Original Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 14, 2011; 17(42): 4675-4681
Published online Nov 14, 2011. doi: 10.3748/wjg.v17.i42.4675
Increased extrinsic apoptotic pathway activity in patients with hepatocellular carcinoma following transarterial embolization
Shih-Ho Wang, Li-Mien Chen, Wen-Kai Yang, Jane-Dar Lee
Shih-Ho Wang, Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung 83301, Taiwan
Li-Mien Chen, Division of Hematology/Oncology, Department of Medicine, Taichung Armed Forces General Hospital, Taichung 41152, Taiwan
Li-Mien Chen, Jane-Dar Lee, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan
Wen-Kai Yang, Jane-Dar Lee, Department of Surgery, Taichung Armed Forces General Hospital, Taichung 41152, Taiwan
Wen-Kai Yang, Department of Life Sciences, National Chung Hsing University, Taichung 40227, Taiwan
Author contributions: Wang SH, Chen LM and Lee JD designed the research; Yang WK performed the research and analyzed the data; Lee JD wrote the paper.
Supported by A grant from Taichung Armed Forces General Hospital, Taiwan
Correspondence to: Jane-Dar Lee, MD, PhD, Department of Surgery, Taichung Armed Forces General Hospital, No. 348, Sec 2, Chungshan Rd, Taiping Dist, Taichung 41152, Taiwan. janedar@hotmail.com
Telephone: +886-4-23925948 Fax: +886-4-23920451
Received: April 14, 2011
Revised: June 10, 2011
Accepted: June 17, 2011
Published online: November 14, 2011

AIM: To determine the apoptosis pathway in residual viable hepatocellular carcinoma (HCC) tissues following transarterial embolization (TAE).

METHODS: Ten patients with HCC who received surgical resection after TAE were enrolled in the study group, and 24 patients with HCC who received surgical resection only served as the control group. In the study group, we measured the changes in tumor size and α fetoprotein (AFP) levels after TAE. All tissue samples were taken from the residual tumors. The expression of various apoptotic proteins was evaluated via immunoblotting procedures. The results were analyzed using a Student’s t test.

RESULTS: Tumor size and the AFP level decreased by 46.2% and 55.3% after TAE, respectively. There was no significant difference detected for the Bcl-2/Bax ratio or the cleaved caspase-9 expression levels in either group. However, extrinsic apoptopic pathway-related expression of Fas and cleaved caspase-8 expression were significantly higher in the study group than in the control group (P < 0.05). In addition, cleaved caspase-3 expression in the study group was higher (1.62-fold) than in control group (P < 0.05).

CONCLUSION: TAE is an effective palliative therapy that decreases tumor size and AFP levels via an increase in extrinsic apoptosis pathway in patients with unresectable HCC.

Keywords: Apoptosis, Hepatocellular carcinoma, Transarterial embolization