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Objective To evaluate the clinical efficacy of microwave ablation and surgical resection for the treatment of early primary hepatocellular carcinoma (HCC).Methods The Cochrane Library, Medline,PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang database, VIP database were searched with the key words of tumor, liver cancer, primary hepatic carcinoma, hepatocellular carcinoma, HCC,surgery, surgical, surgical resection, liver resection, hepatic resection, thermal ablation, percutaneous thermal ablation, microwave coagulation, microwave ablation, 肝癌, 原发性肝癌, 肝细胞癌, 手术, 切除, 手术切除, 肝切除, 微波, 热消融, 微波治疗, 微波凝固, 微波消融 between the database establishment and February 2015.Chinese and English literatures on microwave ablation and surgical resection for the treatment of early primary HCC were retrieved, and data were extracted and analyzed by 2 independent researchers.All the patients were divided into the microwave ablation group and the surgical resection group.Measurement data were represented by the standardized mean difference (SMD) and 95％ confidence interval (CI), and count data were represented by the odds ratio (OR) and 95％ CI.Heterogeneity of the publication was analyzed using the I2 test.Results Seven literature including 6 retrospective cohort studies and 1 randomized controlled trial were retrieved, and total sample size were 993 patients including 648 in the microwave ablation group and 345 in the surgical resection group.There were significant differences in the volume of blood loss and duration of postoperative hospital stay between the2groups (SMD=-5.03,-1.74, 95％ CI:-6.21-3.85,-2.21--1.28, P＜0.05).There were no significant difference in the incidence of postoperative complications, 1-, 3-year overall survival rates, 1-, 3-year tumor-free survival rates and 1-, 2-, 3-year recurrence rates between the 2 groups (OR =1.57, 1.10, 1.20,0.77, 1.23, 1.32, 2.31, 1.39, 95％CI: 0.25-9.78, 0.43-2.86, 0.70-2.06, 0.19-3.12, 0.54-2.81,0.62-2.80, 0.96-5.55, 0.47-4.14, P ＞ 0.05).Conclusions The safety, feasibility and clinical efficacy of microwave ablation for the treatment of early primary HCC is comparable to surgical resection, and microwave ablation has the advantages of lesser blood loss and shorter duration of hospital stay.
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Objective To identify the rate of hepatitis B virus (HBV) reactivation and potential risk factors in hepatitis B surface antigen negative/hepatitis B core antibody positive patients with lung cancer receiving adjuvant chemotherapy without concomitant antiviral prophylaxis.Methods The records of 3280 patients with lung cancer who received adjuvant chemotherapy were retrospectively reviewed from January 2003 to December 2011.Among these patients,367 hepatitis B surface antigen negative/hepatitis B core antibody positive patients were analyzed for the HBV reactivation in this study.The HBV serology marker and biochemical tests of the 367 patients were performed.The data were analyzed by chi square test.Results Among 367 hepatitis B surface antigen negative/hepatitis B core antibody positive patients with lung cancer,14 patients suffered HBV reactivation.Univariate analysis showed that age≥70 years(x2 =13.003,P=0.019),abnormal liver computed tomography findings (x2 =11.225,P =0.026) and the amount of corticost eroids≥ 150 mg(x2 =7.008,P =0.033)were associated with HBV reactivation.However,gender and adjuvant chemotherapy regimens were not related with HBV reactivation.Conclusion HBV reactivation occurs in a proportion of hepatitis B surface antigen negative/hepatitis B core antibody positive patients with lung cancer during adjuvant chemotherapy.
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Objective To investigate clinical features of microscopic colitis (MC) in the elderly and short-term effect of mesalamine on MC.Methods Totally 116 elderly patients with MC in our hospital were recruited from January 2011 to December 2011.Clinical manifestations,use of MC related drugs (MCRDs),pathological classifications and short-term effect of mesalazine were collected and analyzed.Results MC patients accounted for 27.6 ％ in elderly patients with chronic diarrhea,who presented with mild to middle watery or mucous stool,and only 1.7％ of MC patients accompanied with severe stomach pain.Collagenous colitis (CC) and lymphocytic enteritis (LC) accounted for 31.9％ and 68.1％,respectively in MC patients and 50％ of them had MCRDs taking history.There was a significant difference in short-term effective rate between CC group and LC group at 4 weeks after mesalazine treatment (64.9％ vs.84.8％,x2 =5.929,P=0.015).The effective rate was significantly related with the relief of pathology in LC group (x2 =5.896,P=0.015).The relapse rate had no significant difference between CC group and LC group at 8 weeks after withdrawal of mesalazine treatment (45.8％ vs.34.3 ％,P =0.317).Conclusions MC may be one of the main reasons leading to chronic diarrhea in the elderly.Mesalazine has a better effect for the short-term treatment of MC in the elderly,but the long-term maintenance therapy still needs further study.
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Objective To explore the association of C20orf54 gene rs3746804 position single nucleotide polymorphism and susceptibility to esophageal squamous cell carcinoma (ESCC).Methods Purification of genomic DNA from whole blood was used the Maxwell(R) 16 System.rs3746804 in C20ort54 was detected by direct sequencing in 434 ESCC patients from Changzhi (Shanxi province) and Linzhou (Henan province) and 554 healthy controls from Changzhi,Linzhou and including immigrators from Linzhou to Changzhi.Results For rs3746804,the genotypic frequencies of CT(37.5％ vs 51.0％,37.5％ vs 52.0％),CC (44.2％ vs 34.8％,44.2％ vs 33.0％) in Changzhi ESCC patients showed significant differences with healthy Changzhi controls and the healthy immigrator controls (all P ＜ 0.05),and the frequencies of TT(18.3％ vs 4.1％) and CC (44.2％ vs 54.6％) in Changzhi ESCC patients showed significant differences with Linzhou ESCC patients (all P ＜0.05).The genotypic frequencies of TT (4.1％ vs 15.0％),CT (41.2％ vs 52.0％) and CC(54.6％ vs 33.0％) showed significant differences between Linzhou ESCC patients and the healthy immigrator controls (all P ＜ 0.05),and the frequencies of TT (4.1％ vs 14.1％) and CC (54.6％ vs 34.8％) showed significant differences between Linzhou ESCC patients and Changzhi healthy controls (all P ＜ 0.01).Meanwhile,there were significant differences between ESCC patients (including Changzhi and Linzhou ESCC patients) and healthy controls (including the healthy Changzhi,Linzhou and immigrator controls) in genotypic frequencies of CT(39.2％ vs 48.7％) and CC (48.8％ vs 38.2％) (all P ＜ 0.01).CT and CT + TT genotype could decrease the risk of ESCC compared with the CC genotype (OR =0.630,95％ CI0.481-0.826 ; OR =0.654,95％ CI 0.507-0.844).Conclusion There is a closed relationship between SNP rs3746804 in C20orf54 and susceptibility to ESCC.
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ObjectiveTo retrospectively investigate the incidence,outcome and risk factors of HBV reactivation in HBsAg-positive a patients with gastric carcinoma during cisplatin-based adjuvant chemotherapy.Methods We retrospectively reviewed the records of 2,538 patients with gastric carcinoma who received adjuvant chemotherapy from January 2005 to December 2010.Among these patients,146 HBsAg-positive patients were analyzed for the HBV reactivation in this study.The HBV serology and biochemical tests of the 146 patients were performed.The data were analyzed by chisquare test.Results Among 146 HBsAg-positive patients with gastric carcinoma,43 patients (29.5％) developed hepatitis,of which 29 (19.9％) were related to HBV reactivation.Univariate analysis showed that age ≥51 years (P=0.029) and abnormal liver uhrasonography findings such as fatty liver or early cirrhotic changes (P=0.031) were associated with HBV reactivation.However,gender,HBeAg positive status and the use of corticosteroids were not related with HBV reactivation.Conclusions HBV reactivation occurs in a significant proportion of HBsAg-positive patients with gastric carcinoma during adjuvant cisplatin-based chemotherapy.Once hepatitis developed,most patients could not finish the chemotherapy as planned despite lamivudine treatment.Therefore,HBsAg-positive gastric carcinoma patients should initiate prophylactic antiviral treatment before chemotherapy.
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ObjectiveTo study the relationship between plasma riboflavin levels and esophageal squamous cell carcinoma.Methods We detected and compared plasma concentrations of riboflavin in patients with esophageal squamous cell carcinoma (ESCC) and immigrants of Linzhou living in Changzhi.Plasma riboflavin levels were quantified in 445 ESCC patients,689 healthy control subjects and 347 immigrants of Linzhou living in Changzhi by using enzyme-linked immunosorbent assay.ResultsThe plasma riboflavin levels in patients with ESCC were significantly lower than those in the healthy controls and immigrants of Linzhou living in Changzhi [ (731.69 ± 330.67 ) μg/L vs ( 1090.43 ± 445.08 ) μg/L,(731.69 ± 330.67) μg/L vs ( 897.58 ± 177.78) μg/L,respectively,all P ＜ 0.05 ],and the plasma riboflavin levels of the healthy controls were higher than those in the immigrants of Linzhou living in Changzhi (P ＜ 0.05).ConclusionPatients with ESCC have decreased plasma riboflavin levels as compared with the healthy controls and immigrants of Linzhou living in Changzhi,there exists a lack of riboflavin in ESCC patients,but the specific mechanism needs further study.
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Objective To explore the feasibility of Lugol's iodine staining in association with P53 oncoprotein test to detect early esophageal cancer and precancerous lesions through endoscopy. Methods Lugol's iodine was sprayed on esophageal mucosa under endoscopy in 78 patients with suspected early malignancy. Severe dysplasia which taken from unstained position by iodine were prepared immunohistochemically for P53 oncoprotein study. Then endoscopic mucosal resection (EMR) was performed to these severe dysplasia with P53 oncoprotein－ positive mucosa. Results There were 31 unstained areas (25 patients) including squamous cell carcinomas (n=3) and severe dysplasias (n=16). Expression of P53 was found in 7 severe dysplasia (43.8％ ),and 1 carcinoma in situ was found by EMR. Conclusion This modified method seemed feasible not only to detect early esophageal cancer,but also to resect severe dysplasia mucosa selectively by EMR.