| ObjectiveHepatoblastoma(HB)is the most common liver malignant tumor in children,accounting for about 80% of primary liver malignant tumors in children,and the annual incidence of hepatoblastoma is on the rise in recent years.Although the increasing diversification of treatment options has greatly improved long-term survival in children with hepatoblastoma(5-year survival rates are more than 80%),there is still a lack of effective treatment in some poorly differentiated patients with poor prognosis.In recent years,people to a new understanding of HB biology,also pay more attention to participate in the process of tumorigenesis of gene and potential therapeutic targets,but liver tumor etiology and pathogenesis is still not clear,therefore,need to further study the pathogenesis of liver tumor and potential therapeutic targets in order to improve the early diagnosis and treatment level,The purpose of this article is to investigate the underlying pathogenesis of HB.MethodsIn the early stage,the team conducted comprehensive exon sequencing on tumors and adjacent tissues of 16 pairs of children with hepatoblastoma,and conducted bioinformatics analysis on the sequencing results,from which we screened a new candidate gene--PIWIL2 gene,in order to understand the role of PIWIL2 in the occurrence and development of hepatoblastoma.In order to further investigate the effects of PIWIL2 on the proliferation and migration of hepatoblastoma cells,immunohistochemical staining was used to detect the protein expression of PIWIL2 in hepatoblastoma tumors and adjacent tissues.Transient transfection plasmid was used to interfere with PIWIL2 expression,and lentivirus-mediated short hairpin RNA(sh RNA)vector was constructed to stably knock down PIWIL2 gene in HUH6 and Hep G2 cells.The effects of PIWIL2 on HB cell proliferation were investigated by CCK-8 assay,clonogenesis assay and Edu assay.The effect of PIWIL2 on HB cell migration was investigated by Transwell experiment.To further explore the mechanism of PIWIL2 regulating the proliferation and migration of hepatblastoma,transcriptome sequencing was performed on shr NA-NC group and SHRNA-Pi WIL2 group,and bioinformatics was used to analyze the differentially expressed genes between groups,and GO and KEGG were used to enrich the differentially expressed genes.The biological processes and possible pathways involved in PIWIL2 regulation were predicted,and the expression of pathway-related proteins and proliferation-apoptosis-related proteins was verified by immunoimprinting assay.Results1.In this study,the expression of PIWIL2 protein in 33 pairs of hepatoblastoma tumors and adjacent tissues was detected,and it was found that the tumor tissues were significantly higher than the adjacent tissues.2.In vitro experiments,PIWIL2 gene was stably knocked down in hepatoblastoma cell lines(HUH6,Hep G2)by plasmid transient transfection and lentiviral vector mediated short hairpin RNA(sh RNA).After the expression of PIWIL2 was down-regulated,the proliferation and migration of hepatoblastoma cells were reduced.3.Cell transcriptome sequencing showed that PIWIL2 affected cell proliferation through the PI3K/AKT signaling pathway.4.Further immunoimprinting experiments verified that PIWIL2 regulates the proliferation and apoptosis of hepatoblastoma cells through the PI3K/AKT signaling pathway.ConclusionPIWIL2 may serve as a potential biomarker for early diagnosis of hepatoblastoma and provide a new target for molecular therapy of hepatoblastoma.ObjectiveUndifferentiated embryonic sarcoma of the liver is a rare and highly malignant primitive mesenchymal tumor,ranking third among primary malignant tumors of the liver in children.This tumor has a high degree of malignancy and poor prognosis.Complete surgical resection of the tumor is the key factor and important prerequisite for patients to obtain a good prognosis.Because children liver anatomical structure of fine,around tumor vasculature is relatively complex,and undifferentiated embryonal sarcoma huge volume,oppression around vital organs,when total hepatic door and other special parts,and hepatic portal vein blood vessels of tumor,blood vessels to easy complicated with massive hemorrhage during operation,one stage resection is difficult.This study discussed the clinical value of Hisense computer assisted surgery system(Hisense CAS)in the diagnosis and precision liver resection of large undifferentiated embryonic sarcoma of the liver in children.MethodsThe clinical data of 4 cases of undifferentiated embryonic sarcoma of the liver treated in Pediatric Surgery Department of Qingdao University Affiliated Hospital from January2013 to December 2020 were retrospectively analyzed,including 1 male and 3 female,with an average age of 7 years.Dynamic enhanced CT images of the upper abdomen of 4children were collected.Hisense CAS was used for 3D reconstruction and simulated surgery to accurately evaluate the size and location of the tumor,whether vascular invasion was present,and determine the resectable tumor before surgery.Intraoperative SID navigation was performed.The safety and feasibility of Hisense CAS were evaluated in combination with surgical time,intraoperative blood loss,survival rate and postoperative follow-up.ResultsAll patients were successfully operated and the tumor was completely resected under Hisense CAS evaluation.After 3d reconstruction,the three-dimensional image can clearly and accurately restore the spatial position relationship between the tumor and the liver and the intrahepatic vessels such as portal vein and hepatic vein,accurately locate the tumor position,and the system automatically calculates the volume of the tumor and the liver.Among them,2 patients were located in the left lobe of liver,1 in the right lobe,and 1 in the interface area between left medial lobe and right anterior lobe.The tumor volume was 309.4-1392.4m L,and the liver volume was 560.1-709.6m L.All children completed simulated surgery before surgery,and the tumor was assessed to be completely resected.Under intraoperative SID navigation,3d reconstructed images were consistent with the actual intraoperative findings.The average operation time of the 4children was 212 min,and the intraoperative blood loss was 20-100 ml.The 4 children recovered well after surgery and were discharged successfully.Up to now,all the 4children have survived without cancer,with a follow-up period of 8-99 months.ConclusionThe Hisense Computer Assisted surgery system(Hisense CAS)can accurately evaluate undifferentiated embryonic sarcoma in children before surgery,formulate a reasonable surgical plan,and guide the implementation of surgery in real time and accurately with INTRAoperative SID navigation.Hisense CAS can improve the safety and precision of liver resection,provide a basis for planning the resection of undifferentiated embryonic hepatic sarcoma,and provide a possibility to improve the long-term survival rate of children. |
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