Hepatoblastoma (HB) is the most common primary liver cancer in childhood. The fetal and mixed embryonal/fetal epithelial subtypes of HB differ not only in grade of differentiation but probably also in prognosis. We aimed to determine microRNA (miRNA) expression patterns of the main subtypes of epithelial HBs to reveal differences and relate them to survival. We studied 20 cases of epithelial HB, subtyped as pure fetal (n = 12) or embryonal/fetal (n = 8). Tissues were sampled according to subtype to arrive at 15 purely fetal and eight purely embryonal samples (n = 8) and 15 samples of non-tumorous surrounding liver (SL). Relative expression of miR-17-5p, miR-18a, miR-21, miR-34a, miR-96, miR-122, miR-181a, miR-195, miR-210, miR-214, miR-221, miR-222, miR-223, and miR-224 was determined by TaqMan MicroRNA Assays applying miR-140 as reference. A higher level of miR-18a (p < 0.01) was found in embryonal samples than in fetal samples. Lower miR-17-5p, miR-195, miR-210, miR-214, and higher miR-221 levels were detected in fetal samples (p < 0.02) in comparison with SL samples, whereas a lower miR-122 level was observed in embryonal samples (p < 0.003). Histological subtype did not correlate with survival; however, high miR-21, low miR-222, and low miR-224 levels proved to be independently prognostic for HB with significantly increased overall survival (p < 0.03). The fetal and embryonal components of epithelial HB, as well as SL, revealed different miRNA expression patterns. Furthermore, miR-21, miR-222, and miR-224 levels predict overall survival of HB patients regardless of epithelial subtype.

Our data indicate that patients with treated HBs showing high expression of tricellulin have significantly better overall survival, independent of histological subtype. Increased nuclear expression of EZH2 was associated with the presence of distant metastases.

A nosocomial Hepatitis B virus (HBV) outbreak at a paediatric onco-haematology unit was investigated using molecular biological methods to determine the origin of the infections. The National Reference Laboratory of Hepatitis Viruses received seven HBsAg positive sera from patients and one from the brother of a patient. A fragment of the preS1/preS2/S genes from all samples was amplified, the PCR products were sequenced and a rooted phylogenetic tree was constructed. All nucleotide sequences from the different patients were very similar and 6 of the 8 sequences were identical, suggesting a common origin of the infections. These sequences were closely related to those amplified from a nosocomial HBV epidemic in another hospital in Hungary. The on-scene investigation revealed several malpractices. The two hospital departments had close connections and some of the patients were treated in both institutions. Present report underlines the importance of developing screening protocols for hepatitis viruses and that of the introduction of regular training programs for health care professionals in the field of hospital hygiene.

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Mesothelioma S149 patients. Since almost all mesothelioma patients will relapse, the choice of second line chemotherapy is important in clinical practice. Methods: This is a retrospective analysis of 98 patients diagnosed with malignant mesothelioma and treated with chemotherapy at our center. In these patients, we documented demographics, asbestos exposure, histological subtype, involvement of pleura or peritoneum, Eastern Cooperative Oncology Group Performance Status (PS), chemotherapy lines and agents, cycles of chemotherapy received and date of death. For the patients who received 2 nd line treatment we additionally documented PS at the initiation of 2 nd line treatment, best response by RECIST 1.1 criteria and we calculated Overall Survival (OS) from diagnosis, survival from initiation of 2 nd line therapy and Progression Free Survival (PFS) after 2 nd line therapy. Results: 50 patients received 2 nd line treatment. 48% of these patients received a taxane-gemcitabine doublet resulting in 0% Partial Response (PR), 21.74% Stable Disease (SD) and 69.57% Progressive Disease (PD). Patients had a 2.98 months median Progression Free Survival (mPFS), 15.34 months median Overall Survival (mOS) and 5.88 months survival from the initiation of 2 nd line therapy. 18% of the 2 nd line setting patients received docetaxel monotherapy. There were 0% PR, 0% SD and 55.56% PD. 22.22% discontinued due to toxicity and 11.11% due to deteriorating Performance Status. mPFS was 3.02 months, 22.96 months mOS and 5.48 months survival from the initiation of 2 nd line therapy. Finally 8 patients received the third most common 2 nd line option, rechallenge with either the platinumpemetrexed doublet (n = 6) or pemetrexed monotherapy (n = 2). 14.29% of them demonstrated PR, 57.14% SD and 28.57% PD. mPFS was 7.35 months, mOS 29.20 months and 11.13 months survival from the initiation of 2 nd line therapy. Conclusions: The heterogeneity of the three distinctive 2 nd line chemotherapy groups have a negative impact in the reproducibility and interpretation of the results. This study concurs with the literature in that until today no satisfactory 2 nd line chemotherapy agent exists for patients with mesothelioma. Legal entity responsible for the study: University of Athens Funding: University of Athens Disclosure: All authors have declared no conflicts of interest.