) and CA 125(27 U/mL) were normal.The ultrasound (Fig. 1a, b) showed a voluminous hypo-hyperechoic heterogenous solidhepatic mass that had developed to the detriment of segment IV (19 ×25 21mm), andresponsible for dilatation of the left intrahepatic bile ducts. On the CT scan, it was tissular,heterogeneous, andcompartmentalized,presentedhemorrhagicchanges,andhadarteriesrunning through it (Fig. 1 c, d). After injection, moderate enhancement was seen in thearterial phase, increasing in the delayed phase. The hepatic parenchyma was normal; thestaging was negative.On the MRI (Fig. 2), the lesion was clearly hyperintense on the T2-weighted imageswith multiple walls and cavities of varying sizes. After injection, homogeneous peripheralenhancement was seen with uptake by the septa, but not central enhancement.The surgicalresection,whichwasperformedquicklyduetotheimpairedgeneralhealth,confirmed the cystic, encapsulated intrahepatic mass (Fig. 3a, b) centered in segmentIV. The resection was complete. The surgical specimen weighed 3550g and measured27 ×22×10cm. It was composed of multiple cavities of varying size with a necrotic