ABSTRACT
Objective To investigate the regulation of CCL22/CCR4 signaling on CD4 + CD25 + regulatory T cells (Tregs) and immune escape in hepatocellular carcinoma (HCC).Methods CCL22,interleukin-2 (IL-2),transforming growth factor-β (TGF-β),and interleukin-10 (IL-10) levels in tumor tissue of 30 HCC patients were determined by ELISA.Tumor infiltrating lymphocytes were isolated and assayed by flow cytometry to evaluate the change of CD4 + CD25 + Tregs in tumor tissue,and CCR4 in CD4 + CD25 +Tregs were detected.Results The CCL22 level in tumor tissue was obviously increased.The level of CCL22 in tumor tissue was (920.1-± 180.1)ng/L,which was significantly higher than that in non-tumor tissue [(227.2 ± 108.6) ng/L; P ＜ 0.05].The tumor infiltrating CD4 + CD25 + Tregs was obviously increased,reaching approximately to (13.3 ±4.0)％,and the CCR4 expression in CD4+ CD25 + Tregs increased to (8.8 ± 3.0) ％.Along with progression in clinical TNM staging,the levels of CD4 + CD25 + Tregs and CD4 + CD25 + CCR4 + Tregs in tumor tissue increased,and were correlated with the CCL22 level.IL-2 level in tumor tissue was decreased,but TGF-β and IL-10 levels were increased.HCC tissue can secrete a large amount of CCL22 that could recruit CD4 + CD25 + Tregs to tumor tissue by activating CCL22/CCR4 signaling.CD4 + CD25 + Tregs played an important role in the immune escape of HCC by releasing plenty of TGF-β and IL-10 and inhibiting IL-2 secretion.Conclusion This study validates CCL22/CCR4 as therapeutic targets in immunotherapy for HCC.
ABSTRACT
Objective To evaluate surgical resection combined with RFA and TACE for multiple hepatocellular carcinoma.Methods Between 2010 and 2013, 27 multiple hepatocellular carcinoma cases were treated with surgical resection combined with RFA and TACE.The clinical data and postoperative complications were observed.Results Left lateral lobectomy was performed in 4 patients, left hemihepatectomy was performed in 8 patients, right liver resection was performed in 3 patients, irregular right liver resection was performed in 12 patients.The operation time was (223 ± 77) min, The intraoperative bleeding was (435 ± 144) ml.There were not postoperative severe complications, such as hepatic hematoma, liver abscess, intraabdominal hemorrhage, liver failure.Unresected focus uderwent complete necrosis or liquefaction in the RFA regions as shown by CT scanning after 1 month in 24 patients.Postoperative, TACE was performed regularly in all the patients.Lipiodol deposition on the margin of RFA regions was found in 3 patients.After a year, new foci were found in 9 cases.Patients were followed-up from 8-39 months.The median survival time after operation was 26.3 months.The survival rates were 92％, 60％, 15％, respectively after 1, 2, 3 year.Conclusions For patients with multiple hepatocellular carcinoma, surgical resection combined with RFA and TACE was safe and effective.
ABSTRACT
Objective To investigate the changes of hepatocyte growth factor (HGF) and vascular endothelial growth factor(VEGF) after partial hepatectomy in patients with liver cirrhosis and their relationship with liver regeneration. Methods Thirty-five patients with partial hepatectomy between June 2007 and August 2009 were enrolled,according to whether cirrhosis were divided into cirrhosis group (16 cases) and non-cirrhosis group (19 cases). Liver size were measured with angiographic computed tomography at 7,30,90 d after operation. Regeneration rate of remnant liver were calculated. The serum concentrations of HGF and VEGF were meaaured. Postoperative hepatic function and complications incidence rate were comparatively analyzed. Results Compared with non-cirrhosis group, the postoperative hepatic function of cirrhosis group suffered serious damage. In non-cirrhosis group, the remnant liver regeneration rate reached (63.6± 15.9)%, (79.4 ± 17.2)%, (97.2 ± 18.3)% at 7,30,90 d after operation,in cirrhosis group,it reached (41.7 ± 10.7)%, (55.7 ± 13.2)%, (76.6 ± 12.5)%, liver in non-cirrhosis group regenerated rapidly (P <0.05). After hepatectomy,the HGF levels in cirrhosis group increased significantly at 1,3,7 d than those in non-cirrhosis group(P ＜ 0.05), but the VEGF levels were lower. Conclusions Liver in the patients with cirrhosis regenerate slowly and it may be due to in part through a decrease in VEGF. Whether it may,when given therapeutically represent a strategy to optimize liver regeneration in problematic patients needs to be clarified.
ABSTRACT
Objective To study the diagnosis and treatment of portal vein complications after orthotopic liver transplantation. Methods The clinical data of 173 patients receiving orthotopic liver transplantation in our hospital from 2002 to 2005 were retrospectively analyzed. Results The incidence of portal vein complications was 3.5% (6 cases). The incidence of portal vein stenosis was 1.2% and that of portal vein thrombosis was 2. 3%. Three cases had previously been treated for portal hypertension and three cases had had a history of portal vein thrombosis before liver transplantation. All the complicated patients recovered and were discharged after successful treatment. There was no complication related mortality. Conclusions A history of previous treatment for portal hypertension, portal vein thrombosis is a risk factor predisposing the patients to portal vein complications after orthotopic liver transplantation. Color Doppler sonography is a sensitive and specific method for monitoring the portal vein complications following orthotopic liver transplantation. The angiography of portal vein is essential for diagnosis of the complications. Thrombolysis treatment is unsatisfactory for advanced stage portal vein thrombosis. Balloon dilation and stenting are both a safe and effective management modality for simple portal vein stenosis.