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Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence rate and mortality worldwide. However, most patients are not suitable for radical treatment at the time of first diagnosis. As one of the important schemes for the treatment of HCC, one of the most representative drug is Sorafenib, which has certain survival benefits for HCC patients at different stages. However, the drug resistance of HCC to Sorafenib greatly limits its efficacy. So far, people have found that some natural substances, experimental agents and biological macromolecules can reverse the drug resistance of HCC to Sorafenib through tumor cell microenvironment, metabolism and other mechanisms. This article will summarize the above substances and their mechanism in order to provide research ideas for the improvement of Sorafenib′s treatment program.
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Hepatocellular carcinoma (HCC) is the sixth most common malignant disease in the world and one of the main causes of cancer-related death. At present, the treatment of patients with advanced HCC is very limited, and as an important research direction of advanced cancer treatment in recent years, immunotherapy has achieved good results. Up to now, scholars have tested a variety of immunotherapy methods, and the use of immune checkpoint inhibitor (ICIs) in the treatment of advanced cancer has made considerable progress. However, immunotherapy is still incurable for HCC, and the benefit of treatment is limited to a small number of patients. In the current context of liver cancer, one of the key research directions of oncology is to understand the biomarkers that predict the clinical response of immunotherapy, so as to improve patient selection, maximize clinical benefits and avoid unnecessary toxicity. Compared with tumor and surrounding tissue biomarkers, peripheral blood biomarkers play a unique role in clinical research and use because of their advantages of non-invasive detection. In this review, we summarize the peripheral blood biomarkers that play a key role in predicting the clinical response and prognosis of HCC patients.
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Hepatocellular carcinoma is one of the pathological types of primary liver cancer, and its prognosis is often not ideal. The prognosis of patients with hepatocellular carcinoma is not only closely related to tumor load and general physical status, but also closely related to liver reserve function. Albumin-bilirubin grading (ALBI) is a new model reflecting liver reserve function. In many therapeutic measures, such as surgical resection, liver transplantation, transcatheter arterial chemoembolization, radiofrequency ablation and targeted therapy, its ability to predict the prognosis of patients with hepatocellular carcinoma has been proved to be no less than that of Child-Pugh grade, which is widely used in clinic, and its predictive performance will be further improved when combined with other indexes.Therefore, it has great application value in clinical practice. This article mainly reviews the clinical application of ALBI grade in patients with hepatocellular carcinoma and the progress of research results in recent years.
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Chronic inflammation and tumor occurrence and development, recurrence and metastasis and immune escape and other key links have a far-reaching impact. The level of inflammation and immunity can be reflected by the markers of inflammatory response, including C-reactive protein, neutrophils, platelets, lymphocytes and their combinations in the blood, such as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, lymphocyte to monocyte ratio, systemic immune inflammation index and so on. At present, inflammatory index has been proved to be predictors of recurrence and survival in a variety of malignant tumors. Hepatocellular carcinoma (HCC), as a common invasive tumor, is often diagnosed in the late course of the disease, so patients often can not achieve a satisfactory prognosis. This article mainly reviews the clinical application of the above inflammatory response indexes in HCC.
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Objective@#To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage.@*Methods@#Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate.@*Results@#32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively.@*Conclusion@#The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.
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Objective To explore the effect of supplemental parenteral nutrition (SPN) combined with early enteral nutrition (EN) for enhanced recovery in postoperative liver cancer patients.Methods From June 2015 to June 2018,liver cancer patients admitted to our hospital were randomly divided into two groups with 47 patients receiving SPN combined with early EN in the study group and 45 patients receiving early EN in the control group.Results There were no significant difference in bilirubin recovery,liver enzyme recovery,postoperative exhaust and defecation time and complication rate between the two groups (P ＞ 0.05).In study group prealbumin (PAB) synthesis recovered faster (F =7.89,P =0.006),albumin use was significantly lower (t =-2.29,P =0.0024),and postoperative hospital stay was shorter (t =2.46,P =0.016).Conclusion In ERAS patients with liver cancer,the combination of SPN and early EN provide reasonable energy support to improve nutritional status and accelerate patient recovery.
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Objective To investigate the impact of blood glucose level on the recurrence of liver cancer after laparoscopic surgery. Methods The clinical data of 98 patients with primary hepatocellular carcinoma from January 2012 to January 2015 were retrospectively analyzed. All patients were treated by laparoscopic radical resection of hepatocellular carcinoma. Patients were divided into elevated blood glucose group (n = 23) and control group (n = 75) according to whether the fasting blood glucose was ≥6.1 mmol/L. The recurrence of liver cancer in 1 year and 2 years after operation was compared. The factors influencing the recurrence of liver cancer were analyzed by univariate and multivariate analysis. Results The recurrence rates were 47.82% and 21.33% respectively in the patients with elevated blood glucose and the control group. The recurrence rates were 73.91% and 36.00%respectively in the 2-year postoperative patients with blood glucose and 1 year and 2 years. The recurrence rate was higher than that of the control group, the difference was statistically significant (P < 0.05). Logistic multivariate analysis showed that fasting blood glucose was high, Child-Pugh grade B, intraoperative blood transfusion, lymphatic invasion, high clinical pathology stage, postoperative alpha-fetoprotein (AFP) high, no postoperative adjuvant therapy (P < 0.05). Conclusion The recurrence rate of patients with elevated liver cancer after laparoscopic surgery is high, and fasting blood glucose is high, Child-Pugh grade is B grade, blood transfusion is high, there is lymphatic invasion, high clinical pathology stage after AFP high, no postoperative adjuvant therapy for its postoperative recurrence of risk factors, should strengthen the monitoring of high-risk patients, reduce postoperative recurrence rate.
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Eukaryotic initiation factor 5A (eIF5A),which is ubiquitous in the eukaryote,is the unique protein containing the special lysine hypusine.There are evidences show that eIFSA is involved in the progress of translation,peptide elongation and peptide bond formation,and takes part in the occurrence and development of various human diseases.The activation of eIF5A is essential to its biological function.The active eIFSA is involved in the growth of plasmodium and contributes to tumor proliferation.And it can act as nuclear output protein to integrate special mRNA,and in this way the special mRNA can shuttle between the nucleus and cytoplasm.Basing on these findings,the scientists pay more attention to eIF5A,and deem it as a direction to cure some related human diseases.
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Hepatocellular carcinoma is one of the most common malignant tumors.With the concealed characteristics and non-specific clinical expressions,its presence can be frequently missed,allowing progression to advanced stages where prognosis is poor.Therefore,early diagnosis is essential to improve the survival rate of patients with hepatocellular carcinoma.Recent developments in imaging technology and molecular biology are making strides in identifying and finding biomarkers of hepatocellular carcinoma,leading to earlier diagnosis.This article describes the latest developments,in combination with previous diagnostic methods to make a comprehensive examination of strategies for early diagnosis of hepatocellular carcinoma.
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ObjectiveTo study the efficacy of adjuvant percutaneous transhepatic portal vein chemoembolization (PVCE) in the prevention of tumor recurrence after partial hepatectomy for hepatocellular carcinoma.MethodsThe clinical data of 89 patients who received liver resection for hepatocellular carcinoma in our hospital from January 2007 to January 2010 were studied retrospectively.41patients received PVCE (the treatment group) while 48 patients received no PVCE (the control group).Postoperative recurrence and cumulative disease free survivals were compared using the Kaplan-Meier method.ResultsOn follow-up which ranged from 6-42 months,the 1- and 2-year disease free survivals were 76.5％ and 48.0％ in the treatment group,and 53.8％ and 25.8％ respectively in the control group (P＜0.05).The mean disease free survivals were 19.91 (95％ CI,16.09-23.73)and 13.8 months (95 ％ CI,10.95-16.65),respectively.The cumulative disease free survivals in the PVCE group were significantly higher than the control group (P=0.01).Cox multivariate analysis showed that adjuvant PVCE,tumor size,portal vein thrombosis,and postoperative transcatheter arterial chemoembolization (TACE) were independent factors of disease free survival.ConclusionAdjuvant PVCE was effective in preventing postoperative recurrence of hepatocellular carcinoma after partial hepatectomy.
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Objective To study the diagnosis and treatment of synchronous gastric cancer and gastric stromal tumor in 18 cases. Methods Clinical data of 18 cases of synchronous occurrence of gastric cancer and gastric stromal tumor from January 1996 to December 2009 were analyzed retrospectively.Results Clinical features of all cases were atypical. There was 1 case diagnosed preoperatively, 3 cases diagnosed intraoperatively and 14 cases diagnosed postoperatively. The mean size of gastric cancer and gastric stromal tumor was (3.3±2.3) cm and (0.9 ±0.5) cm respectively. There were 16 cases of gastric stromal tumor in low risk of malignance and 2 cases in moderate risk of malignance. All cases were operated without complications and the 1-year, 3-year and 5-year overall survival rate was 88.2%, 63.2% and 36. 1% respectively. Conclusions Clinical features of synchronous occurrence of gastric cancer and gastric stromal tumor are atypical, in this series most gastric stromal tumors are in early stage and of low risk of malignance. The prognosis of patients with synchronous occurrence of gastric cancer and gastric stromal tumor mainly depends on gastric cancer.
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Objective To assess the diagnostic value of MRCP before LC.Methods 944 cases with chronic calculous cholecystitis underwent MRCP before LC from June 2004 to June 2007 in our department.incidence rate of cholecvstolithiasis together with common bile duct stones and incidence rate of anatomic abnormity of bile duct were collected.Results The incidence rate of cholecvstolithiasis together with common bile duct stones were 8.1%(77/944),and the oecurence ofACBDS were 1.2%(11/944).The incidence rate of anatomic abnormity of bile duct were 3.7%(35/944).ConclusionMRCP can not only offer a excellent diagnostic value of ACBDS and anatomic abnormity of bile duct,but also reduce the occurrence of CBDS remainder and iatrogenic bile duct iniuries.