Purpose: This work aimed to investigate the effect of costunolide, a sesquiterpene lactone isolated from Michelia compressa, on cell cycle distribution and radiosensitivity of human hepatocellular carcinoma (HCC) cells. Methods: The assessment used in this study included: cell viability assay, cell cycle analysis by DNA histogram, expression of phosphorylated histone H3 (Ser 10) by flow cytometer, mitotic index by Liu's stain and morphological observation, mitotic spindle alignment by immunofluorescence of alpha-tubulin, expression of cell cycle-related proteins by Western blotting, and radiation survival by clonogenic assay. Results: Our results show that costunolide reduced the viability of HA22T/VGH cells. It caused a rapid G2/M arrest at 4 hours shown by DNA histogram. The increase in phosphorylated histone H3 (Ser 10)-positive cells and mitotic index indicates costunolide-treated cells are arrested at mitosis, not G2, phase. Immunofluorescence of alpha-tubulin for spindle formation further demonstrated these cells are halted at metaphase. Costunolide up-regulated the expression of phosphorylated Chk2 (Thr 68), phosphorylated Cdc25c (Ser 216), phosphorylated Cdk1 (Tyr 15) and cyclin B1 in HA22T/VGH cells. At optimal condition causing mitotic arrest, costunolide sensitized HA22T/VGH HCC cells to ionizing radiation with sensitizer enhancement ratio up to 1.9. Conclusions: Costunolide could reduce the viability and arrest cell cycling at mitosis in hepatoma cells. Logical exploration of this mitosis-arresting activity for cancer therapeutics shows costunolide enhanced the killing effect of radiotherapy against human HCC cells.

An 81-year-old woman without systemic disease presenting with fever and chills for 1 week showed icteric sclera and mild epigastric tenderness. Dynamic liver computed tomography revealed a lobulated, heterogeneous mass in the liver (Figure 1A). Sonography showed a heterogeneic tumor with cystic components (Figure 1B). Escherichia coli was detected and cytology results were negative after pus-like fluid aspiration. However, the symptoms persisted despite optimal antibiotic treatment. Follow-up sonography showed the tumor had a similar size and a larger solid component (Figure 1C).

Incidental pancreatic cystic neoplasms (PCNs) are frequently detected as a result of advances in imaging technologies nowadays. Cystic lesions with higher malignant potential include mucinous neoplasms, such as intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN). There are crucial differences between MCN and IPMN in their biological behavior and clinical prognosis. However, currently available tools are imperfect to differentiate between IPMN and MCN. We reported a case of a 46‐year‐old woman with incidental pancreatic tail cyst of 8 cm size. Computed tomography scan and endoscopic ultrasound with fine‐needle aspiration showed a tumor located at the pancreatic tail. The macrocystic lesion had septa and peripheral calcification, and cystic fluid analysis revealed high level of carcinoembryonic antigen (CEA) with low level of amylase. These clinical features are suggestive of MCN in previous experience. Patient underwent laparoscopic distal partial pancreatectomy and splenectomy. The final pathological result was IPMN. Following the application of updated 2017 consensus guideline and 2018 American College of Gastroenterology (ACG) guideline will provide more precise preoperative evaluation and postoperative surveillance. We try to explain the discrepancy between the diagnostic modalities, and more cost‐effective, validated biomarkers are required for differentiating PCNs in the future.