Takami Taro

We performed this study to investigate whether serum cell-free DNA testing(liquid biopsy)of either methylated SEPT9 or methylated SST, which are possible biomarkers of HCC, in combination with AFP may improve clinical performance for the detection of HCC. Study subjects included 25 healthy controls, 15 patients with chronic liver disease without HCC, and 38 patients with HCC. Methylation level of serum cell-free SEPT9 and SST was measured by methylation-sensitive restriction enzymes followed by multiplex droplet digital polymerase chain reaction. According to receiver operating characteristic curve analysis to discriminate between non-HCC group(including control group and chronic liver disease without HCC group)and HCC group, area under the curve(AUC)was 0.73 by AFP and 0.73 by mSEPT9, whereas it was only 0.59 by mSST. Regarding combination tests, although negative predictive values were almost same between the AFP + mSEPT9 test and the AFP + mSST test(75.0% vs 72.2%),a positive predictive value of AFP + mSEPT9 test was higher than that of the AFP + mSST test(79.4% vs. 66.7%).In conclusions, methylated SEPT9 was a better companion marker of AFP for HCC screening than methylated SST.

A 36-year-old man diagnosed with Charcot-Marie-Tooth(CMT)disease type 1B was treated in the department of neurology of this hospital. Due to a liver injury(AST 237IU/ml, ALT 496IU/ml)which occurred in November 200X, he was introduced to our department. As a result of scrutiny, we diagnosed him with chronic hepatitis C genotype 2a(HCV-RNA 5.4logIU/ml).He will be admitted to the hospital for Interferon(IFN)therapy in April next year. Although the mechanism is unknown, there are a few reports of peripheral neuropathy related to IFN therapy. Therefore, IFN therapy is generally unfavorable for patients with neuromuscular disorders. There are several IFN preparations used in Japan. IFN alfa associated peripheral neuropathy appears less than 0.1-5% of the time. While there is no report of peripheral neuropathy related to IFN beta, we performed IFN beta and Rivabirin combination therapy with a severe follow-up by a neurologist. We could accomplish treatment without the exacerbation of neurologic symptoms. He achieved sustained viral response. When IFN therapy was provided for chronic hepatitis B or chronic hepatitis C complicated with peripheral neuropathy, there is some possibility of performing antiviral therapy safely by using IFN beta.