Cheng Yong, Wang Yue, Zhou Xiao-Fang, You Lai-Wei, Xie Xiao-Yi, Li Hao, Wu Mandi, Guo Jianrong
Department of Anesthesiology, Gongli Hospital of Shanghai Pudong New Area, Shanghai, China.
J Cell Mol Med. 2025 Apr;29(7):e70504. doi: 10.1111/jcmm.70504.
Hepatocellular carcinoma (HCC) represents the predominant form of primary liver cancer, constituting 75%-85% of all liver cancer cases. Despite advances in understanding HCC mechanisms and treatment options, challenges remain and further research is needed to uncover new therapeutic targets and improve patient outcomes. intraoperative cell salvage (IOCS) is an important surgical method that minimises the necessity for transfusions of donor blood, improves haemodynamic stability and may enhance recovery. This study aims to identify safety biomarkers for autologous blood transfusion in HCC patients. We conducted a prospective case-control study on 80 HCC patients undergoing radical surgery. Blood and tumour tissues were collected for analysis. The control group provided blood directly from the surgical site without IOCS processing, while the experimental group used blood collected through the IOCS system. Dual-Luciferase reporter gene assays, immunofluorescence, Western blot and qRT-PCR techniques were employed to assess the expression of key proteins and microRNAs. Comparable demographic and baseline clinical characteristics were observed between groups. The experimental group showed significantly improved pathological features, with an increase in PTEN-positive cells and upregulated protein expression of PTEN, mTOR, c-Met and IGF1R. Additionally, miRNA levels (miRNA-21, miRNA-122, miRNA-223, miRNA-199a and miRNA-375) were significantly reduced in the experimental group (p < 0.05), while mRNA levels for PTEN, mTOR, c-Met, YAP1 and IGF1R were significantly upregulated (p < 0.05). IOCS has a positive impact on liver tissue pathology in HCC patients by reducing apoptosis and modulating key molecular pathways. These findings suggest that IOCS could be a valuable therapeutic strategy for HCC, potentially guiding future treatment approaches and improving patient outcomes.
肝细胞癌（HCC）是原发性肝癌的主要形式，占所有肝癌病例的75%-85%。尽管在理解HCC机制和治疗选择方面取得了进展，但挑战依然存在，需要进一步研究以发现新的治疗靶点并改善患者预后。术中细胞回收（IOCS）是一种重要的手术方法，可减少异体输血的必要性，改善血流动力学稳定性，并可能促进恢复。本研究旨在确定HCC患者自体输血的安全生物标志物。我们对80例行根治性手术的HCC患者进行了一项前瞻性病例对照研究。收集血液和肿瘤组织进行分析。对照组直接从手术部位采集血液，不经过IOCS处理，而实验组使用通过IOCS系统收集的血液。采用双荧光素酶报告基因检测、免疫荧光、蛋白质印迹和qRT-PCR技术评估关键蛋白和微小RNA的表达。两组之间观察到可比的人口统计学和基线临床特征。实验组的病理特征明显改善，PTEN阳性细胞增加，PTEN、mTOR、c-Met和IGF1R的蛋白表达上调。此外，实验组的微小RNA水平（miRNA-21、miRNA-122、miRNA-223、miRNA-199a和miRNA-375）显著降低（p<0.05），而PTEN、mTOR、c-Met、YAP1和IGF1R的mRNA水平显著上调（p<0.05）。IOCS通过减少细胞凋亡和调节关键分子途径对HCC患者的肝组织病理学产生积极影响。这些发现表明，IOCS可能是HCC的一种有价值的治疗策略，有可能指导未来的治疗方法并改善患者预后。
