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Hepatocellular Carcinoma TM M E T H O D S I N M O L E C U L A R M E D I C I N E John M. Walker, SERIES EDITOR 45. Hepatocellular Carcinoma: Methods 33. Cytomegalovirus Protocols, edited and Protocols, edited by Nagy A. by John Sinclair, 2000 Habib, 2000 32. Alzheimer’s Disease: Methods and Protocols, edited by Nigel M. Hooper, 2000 44. Asthma: Mechanisms and Protocols, edited by K. Fan Chung and Ian 31. Hemostasis and Thrombosis Adcock, 2000 Protocols: Methods in Molecular Medicine, edited by David J. Perry 43. Muscular Dystrophy: Methods and and K. John Pasi, 1999 Protocols, edited by Katherine B. Bushby and Louise Anderson, 2000 30. Vascular Disease: Molecular Biology and Gene Therapy Protocols, edited 42. Vaccine Adjuvants: Preparation by Andrew H. Baker, 1999 Methods and Research Protocols, edited by Derek T. O’Hagan, 2000 29. DNA Vaccines: Methods and Protocols, edited by Douglas B. 41. Celiac Disease: Methods and Lowrie and Robert G. Whalen, 2000 Protocols, edited by Michael N. Marsh, 2000 28. Cytotoxic Drug Resistance 40. Diagnostic and Therapeutic Mechanisms, edited by Robert Brown Antibodies, edited by Andrew J. T. and Uta Böger-Brown, 1999 George and Catherine E. Urch, 2000 27. Clinical Applications of Capillary 39. Ovarian Cancer: Methods and Electrophoresis, edited by Stephen Protocols, edited by John M. S. M. Palfrey, 1999 Bartlett, 2000 26. Quantitative PCR Protocols, edited 38. Aging Methods and Protocols, by Bernd Kochanowski and Udo edited by Yvonne A. Barnett and Reischl, 1999 Christopher P. Barnett, 2000 25. Drug Targeting, edited by G. E. 37. Electrically Mediated Delivery of Francis and Cristina Delgado, 2000 Molecules to Cells, edited by Mark J. 24. Antiviral Methods and Protocols, Jaroszeski, Richard Heller, and edited by Derek Kinchington Richard Gilbert, 2000 and Raymond F. Schinazi, 2000 36. Septic Shock Methods and Protocols, 23. Peptidomimetics Protocols, edited by edited by Thomas J. Evans, 2000 Wieslaw M. Kazmierski, 1999 35. Gene Therapy of Cancer: Methods 22. Neurodegeneration Methods and and Protocols, edited by Wolfgang Protocols, edited by Jean Harry Walther and Ulrike Stein, 2000 and Hugh A. Tilson, 1999 34. Rotaviruses: Methods and Protocols, 21. Adenovirus Methods and Protocols, edited by James Gray and Ulrich edited by William S. M. Wold, 1998 Desselberger, 2000 TM M E T H O D S I N M O L E C U L A R M E D I C I N E Hepatocellular Carcinoma Methods and Protocols Edited by Nagy A. Habib Liver Surgery Section, Imperial College School of Medicine, Hammersmith Hospital, London, UK Humana Press Totowa, New Jersey © 2000 Humana Press Inc. 999 Riverview Drive, Suite 208 Totowa, New Jersey 07512 All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permis- sion from the Publisher. Methods in Molecular Medicine™ is a trademark of The Humana Press Inc. All authored papers, comments, opinions, conclusions, or recommendations are those of the author(s), and do not necessarily reflect the views of the publisher. Due diligence has been taken by the publishers, editors, and authors of this book to assure the accuracy of the information published and to describe generally accepted practices. The contributors herein have carefully checked to ensure that the drug selections and dosages set forth in this text are accurate and in accord with the standards accepted at the time of publication. Notwithstanding, as new research, changes in government regu- lations, and knowledge from clinical experience relating to drug therapy and drug reactions constantly occurs, the reader is advised to check the product information provided by the manufacturer of each drug for any change in dosages or for additional warnings and contraindications. This is of utmost importance when the recommended drug herein is a new or infrequently used drug. It is the responsibility of the treating physician to determine dosages and treatment strategies for individual patients. Further it is the responsibility of the health care provider to ascertain the Food and Drug Administration status of each drug or device used in their clinical practice. The publisher, editors, and authors are not responsible for errors or omissions or for any consequences from the application of the information presented in this book and make no warranty, express or implied, with respect to the contents in this publication. This publication is printed on acid-free paper. ∞ ANSI Z39.48-1984 (American Standards Institute) Permanence of Paper for Printed Library Materials. Cover design by Patricia F. Cleary. Cover photo: Figure 1A from Ch. 2, Medical Management of Hepatocellular Carcinoma, by S. M. Riordan and R. Williams. Photocopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Humana Press Inc., provided that the base fee of US $10.00 per copy, plus US $00.25 per page, is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license from the CCC, a separate system of payment has been arranged and is acceptable to Humana Press Inc. The fee code for users of the Transactional Reporting Service is: [0-89603-785-1/00 $10.00 + $00.25]. Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging in Publication Data Hepatocellular carcinoma: methods and protocols / edited by Nagy A. Habib. p. ; cm. -- (Methods in molecular medicine ; 45) Includes bibliographical references and index. ISBN 0-89603-785-1 (alk. paper) 1. Liver--Cancer--Research--Methodology. I. Habib, Nagy A. II. Series. [DNLM: 1. Carcinoma, Hepatocellular--etiology. 2. Carcinoma, Hepatocellular--genetics. 3. Carcinoma, Hepatocellular--therapy. 4. Gene Therapy--methods. WI 735 H5295 2000] RC280.L5 H456 2000 616.99'436--dc21 99-052577 Preface Hepatocellular Carcinoma: Methods and Protocols outlines the research methods applied in the laboratories and clinics of those scientists and clini- cians interested in the understanding and clinical management of patients with hepatocellular carcinoma (HCC). Part I, The Clinical Problem, has been contributed by two leading clini- cal groups who have identified and addressed problem areas related to the management of HCC patients. Various treatment modalities are discussed and emphasis is placed on the limitations they experienced. Part II, HCC Carcinogenesis, reviews the main etiological factors related to hepatitis B and hepatitis C. Part III, Molecular and Biological Characteristics, provides insight into the molecular changes associated with HCC, including tumor-suppressor genes, oncogenes, adhesion molecules, matrix metalloproteinase, and novel genes and markers. Part IV, HCC Gene Therapy, addresses gene therapy approaches to treating hepatocellular carcinoma. It includes the use of various vectors, such as lipids, viruses such as adenoviruses and baculoviruses, and virus detection using elec- tron microscopy assessment. The use of adenovirus with specific promotors, such as AFP, is also included. Preclinical and clinical data on the killing of cancer cells using tumor-suppressor genes, antisense to growth factors, immunogene therapy, or virus-directed enzyme prodrug therapy are addressed. Part V, Clinical Protocol for p53 Gene Therapy for Liver Tumors, offers a future perspective on how to treat the failing liver, which is the principal source of mortality in these patients. It includes gene therapy approaches for use in patients suffering from hypoalbuminemia, abnormal clotting, low platelet count, and viral hepatitis DNA vaccinations. There is no doubt that advances in molecular characterization, novel gene isolation, and gene therapy will improve the services we can provide to patients suffering from hepatocellular carcinoma and ultimately working toward its prevention. Nagy A. Habib v Contents Preface .............................................................................................................v Contributors ..................................................................................................... xi PART I. THE CLINICAL PROBLEM 1 Hepatocellular Carcinoma: The Clinical Problem Valery Usatoff and Nagy A. Habib ....................................................... 3 2 Medical Management of Hepatocellular Carcinoma Stephen M. Riordan and Roger Williams.......................................... 21 PART II. HCC CARCINOGENESIS 3 Possible Involvement of the NS3 Protein of Hepatitis C Virus in Hepatocarcinogenesis: Its Interaction with the p53 Tumor Suppressor Satoshi Ishido, Tsunenori Fujita, and Hak Hotta............................. 37 4 Abrogation of p53-Induced Apoptosis by the Hepatitis B Virus X Gene Xin Wei Wang ....................................................................................... 57 5 Hepatocellular Carcinoma: Role of Hepatitis Viruses and Liver Cell Dysplasia Carmen Vandelli and Francesco Renzo ........................................... 71 PART III. MOLECULAR AND BIOLOGICAL CHARACTERISTICS 6 Impact of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV): From Research to Clinical Practice Maurizia Rossana Brunetto, Filippo Oliveri, and Ferruccio Bonino ..................................................................... 99 7 Mutation of p53 Tumor Suppressor Gene in Hepatocellular Carcinoma Apollonia Tullo and Elisabetta Sbisà .............................................. 113 8 Diagnostic Markers in Hepatocellular Carcinoma Using Immunohistochemical Techniques Yaw Ohene-Abuakwa and Massimo Pignatelli .............................. 131 vii viii Contents 9 Assessing Matrix Metalloproteinase Expression and Activity in Hepatocellular Carcinomas Orlando Musso, Bruno Clément, and Nathalie Théret .................. 139 10 Isolation of Novel Markers for Hepatocellular Carcinoma by a Subtraction-Enhanced Display Technique Chuan-Ging Wu .................................................................................. 157 WAF1 11 Measurement of Protein Expression of p53, p21 , and Rb in Patients with Surgically Treated Hepatocellular Carcinoma by Using Catalyzed Signal-Amplication System Takuji Naka, Tetsuya Kaneko, and Nobuaki Kaibara .................... 167 PART IV. HCC GENE THERAPY 12 Gene Therapy Vectors Harboring AFP Regulatory Sequences: Preparation of an Adenoviral Vector Shuichi Kaneko and Taiki Tamaoki ................................................. 177 13 Advantages and Disadvantages of Multiple Different Methods of Adenoviral Vector Construction Prem Seth and James Higginbotham ............................................. 189 14 Electron Microscopic Assessment of Adenovirus-Mediated Transfer Catherine E. Sarraf ............................................................................ 199 15 p53 Plasmid Preparation and Techniques for Analysis of Gene Transfer and Expression Ragai R. Mitry, Michael D. Kelly, Jian Zhao, Satoko Negishi, Marc R. Mansour, and Nagy A. Habib ......................................... 207 16 Antisense IGF-I for Hepatocellular Carcinoma Yanjun Liu, Jian Zhao, Yang Lu, Jerzy Trojan, Mengchao Wu, and Yajun Guo ............................................................................... 221 17 Novel Effective Tumor Vaccines for Hepatocellular Carcinoma Lixin Wei, Hao Wang, Yanjun Liu, Mengchao Wu, and Yajun Guo ............................................................................... 237 18 Immunoglobulin Fusion Proteins as a Tool for Evaluation of T-Cell Costimulatory Molecules Andrei I. Chapoval, Gefeng Zhu, and Lieping Chen ..................... 247 19 Adenovirus-Mediated Drug Sensitivity Gene Therapy for Hepatocelular Carcinoma Fumihiko Kanai, Makoto Ohashi, Paola A. Marignani, Yasushi Shiratori, Hirofumi Hamada, and Masao Omata......... 257 Contents ix PART V. CLINICAL PROTOCOL FOR P53 GENE THERAPY FOR LIVER TUMORS 20 Clinical Protocol for p53 Gene Therapy for Liver Tumors Michael D. Kelly, Ragai R. Mitry, and Nagy A. Habib .................... 273 Index ............................................................................................................ 299 Contributors FERRUCCIO BONINO, MD • Unitá Operativa, Gastroenterologia ed Epatologia, Pisa, Italy MAURIZIA ROSSANA BRUNETTO, MD • Unitá Operativa, Gastroenterologia ed Epatologia, Pisa, Italy ANDREI I. CHAPOVAL • Department of Immunology, Mayo Medical School, Mayo Clinic, Rochester, MN LIEPING CHEN, MD • Department of Immunology, Mayo Medical School, Mayo Clinic, Rochester, MN BRUNO CLÉMENT • INSERM U-456, Université de Rennes I, Rennes, France TSUNENORI FUJITA • Department of Microbiology, Kobe University School of Medicine, Kobe, Japan YAJUN GUO, MD • Director of Immunogene Therapy Program, Sidney Kimmel Cancer Centre, San Diego, CA, and Director of Shanghai International Cancer Institute and Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, People’s Republic of China NAGY A. HABIB • Head of Liver Surgery Section, Division of Surgery, Anaesthetics and Intensive Care, Imperial College School of Medicine, Hammersmith Hospital, London, UK HIROFUMI HAMADA • Department of Molecular Biotherapy Research, Cancer Chemotherapy Center, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan JAMES HIGGINBOTHAM • National Cancer Institute, National Institutes of Health, Bethesda, MD HAK HOTTA, MD • Head of Department of Microbiology, and Director of International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan SATOSHI ISHIDO • Department of Microbiology, Kobe University School of Medicine, Kobe, Japan NOBUAKI KAIBARA • First Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan FUMIHIKO KANAI, MD • Department of Cell Biology, Harvard Medical School, Boston, MA and Department of Gastroenterology, University of Tokyo, Tokyo, Japan xi xii Contributors SHUICHI KANEKO • First Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan TETSUYA KANEKO • First Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan MICHAEL D. KELLY • Liver Surgery Section, Imperial College School of Medicine, Hammersmith Hospital, London, UK YANJUN LIU • Head of Department of Molecular Biology, International Joint Cancer Institute, Second Military Medical University, Shanghai, People’s Republic of China YANG LU • Shanghai International Joint Cancer Institute, Shanghai, China MARC R. MANSOUR • Liver Surgery Section, Imperial College School of Medicine, Hammersmith Hospital, London, UK PAOLA A. MARIGNANI • Division of Signal Transduction, Department of Medicine, Beth Israel Deaconess Medical Center and Department of Cell Biology, Harvard Medical School, Boston, MA RAGAI R. MITRY • Liver Surgery Section, Imperial College School of Medicine, Hammersmith Hospital, London, UK ORLANDO MUSSO • INSERM U-456, Université de Rennes I, Rennes, France TAKUJI NAKA • First Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan SATOKO NEGISHI • Liver Surgery Section, Imperial College School of Medicine, Hammersmith Hospital, London, UK MAKOTO OHASHI • Department of Gastroenterology, University of Tokyo, Tokyo, Japan YAW OHENE-ABUAKWA • Division of Histopathology, Department of Pathology and Microbiology, University of Bristol, Bristol Royal Infirmary, Bristol, UK FILIPPO OLIVERI, MD • Unitá Operativa, Gastroeneterologia ed Epatologia, Pisa, Italy MASAO OMATA • Department of Gastroenterology, University of Tokyo, Tokyo, Japan MASSIMO PIGNATELLI • Division Histopathology, Department of Pathology and Microbiology, University of Bristol, Bristol Royal Infirmary, Bristol, UK FRANCESCO RENZO • Dipartimento Medicina Interna, Modena University, Modena, Italy STEPHEN M. RIORDAN, MD • Department of Gastroenterology, The Prince of Wales Hospital, Randwick, Australia CATHERINE E. SARRAF • Department of Histopathology, Imperial College School of Medicine, Hammersmith Hospital, London, UK ELISABETTA SBISÀ • Centro di Studio sui Mitocondri e Metabolismo Energetico, Consiglio Nazionale delle Ricerche, Bari, Italy

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