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Abstract Background Hepatitis delta virus (HDV) ribozyme is an attractive molecular tool that can specifically recognize and catalyze the self-cleavage of the viral RNA phosphodiester backbone. However, a major obstacle in the medical application of the HDV ribozyme is the lack of specificity in the delivery of the ribozyme to defined target cells. Results The objective of this study was to determine whether retroviral vectors can deliver the HDV ribozyme into the target cells and to elucidate whether HDV ribozyme plays a role in hepatitis B virus (HBV) replication. In our study, the transduction of helper-free pseudotyped retrovirus, which showed a broad host range, in human hepatoma cells was performed under 2 conditions, that is, in the presence of polymerized human serum albumin (pHSA) and in the absence of pHSA. The transduction ability in the presence of pHSA was higher than in the absence of pHSA. Moreover, HBsAg and HBeAg levels after transductions with pHSA were significantly lower than those in the absence of pHSA, thus indicating that the recombinant retrovirus had HBV-specific cleavage activity and targeted HepG2215 cells. Conclusions These data suggest that this system provides a new approach for targeting hepatocytes and has a great potential in gene therapy for HBV infection.

Upregulation of histone methyltransferase SET domain bifurcated 1 (SETDB1) is associated with poor prognosis in cancer patients. However, the mechanism of oncogenicity of SETDB1 in cancer is hitherto unknown. Here, we show that SETDB1 is upregulated in human colorectal cancer (CRC) where its level correlates with poor clinical outcome. Ectopic SETDB1 promotes CRC cell proliferation, whereas SETDB1 attenuation inhibits this process. Flow cytometry reveals that SETDB1 promotes proliferation by driving the CRC cell cycle from G0/G1 phase to S phase. Mechanistically, SETDB1 binds directly to the STAT1 promoter region resulting in increased STAT1 expression. Functional characterization reveals that STAT1-CCND1/CDK6 axis is a downstream effector of SETDB1 -mediated CRC cell proliferation. Furthermore, SETDB1 upregulation is sufficient to accelerate in vivo proliferation in xenograft animal model. Taken together, our results provide insight into the upregulation of SETDB1 within CRC and can lead to novel treatment strategies targeting this cell proliferation-promoting gene. [ABSTRACT FROM AUTHOR]

Nasopharyngeal carcinoma (NPC) is a type of cancer that is characterized by increased invasiveness, metastatic potential and tumor recurrence. Camptothecin has been demonstrated to exhibit anticancer activity. However, the potential underlying molecular mechanisms mediated by camptothecin in NPC cells remain elusive. In the present study, the efficacy of camptothecin for NPC was investigated in vitro and in vivo. Additionally, the potential signaling pathway mediated by camptothecin in NPC cells was also examined. The results indicated that the viability and aggressiveness of NPC cells were suppressed by camptothecin treatment in a dose-dependent manner. Camptothecin administration downregulated the expression levels of cell-cycle-associated proteins including cyclin 1, cyclin-dependent kinase (CDK)1 and CDK2 in NPC cells. Expression levels of migration-associated proteins including vimentin, fibronectin and epithelial cadherin were regulated by camptothecin treatment in NPC cells. Additionally, camptothecin inhibited the expression of transforming growth factor-β (TGF-β), phosphoinositide 3-kinase (PI3K) and protein kinase B (AKT), whereas TGF-β overexpression abrogated camptothecin-mediated inhibition of PI3K and AKT expression and camptothecin-mediated inhibition of the viability and aggressiveness of NPC cells. Camptothecin significantly inhibited tumor growth and increased survival times in a mouse model of cancer. In conclusion, these results indicate that camptothecin treatment may inhibit the viability of NPC cells and aggressiveness by regulating the TGF-β-induced PI3K/AKT signaling pathways, which in turn may be a potential molecular target for the treatment of NPC. [ABSTRACT FROM AUTHOR]

The expression of microRNA (miR-433) is altered in various types of human cancer. The present study analyzed the prognostic and biological value of miR-433 expression in colorectal cancer using reverse transcription-quantitative polymerase chain reaction in 125 colorectal tissue specimens (including a test cohort of 40 cases of paired colorectal cancer and adjacent normal mucosae and a confirmation cohort of 85 cases of stage I-III colorectal cancer). In vitro and nude mouse xenograft experiments were subsequently used to assess the effects of miR-433 expression on the regulation of colorectal cancer cell proliferation, adhesion, migration, and invasion. The data indicated that miR-433 expression was significantly downregulated in colorectal cancer tissues in the test and confirmation patient cohorts and that low miR-433 expression was associated with advanced tumor stage and early relapse. Furthermore, the restoration of miR-433 expression was able to significantly inhibit the proliferation of tumor cells by inducing G1-S cell cycle arrest, suppressing cyclinD1 and CDK4 expression, and markedly inhibited the migratory and invasive capacities of tumor cells in vitro. The restoration of miR-433 expression or liposome-based delivery of miR-433 mimics suppressed the growth of colorectal cancer cell xenografts in nude mice. In conclusion, miR-433 may be a putative tumor suppressor in colorectal cancer, and the detection of low miR-433 expression will be investigated in further studies as a putative biomarker for the detection of early relapse in patients with colorectal cancer. [ABSTRACT FROM AUTHOR]

The aim of this study was to ascertain the diagnostic value of serum squamous cell carcinoma antigen (SCCA) and SCCA-IgM for hepatocellular carcinoma (HCC). After a comprehensive search of PubMed and Web of Science databases, we identified eligible studies on the diagnostic value serum SCCAs for HCC. The quality of the eligible studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tool. The overall diagnostic value of SCCAs for HCC was pooled using a bivariate model. Twelve studies were included in this systematic review and meta-analysis. The pooled sensitivities for SCCA and SCCA-IgM were 0.61 (95% confidence interval [CI], 0.37–0.81) and 0.70 (95% CI, 0.55–0.82), respectively. The corresponding specificities were 0.80 (95% CI, 0.52–0.94) and 0.62 (95% CI, 0.51–0.72), respectively. The areas under summary receiver operating characteristic (sROC) curves for SCCA and SCCA-IgM were 0.76 (95% CI, 0.72–0.80) and 0.70 (95% CI, 0.66–0.74), respectively. Major design deficiencies of the included studies were two-gate design and partial verification bias. Therefore, we concluded that both serum SCCA and SCCA-IgM have a fair diagnostic value for HCC. [ABSTRACT FROM PUBLISHER]

Background and Aims: MicroRNAs (miRNA) can act as oncogenes or tumor suppressors. Polymorphisms present in pri-, pre- and mature miRNAs can potentially modulate the expression of hundreds of genes, broadly affecting miRNA function. Notably, the rs11614913 SNP in miR-196a2 has been implicated in carcinogenesis, but its association with colorectal cancer (CRC) remains unexplored. We performed a case−control study to investigate the genetic association between this functional SNP and CRC susceptibility and progression. Methods: We genotyped the rs11614913 SNP in 252 CRC patients and 543 healthy controls by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). In addition, we examined miR-196a expression level in colorectal cancer tissues (n = 50) obtained from the studied CRC patients. Results: Frequency of the CC genotype was higher in CRC patients than controls, implying that the subjects with the CC genotype or C allele containing genotypes (CT and CC) have a higher risk of CRC. However, no significant association between this polymorphism and CRC progression was observed. Expression analysis revealed that rs11614913 CC or carrying at least one C allele was associated with a significantly increased level of mature miR-196a (p = 0.010 or = 0.022). Conclusions: The present study provides the first evidence that miR-196a2 polymorphism may contribute to CRC susceptibility in a Chinese population through modulating mature miR-196a expression. [ABSTRACT FROM AUTHOR]

Purpose: To test the radiosensitising effects of a tumour-suppressor gene, phosphatase and tensin homologue deleted from chromosome 10 (PTEN), in hepatocellular carcinoma cells (HCC). Materials and methods: Radiation-induced wild-type PTEN or mutant PTEN was transfected into the SMMC-7721 human hepatocellular carcinoma cells. The expressions of PTEN and serine/threonine protein kinase (Akt) were detected by Western blot analysis. 3-(4,5)-dimethylthiahiazo-(-z-y1)- 3,5-di-phenytetrazoliumromide (MTT) absorbance and clonogenic survival assays were used to determine cell viability, proliferation and radiosensitivity. By performing cell-cycle analysis, terminal deoxynucleotidyltransferase (TdT)-mediated dUTP biotin nick end labelling (TUNEL) assays and gamma-histone H2A (γ-H2AX) formation assays, we were able to explore the mechanism of PTEN enhancement of radiosensitivity. Results: Restoration of wild-type PTEN induced growth suppression and sensitised the cells to ionising radiation specifically by its lipid phosphatase activity through the PTEN-phosphatidylinositol 3-kinase (PI3K)-Akt signalling pathway. Restoring PTEN function correlated with G2/M arrest, apoptosis and the retardation of repair of radiation-induced double strand breaks (DSB). Conclusions: Our study suggests that strategies designed to restore the expression of PTEN may represent promising new therapies for sensitising HCC cells to ionising radiation. [ABSTRACT FROM AUTHOR]

Purpose: Assuming F-18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET)/computed tomography (CT) to be more accurate in representing the true disease extent than CT alone, we prospectively designed this study to evaluate how the addition of FDG-PET influences CT-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma. Patients and Methods: All patients underwent FDG-PET/CT simulation scans. For each patient, the gross tumor volume (GTV) was separately delineated with or without the addition of PET information and defined as GTVPET/CT and GTVCT, respectively. Corresponding planning target volumes (PTV) were generated for the GTVCT (PTVCT) and GTVPET/CT (PTVPET/CT). Three-dimensional conformal radiotherapy plans were separately created for PTVCT and PTVPET/CT. To assess the potential geographic miss of the PET/CT-based disease in CT-based treatment planning, the size and location of the GTVPET/CT, PTVPET/CT, and PTVCT were analyzed, and the three-dimensional conformal radiotherapy plans created using the PTVCT were evaluated with the GTVPET/CT and PTVPET/CT information. Results: A total of 43 patients were enrolled in this study. Distant metastasis was found in 4 patients with the addition of the PET information. The 39 patients without distant metastasis proceeded to three-dimensional conformal radiotherapy planning. Inadequate coverage of the GTVPET/CT and PTVPET/CT by the PTVCT occurred in 7 (18%) and 20 (51%) patients, respectively. This resulted in <95% of the GTVPET/CT and PTVPET/CT receiving ≥95% of the prescribed dose in 4 (10%) and 13 (33%) patients, respectively. Conclusions: The addition of FDG-PET information might influence CT-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma by altering the definition of the target volume, with the potential to avoid a geographic miss of true disease. [Copyright &y& Elsevier]

Purpose: The purpose of this study was to evaluate the role of [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) in influencing salvage treatment decision making for locally persistent nasopharyngeal carcinoma (NPC). Methods and Materials: A total of 33 NPC patients with histologic persistence at nasopharynx 1 to 6 weeks after a full course of radiotherapy underwent both computed tomography (CT) and FDG-PET/CT simulation at the same treatment position. The salvage treatment decisions, with regard to the decision to offer salvage treatment and the definition of gross tumor volume (GTV), were made before knowledge of the FDG-PET findings. Subsequently the salvage treatment decisions were made again based on the FDG-PET findings and compared with the pre-FDG-PET decisions. Results: All 33 patients were referred for salvage treatment in the pre-FDG-PET decision. After knowledge of the FDG-PET results, the decision to offer salvage treatment was withdrawn in 4 of 33 patients (12.1%), as no abnormal uptake of FDG was found at nasopharynx. Spontaneous remission was observed in repeat biopsies and no local recurrence was found in these 4 cases. For the remaining 29 patients, GTV based on FDG-PET was smaller than GTV based on CT in 24 (82.8%) cases and was greater in 5 (17.2%) cases, respectively. The target volume had to be significantly modified in 9 of 29 patients (31%), as GTV based on FDG-PET images failed to be enclosed by the treated volume in the salvage treatment plan performed based on GTV based on CT simulation images. Conclusion: Use of FDG-PET was found to influence the salvage treatment decision making for locally persistent NPC by identifying patients who were not likely to benefit from additional treatment and by improving accuracy of GTV definition in salvage treatment planning. [ABSTRACT FROM AUTHOR]

SETDB1 is a novel histone methyltransferase associated with the functional tri-methylation of histone H3K9. Although aberrant high expression of SETDB1 was experimentally obversed in a variety of solid tumors, its underlying mechanisms in human carcinogenesis are not well known. In this study, we investigated the expression of SETDB1 in a large cohort of colorectal cancer (CRC) samples and cell lines for the first time. Our findings showed that SETDB1 was highly expressed in majority CRC tissues and cell lines; moreover, up-regulation of SETDB1 was negatively correlated with the survival rate of CRC patients. Functionally, over-expression of SETDB1 significantly promoted the proliferation and migration of CRC cells in vitro and in vivo , while knocking down SETDB1 suppressed their growth. Mechanistically, we showed that over-expression of SETDB1 significantly inhibited the apoptosis induced by 5-Fluorouracil in CRC cells, which was closely related to the inhibition of TP53 and BAX expression. Furthermore, we confirmed that SETDB1 could be recruited to the promoter region of TP53, which might contribute its inhibition of apoptosis. For conclusion, our study indicated that SETDB1 is essential for colorectal carcinogenesis, and may be a newly target for treatment and prognostic evaluation in CRC., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.

Background: Because there is no clear consensus for the prognostic implication of KRAS mutations in patients with non-small cell lung cancer (NSCLC), we conducted a meta-analysis based on 12 randomized trials to draw a more accurate conclusion., Materials and Methods: A systematic computer search of articles from inception to May 1, 2014 using the PubMed, EMBASE, and Cochrane databases was conducted. The enrollment of articles and extraction of data were independently performed by two authors., Results: Our analysis was based on the endpoints overall survival (OS) and progression-free survival (PFS). Nine records (All for OS, 7 for PFS) comprising 12 randomized trials were identified with 3701 patients who underwent a test for KRAS mutations. In the analysis of the pooled hazard ratios (HRs) for OS (HR: 1.39; 95% confidence interval [CI] 1.23-1.56) and PFS (HR: 1.33; 95% CI 1.17-1.51), we found that KRAS mutations are related to poor survival benefit for NSCLC. According to a subgroup analysis stratified by disease stage and line of therapy, the combined HRs for OS and PFS coincided with the finding that the presence of a KRAS mutation is a dismal prognostic factor. However, the prognostic role of KRAS mutations are not statistically significant in a subgroup analysis of patients treated with chemotherapy in combination with cetuximab based on the endpoints OS (P=0.141) and PFS (P=0.643)., Conclusions: Our results indicate that KRAS mutations are associated with inferior survival benefits for NSCLC but not for those treated with chemotherapies integrating cetuximab.

Background: Overexpression of decoy receptor 3 (DcR3) have been reported in various classes of malignancies. However, its expression and clinicopathological contribution in gliomas has not been fully elucidated., Objective: To explore the expression and clinical significance of DcR3 protein in relation to tumor cell differentiation and proliferation in glioma cell lines and tissues., Methods: One hundred and twenty-five samples of glioma patients and 18 cases of normal brain tissues were recruited. The expression of DcR3 protein was detected using immunohistochemistry. Tumor differentiation was assessed by histologic characters and the status of glial fibrillary acidic protein (GFAP). Tumor cell labeling indexes (LIs) of Ki-67 and PCNA were also obtained. The relationship between the DcR3 level and clinicopathological features was investigated, including tumor differentiation, LIs, and survival. Meanwhile, the expression of DcR3 protein was also measured in the supernatants of 8 glioma cell lines and glioma cells freshly prepared from 8 human glioblastoma specimens by using western blot., Results: The level of DcR3 protein in gliomas was significantly higher than that in normal brain tissues (P < 0.01). DcR3 expression showed positive correlations with tumor pathological grade (r = 0.621, P < 0.01) and negative with GFAP expression (r = -0.489, P < 0.01). Furthermore, there were positive correlations between DcR3 expression and Ki-67, PCNA LIs (r = 0.529, P < 0.01; r = 0.556, P < 0.01). The survival in the DcR3 negative group was 50 ± 1.79 months, longer than that of the DcR3 positive group (48.36 ± 2.90), however, without significance (P = 0.149). Different levels of DcR3 could also be detected in the culturing supernatants of all the 8 glioma cell lines and glioma cells freshly obtained from 8 human glioblastoma specimens., Conclusions: The overexpression of DcR3 might play a crucial role in the tumorigenesis, differentiation, and proliferation of glioma.

Mouse double minute 4 (MDM4) is a critical negative regulator of the tumor suppressor p53. The results of studies have revealed that an MDM4 polymorphism (rs1563828) may contribute to the earlier onset of several malignant diseases. However, the correlation between this polymorphism and nasopharyngeal carcinoma (NPC) susceptibility has not been explored. We performed a case-control study with 210 NPC patients and 200 healthy controls. Significant associations were found when comparing the age of onset of NPC according to the rs1563828 genotype (P=0.01). The average age of onset of NPC in patients with the TT, CC and CT genotypes was 39.3, 48.2 and 45.5 years, respectively. Homozygous variant (TT) carriers developed NPC at an earlier age than homozygous (CC) carriers, such that the age of onset was accelerated by 8.9 years (P=0.002). Our data suggest that rs1563828 is a modifier of the age of onset of NPC in the population studied. The age of onset for NPC with TT homozygotes was earlier than CC carriers.

Breast cancer-initiating cells are a relatively radioresistant subpopulation of breast cancer cells. However, the mechanism of this radioresistance is still unclear. This study aimed to investigate the effect of radiation on the levels of signal transducer and activator of transcription 1 (STAT1) in mammospheres of cancer-initiating cells and monolayer cultures of MCF-7 cells. We isolated CD44(+)/CD24(-/low) cancer-initiating cells from MCF-7 cells and propagated them as mammospheres. Next we used realtime quantitative reverse-transcriptase polymerase chain reaction to examine the mRNA level of STAT1 in mammospheres of breast cancer-initiating cells and monolayer cultures of MCF-7 cells. The apoptosis rate and surviving fraction using clonogenic assays was observed after treating the cells with a STAT1 inhibitor. After irradiation, the STAT1 level in the mammospheres was higher than that in the monolayer cultures. STAT1 inhibitor treatment did not cause significant changes in the apoptosis rate and surviving fraction in the MCF-7 monolayer cultures. However, the inhibitor treatment caused significant differences in the apoptosis rate and surviving fraction in mammospheres. Our study provides the first evidence that STAT1 signaling contributes to radioresistance in breast cancer-initiating cells and reveals STAT1 as a promising target to reduce radioresistance and enhance the efficacy of radiotherapy for breast cancer.

Increasing evidence indicates that stimulating hippocampal neurogenesis could provide novel avenues for the treatment of depression, and recent studies have shown that in vitro neurogenesis is enhanced by hypoxia. The aim of this study was to investigate the potential regulatory capacity of an intermittent hypobaric hypoxia (IH) regimen on hippocampal neurogenesis and its possible antidepressant-like effect. Here, we show that IH promotes the proliferation of endogenous neuroprogenitors leading to more newborn neurons in hippocampus in adult rats. Importantly, IH produces antidepressant-like effects in multiple animal models screening for antidepressant activity, including the forced swimming test, chronic mild stress paradigm, and novelty-suppressed feeding test. Hippocampal x-ray irradiation blocked both the neurogenic and behavioral effects of IH, indicating that IH likely produces antidepressant-like effects via promoting neurogenesis in adult hippocampus. Furthermore, IH stably enhanced the expression of BDNF in hippocampus; both the antidepressant-like effect and the enhancement of cell proliferation induced by IH were totally blocked by pharmacological and biological inhibition of BDNF-TrkB (tyrosine receptor kinase B) signaling, suggesting that the neurogenic and antidepressant-like effects of IH may involve BDNF signaling. These observations might contribute to both a better understanding of physiological responses to IH and to developing IH as a novel therapeutic approach for depression.

Background: Hepatitis delta virus (HDV) ribozyme is an attractive molecular tool that can specifically recognize and catalyze the self-cleavage of the viral RNA phosphodiester backbone. However, a major obstacle in the medical application of the HDV ribozyme is the lack of specificity in the delivery of the ribozyme to defined target cells., Results: The objective of this study was to determine whether retroviral vectors can deliver the HDV ribozyme into the target cells and to elucidate whether HDV ribozyme plays a role in hepatitis B virus (HBV) replication. In our study, the transduction of helper-free pseudotyped retrovirus, which showed a broad host range, in human hepatoma cells was performed under 2 conditions, that is, in the presence of polymerized human serum albumin (pHSA) and in the absence of pHSA. The transduction ability in the presence of pHSA was higher than in the absence of pHSA. Moreover, HBsAg and HBeAg levels after transductions with pHSA were significantly lower than those in the absence of pHSA, thus indicating that the recombinant retrovirus had HBV-specific cleavage activity and targeted HepG2215 cells., Conclusions: These data suggest that this system provides a new approach for targeting hepatocytes and has a great potential in gene therapy for HBV infection.

The human CD2-associated protein (CD2AP) is involved in several molecular signaling pathways and is an important factor responsible for nephrotic syndrome. Here we report the identification of the transcription start point and promoter region of the human CD2AP gene in renal tubular epithelial cells. With luciferase assays and deletion analysis, we found that the region between -558 and -1bp ahead of the transcription start point is indispensable for the promoter activity of the human CD2AP gene. A CREB site and two Sp1 sites were essential for maintaining the basal transcriptional activity of the human CD2AP promoter. Overexpression of phosphorylated CREB and Sp1 transactivated the human CD2AP promoter, whereas small interfering RNA-mediated blockage of CREB and Sp1 genes expressions inhibited markedly its activity. These findings provide the first analysis of the human CD2AP gene promoter and demonstrate that not only CREB but also Sp1 plays a critical role in regulating basal CD2AP promoter activity in renal tubular epithelial cells.

Objective: To silence annexin II gene expression by using small interference RNA (siRNA) in prostate cancer cell line PC3., Methods: For in vitro transcription, four sequences of 29-nucleotide DNA template oligonucleotides were designed, and one pair of the sequences were complementary to annexin II gene. The other pair was negative control. The 8 nucleotides at the 3' end of each oligonucleotide were complementary to the T7 Promoter Primer. The sense and antisense siRNA templates were transcribed by T7 RNA polymerase and the resulting RNA transcripts were hybridized to create dsRNA. The siRNA was transfected into prostate cancer cell PC3. For assaying the efficiency of siRNA, confocal microscopy, Northern blotting, and Western blotting were employed to examine the expression of annexin II protein and its mRNA. 3H thymidine was used to measure DNA synthesis., Results: The siRNA sequence specific to annexin II gene was capable of inhibiting the expression of annexin II protein and its mRNA. And cellular DNA synthesis was significantly reduced in siRNA transfected cells., Conclusions: The protocol for the synthesis of siRNA by T7 RNA polymerase is feasible. Annexin II might be involved in DNA synthesis.

Purpose: The purpose of this study was to evaluate the role of [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) in influencing salvage treatment decision making for locally persistent nasopharyngeal carcinoma (NPC)., Methods and Materials: A total of 33 NPC patients with histologic persistence at nasopharynx 1 to 6 weeks after a full course of radiotherapy underwent both computed tomography (CT) and FDG-PET/CT simulation at the same treatment position. The salvage treatment decisions, with regard to the decision to offer salvage treatment and the definition of gross tumor volume (GTV), were made before knowledge of the FDG-PET findings. Subsequently the salvage treatment decisions were made again based on the FDG-PET findings and compared with the pre-FDG-PET decisions., Results: All 33 patients were referred for salvage treatment in the pre-FDG-PET decision. After knowledge of the FDG-PET results, the decision to offer salvage treatment was withdrawn in 4 of 33 patients (12.1%), as no abnormal uptake of FDG was found at nasopharynx. Spontaneous remission was observed in repeat biopsies and no local recurrence was found in these 4 cases. For the remaining 29 patients, GTV based on FDG-PET was smaller than GTV based on CT in 24 (82.8%) cases and was greater in 5 (17.2%) cases, respectively. The target volume had to be significantly modified in 9 of 29 patients (31%), as GTV based on FDG-PET images failed to be enclosed by the treated volume in the salvage treatment plan performed based on GTV based on CT simulation images., Conclusion: Use of FDG-PET was found to influence the salvage treatment decision making for locally persistent NPC by identifying patients who were not likely to benefit from additional treatment and by improving accuracy of GTV definition in salvage treatment planning.

Aim: To investigate the killing effect and radiosensitization of double suicide gene mediated by adenovirus on colorectal carcinoma cells., Methods: Colorectal carcinoma cell line SW480 was transfected with adenovirus expression vector containing cytosine deaminase (CD) and thymidine kinase (TK) fusion gene. The expression of CD-TK fusion gene was detected by reverse transcriptase-polymerase chain reaction. The toxic effect of ganciclovir (GCV) and 5-fluorocytosine (5-FC) on infected cells was determined by MTT assay. The radiosensitization of double suicide gene was evaluated by clonogenic assay., Results: After prodrugs were used, the survival rate of colorectal carcinoma cells was markedly decreased. When GCV and 5-FC were used in combination, the cytotoxicity and bystander effect were markedly superior to a single prodrug (chi2 = 30.371, P<0.01). Both GCV and 5-FC could sensitize colorectal carcinoma cells to the toxic effect of radiation, and greater radiosensitization was achieved when both prodrug were used in combination., Conclusion: CD-TK double suicide gene can kill and radiosensitize colorectal carcinoma cells.

Aim: To explore the impact of prolonged fraction dose-delivery time modeling intensity-modulated radiation therapy (IMRT) on cell killing of human hepatocellular carcinoma (HCC) HepG2 and Hep3B cell lines., Methods: The radiobiological characteristics of human HCC HepG2 and Hep3b cell lines were studied with standard clonogenic assays, using standard linear-quadratic model and incomplete repair model to fit the dose-survival curves. The identical methods were also employed to investigate the biological effectiveness of irradiation protocols modeling clinical conventional fractionated external beam radiotherapy (EBRT, fraction delivery time 3 min) and IMRT with different prolonged fraction delivery time (15, 30, and 45 min). The differences of cell surviving fraction irradiated with different fraction delivery time were tested with paired t-test. Factors determining the impact of prolonged fraction delivery time on cell killing were analyzed., Results: The alpha/ beta and repair half-time (T(1/2)) of HepG2 and Hep3b were 3.1 and 7.4 Gy, and 22 and 19 min respectively. The surviving fraction of HepG2 irradiated modeling IMRT with different fraction delivery time was significantly higher than irradiated modeling EBRT and the cell survival increased more pronouncedly with the fraction delivery time prolonged from 15 to 45 min, while no significant differences of cell survival in Hep3b were found between different fraction delivery time protocols., Conclusion: The prolonged fraction delivery time modeling IMRT significantly decreased the cell killing in HepG2 but not in Hep3b. The capability of sub-lethal damage repair was the predominant factor determining the cell killing decrease. These effects, if confirmed by clinical studies, should be considered in designing IMRT treatments for HCC.

Aim: To investigate KAI1 gene expression in the progression of human colonic carcinoma and its clinical significances., Methods: KAI1 expression was detected by in situ hybridization and immunohistochemistry in the 4 established cell lines of colorectal carcinoma with different metastatic potentials, and in 80 specimens of colonic carcinoma, 21 colonic carcinoma specimens with lymphatic metastasis and 20 controls of normal colonic mucosa., Results: The expressions of KAI1 in HT29 and SW480 cell lines were higher than those in LoVo and SW620. The expression of KAI1 gene was significantly higher in colorectal carcinoma compared with normal colonic mucosa and lymphatic metastasis (chi(2)=46.838, P<0.01). The expression of KAI1 gene had no relationship with histological grade. The KAI1 expressions in Dukes A and B carcinoma were higher at both mRNA and protein levels compared to Dukes C carcinoma (chi(2)=16.061, P<0.05). The expression of KAI1 in colonic carcinoma specimens with lymphatic metastasis was almost lost. The results of in situ hybridization were in concordance with immunohistochemistry., Conclusion: KAI1 is highly related to the metastasis of colonic carcinoma and may be a useful indicator of metastasis in colonic carcinoma.

Aim: To evaluate the therapeutic efficacy of three-dimensional conformal radiotherapy (3D-CRT) combined with transcatheter arterial chemoembolization (TACE) on the patients with hepatocellular carcinoma (HCC)., Methods: Between 1998 and 2001, 94 patients with HCC received 3D-CRT combined with TACE. A total 63 patients had a Okuda stage I lesion and 31 patients had stage II. The median tumor size was 10.7 cm (range 3.0-18 cm), and liver cirrhosis was present in all the patients. There were 43 cases of class A and 51 class B. TACE was performed using lipiodol, 5-fluorouracil, cisplatin, doxorubicin hydrochloride and mitomycin, followed by gelatin sponge cubes. Fifty-nine patients received TACE only one time, while the others 2 to 3 times. 3D-CRT was started 3-4 wk after TACE. All patients were irradiated with a stereotactic body frame and received 4-8 Gy single high-dose radiation for 8-12 times at the isocenter during a period of 17-26 d (median 22 d)., Results: The median follow-up was 37 mo (range 10-48 mo) after diagnosis. The response rate was 90.5%. The overall survival rate at 1-, 2-, and 3- year was 93.6%, 53.8% and 26.0% respectively, with the median survival of 25 mo. On univariate analysis, age (P=0.026), Child-Pugh classification for cirrhosis of liver (P=0.010), Okuda stage (P=0.026), tumor size (P=0.000), tumor type (P=0.029), albuminemia (P=0.035), and radiation dose (P=0.000) proved to be significant factors for survival. On multivariate analysis, age (P=0.024), radiation dose (P=0.001), and tumor size (P=0.000) were the significant factors., Conclusion: 3D-CRT combined with TACE is an effective and feasible approach for HCC. Age, radiation dose and tumor size were found to be significant prognostic factors for survival of patients with HCC treated by 3D-CRT combined with TACE. Further study for HCC is needed to improve the treatment efficacy.

Objective: To evaluate the effects of the two conformal radiotherapy modalities in the treatment of locally advanced pancreatic carcinoma., Methods: From October, 1998 to June, 2001, 67 patients with locally advanced pancreatic carcinoma received conformal radiotherapy (CRT). Vacuum cushions were applied to immobilize the patients before contrast CT scans, the treatment plans were simulated by three-dimensional treatment planning system. The patients were randomized into group A to receive a total dose of 45-54 Gy given in 8-12 fractions completed in 18-27 d and group B with a total dose of 45-54 Gy in 15-18 fractions within 20-25 d., Results: The partial and complete pain relief rates of the two groups were 95.9% and 81.6%, respectively, one month after the completion of the radiotherapy, with a median survival of 12.5 months. The response rates of the patients and the 2-year overall survival rates in group A were 81.8% and 51.6%, respectively, and were 35.3% and 12.1% in group B. The low-dose fractionated CRT was superior than accelerated CRT., Conclusion: For patients with unresectable pancreatic cancer receiving low-dose fractionated CRT, a high dose targeted at the tumor can be given in a fraction and the normal surrounding tissues are exposed to low-dose radiation, to achieve good therapeutic effect with minimized adverse effects on normal tissues in relation to the exposure.

Objective: To explore the etiology of the sequelae of radiotherapy for nasopharyngeal carcinoma (NPC) so as to find the possible means for reducing or preventing its occurrence., Methods: A total of 112 pathologically confirmed patients with nasopharyngeal carcinoma, who had survived for 5 years following the radiotherapy, were included in this study. Sixty-four patients with the primary carcinoma in the nasopharyngeal region received radiotherapy with the radiation field covering the bilateral anterior ear regions, and in the other 48 patients, adjuvent exposure of the anterior nasal region was administered. The metastases in the cervical lymph nodes were exposed to tangential radiation by 40 Gy X-ray followed by approximately 20 Gy vertical electron beam exposure., Results: Limited mouth-opening and dry mouth occurred mostly during the first 2 years after radiotherapy, and hearing loss in the first year. Neck fibrosis tended to increase with the time elapse after the therapy, and posterior cranial nerve damages showed no signs of time-related occurrence. It was found that the occurrence of neck fibrosis, dry mouth and the nerve injuries did not obviously correlate with the dosage of X-ray exposure in the anterior ear regions, while limited mouth-opening and the hearing loss increased with the radiation dosage. The sequelae did not arise from different radiation field selection as adopted in this study., Conclusion: The radiation dose should be controlled at around 70 Gy for NPC treatment, and for carcinoma remnant in the nasopharyngeal region, additional dose in the cavity would be appropriate. When the X-ray dose of 65 Gy in the neck region fails to result in satisfactory recession of lymph node metastasis, comprehensive treatment involving multiple modalities should be considered.

Objective: To study the expression of KAI1/CD82 in human colorectal tumor and its significance., Methods: Immunohistochemistry was used to detect the expression of CD82 in 40 colorectal carcinoma, 20 lymphatic metastasis, 18 adenoma and 20 normal colorectal epithelium specimens, respectively., Results: The expression of CD82 was rather low in adenoma and normal colorectal epithelium, with the positivity rates of 25% and 10% respectively; 28 of the 40 colorectal carcinoma specimens were positive for CD82, resulting in a positivity rate of 70%. The rate for lymphatic metastasis was only 5%. The differences between the 4 groups were significant (P <0.05), and the expression of CD82 in the carcinoma was not related to the histological grades (P >0.05), but was associated with the presence of metastasis (P <0.05)., Conclusion: CD82 is related to the progression of colorectal carcinoma.

Objective: To evaluate the therapeutic effect of three-dimensional conformal radiation therapy (3D-CRT) on small hepatocellular carcinoma., Methods: Between May 1998 and Dec 2002, 32 patients with small primary hepatocellular carcinoma underwent 3D-CRT (mean total dose of 55 Gy, ranging from 48 to 63 Gy, given in 6 to 9 fractions completed within 12 to 18 d). The clinical target volumes (CTVs) were covered with 100% isodose curve, using 6 MV X-ray. CT studies before and during a follow-up period of 3 years after 3D-CRT were conducted to evaluate the therapeutic effects, with alpha-feto-protein (AFP) levels also tested., Results: Completed remission of the tumor occurred in 87.5% (28/32) of the cases, and partial remission (PR) was obtained in 12.5% (4/32) of the cases after one year. The 1-year survival rate at stage III was 100%, and 2- and 3-year survival rates were both 97%, with death occurring only in one case because of cerebral hemorrhage. AFP levels of these patients with hepatocellular carcinoma were all significantly decreased (P=0.025)., Conclusion: 3D-CRT is an effective method in the treatment of patients with small primary hepatocellular carcinoma.

Objective: To evaluate the short-term effects of 3D conformal hypofractionated single high-dose radiotherapy for lung tumors., Methods: Thirty-four patients with lung tumors that defied surgical removal were treated with 3D conformal hypofractionated single high-dose radiotherapy, and the short-term therapeutic effects and survival rates of the patients were assesses., Results: In 31 (91.2%) of the patients, the local tumor growth was successfully controlled, with the 1-, 2-, and 3- year survival rates of 88.2% (30/34), 35.3% (12/34), and 26.5% (9/34), respectively., Conclusion: 3D conformal hypofractionated single high-dose radiotherapy is effective and feasible approach for unresectable lung tumors judging from the short-term effects, but its long-term efficacy awaits further study.

Objective: To improve the therapeutic effect of radiotherapy without increasing the risk of radiation injury in patients with non-small cell lung cancer (NSCLC)., Methods: From August 1998 to August 1999, 135 patients with NSCLC received radiotherapy, of whom 62 were treated with high-dose three-dimensional conformal radiotherapy (3D-CRT) at the total dose of 48 to 64 Gy in 6 to 8 fractions implemented in a course of 2 to 3 weeks, 6 to 8 Gy for each fraction. The other 73 patients underwent conventional radiotherapy (CR) at the total dose of 60 to 70 Gy in 30 to 35 fractions completed in 6 to 7 weeks. Follow-up study was conducted in all the cases, and CT-scan or magnetic resonance imaging was performed once every 3 months after the therapy to assess the local control rate, survival rate, radiation-induced lung and esophageal injuries., Results: Three months after radiation therapy, complete remission of the lesions was achieved in 44.9% (CR group) and 77.8% (3D-CRT group) of the cases with the efficacy rates of 94.4% and 100% respectively, showing significant differences between the 2 groups (P<0.01). The 1- and 2-year survival rate of the patients in the 2 groups were 42.5% vs 77.8% and 30.1% vs 48.6% respectively, also with significant differences between the 2 groups (P<0.01). Significant difference also occurred in the 1- and 2-year local control rates between the 2 groups, but not in the incidences of radiation-induced lung and esophageal injuries., Conclusion: 3D-CRT may yield better therapeutic effect than CR does and has comparable safety with the latter.

Objective: To establish appropriate animal models for observing the effects of X-ray irradiation on limb allograft rejection., Methods: Wistar rats were used as donators and SD rats as recipients, the latter divided into 2 groups, namely irradiation group and non-irradiation group according to pretransplant treatment with or without X-ray radiation (5 Gy) on the part of the donators. The donor limbs were transplanted into SD rats who had their own limbs cut off, and the sciatic nerve, femoral nerve, and femoral artery and femoral vein were anastomosed in operation. After the operation, all the recipients were given benzathine benzylpenicillin, and their vital signs, together with changes of the allografts, observed., Results: A total of 16 rats received transplantation that was successful in 6 rats of non-radiation group and 7 of irradiation group. The graft survival averaged 12.0+/-2.4 d in non-irradiation group and 24.7+/-8.1 d in irradiation group, showing significant difference in the lengths of survival between the 2 groups (P<0.05)., Conclusion: The graft survival time in rats can be significantly prolonged by pretransplant irradiation of the allograft, which also help control acute rejection of the allograft.

OBJECTIVE: To assess the radiosensitivity of human hepatocarcinoma cell line BEL-7402. METHODS: Human hepatocarcinoma cell line BEL-7402 was cultured in vitro and then subjected to exposure to 6 MV X-ray at the doses ranging from 0 to 10 Gy. The survival rate of the cells following the exposure was assessed by determining the colony-forming units during further cell culture 12 to 14 d after the exposure, and the parameters for the radiosensitivity calculated. RESULTS and CONCLUSION: The parameters of BEL-7402 cells (D0=1.6, Dq=1.3, n=2, 4, SF2=0.63+/-0.05 Gy) demonstrates a high sensitivity of the cells to radiation.