ABSTRACT
Objective:To investigate the prognostic factors that influence Barcelona (Barcelona clinical liver cancer staging system, BCLC)stage B hepatocellular carcinoma patients after hepatectomy.Methods:Retrospective analysis was made on clinical and pathological data of 50 standardized hemihepatectomy in Barcelona stage B hepatocellular carcinoma from 2013 to 2017.Results:Single-factor results showed that high expression of tumor microvascular invasion (MVI) and proliferation of nuclear antigen (Ki-67) were the prognostic factors ( respectively χ 2 =8.411, 10.939, all P<0.05). Multivariate analysis showed that the difference of high expression of Ki-67 and survival rate was statistically significant (respectively F=5.710, 8.254, all P<0.05). Ki-67 expression level and tumor differentiation were statistically significant (χ 2=0.497, P<0.05). There was a statistically significant difference in survival between the high-risk group and the low-risk group according to the risk factors (χ 2=12.152, P<0.05). Conclusions:MVI and high expression of Ki-67 were high risk factors affecting the overall survival rate of liver cancer after hemihepatectomy.
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ObjectiveTo summarize the experience of managing portal hypertension( PHT) complicated with hyperthyroidism. Methods5 patients with hyperthyroidism complicated PHT were performed with splenectomy plus pericardial devascularization after preoperative management, and the experience of pre- and postoperative management was summarized. Results1 patient occurred postoperative thyroid crisis and was cured with tranquilizing, prenisone and sodium iodide;the other 4 went through perioperation safely. The preoperative WBC,RBC,Hb and Pt were(2.018±0.536)×109/L,(2.97±0.42)×1012/L,(87±15.6)g/L and (38.4±13.24)×109/L, respectively, which rose to (6.54±0.398)×109/L, (3.636±0.387)×1012/L, (108.6±9.633)g/L and (240.4±84.54)×109 /L, respectively after operation. WBC and platelets of all patients reached normal level postoperatively. ConclusionProper perioperative management ensures that patients with hyperthyroidism complicated PHT survive the splenectomy plus pericardial devascularization, which renders opportunity for treating hyperthyroidism with medicine or surgery.
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Objective To study the mechanism of acute portal vein thrombosis (APVT) after pericardial devascularization with splenectomy for the treatment of portal hypertension. MethodsThe expression of intercelluar adhesion molecule-1(ICAM-1) in spleen veins of 34 patients with portal hypertension and control vessels was studied by immunohistochemistry. Samples from spleen veins were examined by HE staining. Results The ICAM-1 level was higher in the spleen vessels in portal hypertensive (PH) patients than in controls (P