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Objectives: To assess the performance of acoustic radiation force impulse (ARFI) imaging for identification of malignant liver lesions using meta-analysis.Methods: PubMed, the Cochrane Library, the ISI Web of Knowledge and the China National Knowledge Infrastructure were searched. The studies published in English or Chinese relating to evaluation accuracy of ARFI imaging for identification of malignant liver lesions were collected. A hierarchical summary receiver operating characteristic (HSROC) curve was used to examine the ARFI imaging accuracy. Clinical utility of ARFI imaging for identification of malignant liver lesions was evaluated by Fagan plot analysis.Results: A total of eight studies which included 590 liver lesions were analysed. The summary sensitivity and specificity for identification of malignant liver lesions were 0.86 (95 % confidence interval (CI) 0.74-0.93) and 0.89 (95 % CI 0.81-0.94), respectively. The HSROC was 0.94 (95 % CI 0.91-0.96). After ARFI imaging results over the cut-off value for malignant liver lesions ("positive" result), the corresponding post-test probability for the presence (if pre-test probability was 50 %) was 89 %; in "negative" measurement, the post-test probability was 13 %.Conclusions: ARFI imaging has a high accuracy in the classification of liver lesions.Key Points: Acoustic radiation force impulse (ARFI) imaging is a novel ultrasound-based elastography method. This study comprehensively assessed the published performance of ARFI for liver lesions. ARFI imaging appears to have high sensitivity and specificity for liver lesions. ARFI can help differentiate liver lesions and may prevent unnecessary biopsies. [ABSTRACT FROM AUTHOR]

The growth factor heregulin-beta1 (HRG-beta1), which is expressed in breast cancer, activates the HER-2 signaling pathway through induction of heterodimeric complexes of HER-2 with HER-3 or HER-4. It has been shown in many studies that HRG-beta1 induces the tumorigenicity and metastasis of breast cancer cells. Matrix metalloproteinase (MMP) 9 is a key enzyme in the degradation of extracellular matrices, and its expression may be dysregulated in breast cancer invasion and metastasis. Resveratrol, a major component in grape, exhibited potential anticarcinogenic activities in both in vitro and in vivo studies. However, the inhibitory effect of resveratrol on HER-2-mediated expression of MMP-9 has not been demonstrated yet. In the present study, we investigated the anti-invasive mechanism of resveratrol in human breast cancer cells. Human breast cancer MCF-7 cells were exposed to resveratrol (2, 5 and 10 microM). The expression activity of MMP-9 was measured by zymogram analysis. Phosphorylated levels of HER-2 and mitogen-activated protein kinase (MAPK)/ERK were measured by Western blot analysis. Total actin was used as internal control for protein expression. HRG-beta1 induced the phosphorylation of HER-2/neu receptor and MMP-9 expression in human breast cancer MCF-7 cells. Resveratrol significantly inhibited HRG-beta1-mediated MMP-9 expression in human breast cancer cells. MEK inhibitor induced a marked reduction in MMP-9 expression, and it suggested that ERK1/2 cascade could play an important role in HRG-beta1-mediated MMP-9 expression. Furthermore, resveratrol significantly suppressed HRG-beta1-mediated phosphorylation of ERK1/2 and invasion of breast cancer cells. However, resveratrol had negligible effects on either HRG-beta1-mediated phosphorylation of HER-2 receptor or expression of the tissue inhibitor of MMP, tissue inhibitor metalloproteinase protein 1. Taken together, our results suggest that resveratrol inhibited MMP-9 expression in human breast cancer cells. The inhibitory effects of resveratrol on MMP-9 expression and invasion of breast cancer cells are, in part, associated with the down-regulation of the MAPK/ERK signaling pathway. [ABSTRACT FROM AUTHOR]