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Objective:To explore the diagnosis and treatment of hepatocellular adenoma.Methods:The clinical data of 23 hepatocellular adenoma patients admitted to the Affiliated Hospital of Qingdao University from May 2013 to May 2020 were retrospectively analyzed.Results:Fifteen patients were female, the age ranged from 21 to 60. The maximum tumor diameter was from 2.5 cm to 15 cm.Most patients (15/23) were asymptomatic. There were 20 cases (87%) with single lesion and 3 cases (13%) with multiple lesions. Contrast-enhanced CT and MRI showed enhancement in the arterial phase, and de-enhancement in the portal phase as well as in the delayed phase. All cases underwent tumor resection. Hepatocellular adenoma was confirmed by pathology with partial canceration in one case and intratumoral hemorrhage in two cases. Sixteen cases were misdiagnosed preoperatively, 20 were followed up with the median follow-up time of 36 months. Recurrence was not found.Conclusion:Hepatocellular adenoma is uncommon and often misdiagnosed. Preoperative diagnosis is dependent on MRI.Given the fact of high rate misdiagnosis and a tendency of canceration,resection is recommended.
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Objective@#To clarify the clinicopathologic features of hepatocellular carcinoma (HCC) patients survived more than 10 years after radical hepatectomy.@*Methods@#Two hundreds and fifty-two patients who underwent curative resection for HCC between January 1999 and March 2006 at Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qingdao University were included.There were 217 male cases and 35 female cases aging from 17 to 82 years with median age of (53.8±10.5)years. Followed by March 31 2016, clinicopathologic factors in 10-year survivors and patients who died within 10 years were compared by χ2 test, Kaplan-Meier survival analysis and Cox proportional hazards model and the prognostic factors affecting survival were identified.@*Results@#All patients were followed-up for 4.0 to 205.7 months with median time of 53.4 months. The 10-year overall survival rate was 26%, there were 62 cases(26.2%) who survived for more than 10 years after initial hepatectomy. In survival >10-year group, the paitents with ALT<40 U/L, gamma-glutamyl transpeptidase<64 U/L, albumin≥35 g/L, without liver cirrhosis and portal hypertension, Child-Pugh grade A, no blood transfusion, AFP≤20 μg/L, tumor size ≤5.0 cm, single tumor, high differentiation, TNM stage Ⅰ and TACE negative after resection were more than the patients in survival <10-year group (P<0.05). In multivariate analysis, Child-Pugh grade A, the tumor size ≤5.0 cm and TACE negative after resection were favorable independent factors associated with 10-year survival (P<0.05).@*Conclusion@#Based on the results of the study, Child-Pugh grade A, tumor size ≤5.0 cm and TACE negative after resection at initial hepatectomy might be biologically favorable conditions for patients surviving more than 10 years.
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Objective To analyze the law of the mid﹣term hepatic hemodynamics after liver transplantation and to investigate its relationship with liver function. Methods A total of 56 recipients underwent liver transplantation in the Affiliated Hospital of Qingdao University from February 2014 to October 2015 were studied,and divided into normal group (n =24)and abnormal group (n =32)according to the liver function.General information and liver function of both groups were recorded.Furthermore,hepatic artery peak velocity (HAP),portal vein peak velocity (PVP)and portal vein flow (PVF)before the liver transplantation and on postoperative day 1,30 and 90 were measured through ultrasonic detection;hepatic arterial buffer capacity (BC)and adjustment BC were calculated.The univariable and multivariable analysis were performed to analyze the relationship between hepatic hemodynamics and liver function in two groups,and the receiver operating curve (ROC)was drawn. Results The PVP and PVF on postoperative day 30 in abnormal group were significantly higher than those of normal group (P =0.014,0.049).The BC and adjustment BC in normal group were significantly higher than those of abnormal group (P =0.048,0.011).The multivariable analysis showed that adjustment BC was the independent risk factor (P =0.047),with the area under the curve (AUC)of ROC of 0.705,sensitivity of 0.652 and specificity of 0.750. Conclusions PVP,PVF,BC and adjustment BC on postoperative day 30 may be related to abnormal liver function,of which adjustment BC can be used as one of the indicators for diagnosis and intervention of abnormal liver function.
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Objective To study the prognosis of patients with huge hepatocellular carcinoma (HCC) after R0 resection.Methods 517 patients with primary HCC who underwent R0 resection from January 1997 to December 2008 at the Affiliated Hospital of Medical College Qingdao University were analyzed retrospectively.Results The 5-and 10-years overall survivals (OS) in patients with huge HCC (≥10 cm; n=69) and in patients with HCC ＜10 cm (n=448) were 24％,18％ and 49％,30％,respectively.The median OS was 23.0 and 58.0 month (P＜0.001,log rank test) ; and the median disease-free survivals (DFS) were 15.3 and 34.8 month (P＜0.001),respectively.The recurrence rate within the first year and the extrahepatic recurrence after resection in patients with huge HCC was significantly higher than in patients with HCC ＜10 cm (44.9％ vs.24.3％,P=0.022;32.7％ vs.16.0％,P=0.004).Independent poor prognostic factors of OS and DFS for patients with huge HCC after R0 resection were portal hypertension and vascular invasion.Preoperative transcatheter arterial chemoembolization (TACE) was an independent prognostic factor for better DFS.Conclusions Surgical resection for huge HCC is safe and feasible.For huge HCC after resection,portal hypertension and vascular invasion were poor prognostic factors.Preoperative TACE improved DFS after resection.
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Objective To analyze the factors that influence the survival condition during the first year after hepatectomy in patients with hepatocellular carcinoma (HCC). Methods Five hundred twentyeight HCC cases undergoing hepatectomy were included from January 1997 to December 2008.The factors and survival outcomes in these patients were analyzed. Results There were 302 patients dying during a medium follow-up of 35 months and 1-year cumulative survival was 85％.The causes of death during first year were tumor recurrence (78.1％,75/96) and liver dyscompensation ( 19.8％,19/96).By Cox regression analysis,tumor size ≥5 cm (P =0.047 ),vascular invasion ( P =0.018),histologic moderately and poorly differentiation ( P =0.001 ) and pathologically positive margin ( P =0.004 ) were significantly associated with tumor recurrence,and portal hypertension was an independent factor for patients dying from liver dysfunction ( P =0.001 ).Positive tumor margin was the most important factor associated with postoperative death within one year (59.3％,60/96). Conclusions During the first year after HCC resection,tumor recurrence and liver dysfunction are main factors influencing HCC patients' survival,nonR0 resection is the main factor causing tumor recurrence,and portal hypertension is an independent factor for patients dying of liver dyscompensation.
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Objective To study the expressions of Cx43,CD105 and VEGF in HBV related HCC tissues and the relationships between Cx43 expression and recurrence and prognosis after cancer radical resection in HCC patients stratified by serum AFP levels. Methods The expressions of Cx43,CD105,VEGF in 234 HBV related HCC tissues were examined by tissue microarray and two-step methods of PV-6000 of immunohistochemistry and the expressions of Cx43 in 20 frozen HCC specimens were examined by RT-PCR. Results Cx43 in HCC tissues was positive as examined by both immunohistochemistry and RTPCR methods.Positive Cx43 expression is correlated with lower early recurrence ( Log Rank P =0.001 ),longer disease free survival (Log Rank P =0.026 ) and overall survival( Log Rank P =0.000 ) as showed by the Kaplan-Meier analysis in patients with AFP ＜ 400 μg/L. The expression of Cx43 is an independent prognostic factor.The positive expression of Cx43 related with lower positive expression of CD105 and VEGF (P =0.018,0.023 ),and correlated with histological differentiation (P =0.002),the number of focus (P =0.033 ),blood vessel tumor embolism ( P =0.029 ). Conclusions The expression of Cx43 is correlative with the expression of CD105 and VEGF,and is predictive of HCC early recurrence and poor prognosis after radical hepatectomy in HBV related HCC patients with serum AFP ＜ 400 μg/L.
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Objective:To explore the expression of TGF-?,TGF-?1 in the tissues of pancreatic adenocarcinoma and normal pancreas,and study the changes and the relationships with the clinicopathological parameters of pancreatic adenocarcinomas.Methods:The expressions of the TGF-?,TGF-?1 were assayed in formalin-fixed paraffin embedded samples of 41 patients with pancreatic adenocarcinoma and 12 normal pancreatic tissues by means of SABC immunohistochemistry.The relationships between the expression and clinical parameters were analysied,such as ages,gender,tumor size,location,degree of differentiation and stage(UICC).Results:The positive rate of TGF-?,TGF-?1 were73.2%,63.4% respectively in pancreatic adenoeareinoma and were16.7 %,25% respectively in normal pancreatic tissues.Significant differences were found between the two groups(P