ABSTRACT
The present study aimed to research pathogenesis and therapeutics of hepatocellular carcinoma (HCC) with the method of tissue metabolomics.A combined gas chromatography-mass spectrometry (GC-MS) method was developed suitable for analyzing the endogenous small molecule of liver cancer tissues and adjacent tissues.The unidimensional and multidimensional statistics were used to look for differential metabolites.And then,the KEGG and HMDB database were utilized to find related differential pathways and pathogenesis of HCC.The PCA and PLS-DA showed that there were significant differences on the endogenous small molecule of liver cancer tissues and adjacent tissues.Through the OPLS-Loading plot analysis,there were 25 differential metabolites and 36 relevant pathways.The differential pathways belong to carbohydrate metabolism,amino acid metabolism and mitochondrial transfer.There were 16 metabolites' area under the ROC curve which was bigger than 0.8,which were related with ATP-binding cassette (ABC) transporters,galactose metabolism,amino sugar and nucleotide sugar metabolism.It was concluded that the Warburg effect exists in HCC cells.The energy of HCC cell was from glycolytic function,because the glycolysis was enhanced and the citric acid cycle decreased.Mitochondrial dysfunction and the increased cobalt content may correlate with the Warburg effect,which may be one of the pathogenesis of liver cancer,and expected to become the breakthrough point of a new targeting therapeutic approach.
ABSTRACT
Objective To study the outcomes of partial hepatectomy in patients with liver metastases from breast cancer.Methods The data of 47 patients who underwent partial hepatectomy for liver metastases from breast cancer between 2000 and 2009 were studied.The relationship between the clinical features and outcomes were analyzed retrospectively.Results The mortality of surgery was 0％.The 1-,3-,and 5-year survival rates for these 47 patients were 74.5％,42.5％ and 17.0％ respectively.The median survival was 29 months.Patients with less than 3 metastatic nodules survived longer than those with more than 3 metastatic nodules.The 1-,3-,and 5-year survival rates were 86.7％,53.3％,23.3 ％ versus 52.8％,23.5％,5.9 ％,and the mean survival was 79.4 months versus 34.6 months (P=0.001),respectively.Patients without local lymph node metastases had longer survival than those with local lymph nodes metastases.The 1-,3-,and 5-year survival rates were 82.3％,50.0％,23.5％ versus 53.8％,23.1 ％,0％,and the mean survival was 71.9 mouths versus 28.6 months (P＝0.002),respectively.There was no relationship between survival and tumor differ entiation,expression of ER,PR and Her 2.Conclusion Surgical treatment was safe for patients with liver metastases from breast cancer.The long-term survival was better for patients with liver metastases with less than 3 nodules compared to those with more than 3 nodules.The survival was poorer in patients with local lymph node metastases than those without lymph node metastases.
ABSTRACT
Objective To evaluate the safety and feasibility of hepatectomy for huge focal nodu-lar hyperplasia of the liver. Methods The clinical data of 29 cases of huge FNH of the liver with an average diameter of 12.5 cm (10-26 cm) who were admitted to our hospital from 1996 to 2007 were retrospectively analyzed. Lesions protruded from the liver in 26 cases, compressed extrahepatic organs in 10 and adjoined or compressed hepatic hila in 19. Results All the lesions were successfully resected without operative death. The mean intraopreative blood loss was 747 ml (100-4000 ml). The first he-patic portal blocking was performed in 27 cases and the mean blocking time was 26 min (13-78 min).Among 19 cases of huge FNH involving hepatic hila, the mean intraopreative blood loss was 1011 ml,the mean blocking time 30 min and the liver cross-section was not completely sutured in 7 of these ca-ses. The intraoperative hemorrhea occurred in 7 and postoperative biliary fistula in 1. Twenty-seven cases were followed up for a median of 46 months (4-132 months) with no recurrence and the longest survival time had reached to 11 years. Conclusion Hepatectomy is a safe and feasible means for huge focal nodular hyperplasia of the liver. For those involving hepatic hila, distinguishing between the le-sion and intrahepatic vessels, performing resection closely around the lesion and dealing with the liver cross-section properly may be helpful to reduce the surgical complications.