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Objective:To investigate anticoagulant effects of mechanical methods in obese patients undergoing laparoscopic sleeve gastrectomy (LSG).Methods:In this prospective study, 54 obese patients receiving LSG were enrolled . All patients were given post-op mechanical methods for thrombogenic interventions. BMI and the operation-related factors were recorded. Venous blood specimens were taken from each patient before surgery, at the end of pneumoperitoneum (i.e., 0 h after surgery), at 24 hours after surgery for prothrombin time (PT) and activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimer (D-D).Results:All 54 obese patients successfully underwent LSG. No severe complications were observed. Before operation, the mean BMI was (43.49±8.29) kg/m 2. DVT-2600 device was applied in all patients for 3 consecutive days after surgery. The PT values increased at 0 h, 24 h after surgery [(12.4±1.2) s, (12.4±0.8) s vs. (11.2±0.8) s, P=0, 0]. The APTT values at 0 h, 24 h after surgery decreased [(29.7±3.6) s, (29.0±3.1) s vs.(31.2±3.3) s, P=0.020, 0.001]. However, the D-D values increased at 0 h,24 h after operation [(213±143) ng/ml ,(445±237) ng/ml vs. (85±108) ng/ml, P=0, 0]. All patients were followed up for 1 month, and no thrombosis -related complications were observed. Conclusion:Mechanical methods for obese patients after LSG can help decrease the risk of deep venous thrombosis.
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Objective:To compare the clinical effects of microwave ablation (MWA) and surgical resection in the treatment of small hepatocellular carcinoma(SHCC).Methods:Sixty five SHCC patients with intact clinical data, treated in the Center of Hepatobiliary Surgery, Peking University People's Hospital between Feb 2005 and Aug 2012, were enrolled in this study. Among them, 30 patients were treated by MWA, and the other 35 by hepatectomy. Follow-up was conducted from Mar 2013 to Feb 2021. The differences in long-term survival, intraoperative blood loss, operative time, postoperative complications, performance status (PS), and postoperative hospital stay were compared between the two groups.Results:The survival probability at 1, 3, 5 and 10 years was 93.2%, 82.5%, 55.6% and 41.2%, respectively, in the MWA group, and 97.1%, 82.6%, 67.2% and 48.3%, in the resection group ( P=0.347). The MWA group had less perioperative complications, less blood loss, shorter operation time, better PS score and better hospital stay than the surgical resection group (all P<0.001).There was no statistically significant difference in the survival rate between BCLC stage 0~A1 and A2~A4 patients( P=0.773, 0.536). Conclusions:Microwave ablation in the treatment of small hepatocellular carcinoma can achieve similar results as hepatectomy with less traumatic,better postoperative PS score and shorter postoperative hospital stay.
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Objectives To investigate the efficacy of laparoscopic sleeve gastrectomy (LSG)for patients of type 2 diabetes mellitus (T2DM).Methods Between Jun 2013 and Jun 2017,39 T2DM patients were enrolled in this study and underwent LSG.The clinical data of all patients were collected.The fasting plasma glucose (FPG),glycosylated hemoglobin (HbAl c),C-peptide,fasting insulin (FINS),glucagon-like peptide-1 (GLP-1) as well as BMI of all patients were measured before and at 1,6 months after surgery.Results All patients underwent LSG surgery successfully.The mean levels of FPG,HbAlc,C-peptide,FINS and BMI of all patients decreased at 6 months after surgery respectively compared to those before surgery [(6.4 ± 1.2) mmol/L vs.(9.6 ± 2.3) mmol/L,t =9.455,P =0.000;(6.0 ± 0.7) ％ vs.(7.5 ±1.0)％,t=10.538,P=0.000;(2.7±2.2)ng/ml vs.(4.0±2.6) ng/ml,t=3.491,P=0.001;(9.2 ±6.3) μIU/L vs.(15.5 ±11.1) μIU/L,t=4.902,P=0.000;(32.0 ±6.1) kg/m2 vs.(41.0 ± 7.5) kg/m2,t =10.826,P =0.000],however the mean GLP-1 of all patients increased after surgery compared to that before surgery [(4.0 ± 2.1) pmol/L vs.(3.1 ± 2.2) pmol/L,t =-4.242,P =0.000].At 6 months after surgery,32 patients achieved complete remission of T2DM,5 patients gained partial remission of T2DM and 2 patients got no remission of T2DM.Conclusions LSG is effective for obesity patients as well as patients suffering from T2DM.
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Objective To explore the morbidity of surgery in connection with laparoscopic sleeve gastrectomy (LSG) and its effect on obese T2DM.Methods 106 obese T2DM patientes undergoing LSG were divided into 2 groups in group 125 patients did not have oversewing the staple line and group 281 patients had the staple line oversewn in order to reduce bleeding.Results The differences in intraoperative blood loss (35 ± 15) ml vs.(28 ± 18) ml,postoperative recovery time (2.4 ± 0.9) d vs.(2.3 ± 0.9) d,time to taking liquid food (4.7 ± 1.0) d vs.(4.6 ± 1.0) d between two groups were not significant.There were no significant difference of complication between 2 groups (x2 =3.271,P =0.071).Comparing before surgery to 6 month after surgery,the BMI in group 1,was from (39 ± 5) to (29 ±4) kg/m2;in group 2,from (40 ±6) to (31 ±5) kg/m2,FPG in group 1,from (8.4 ± 1.4) to (6.4 ±1.2) mmol/L;in group 2,from (8.2 ± 2.0) to (6.8 ± 1.5) mmol/L,2 hour post-meal blood sugar [group 1,(13.2±4.1) to (9.6±3.2) mmol/L;group 2,(12.2±3.2) to (10.6±2.8) mmol/L] and HbAlc (group 1,7.2％ ±1.2％ to5.5％ ±1.1％;group 2,7.1％ ±1.1％ to 5.9％ ±1.2％) decreased significantly in both groups (P ＜ 0.01).There was 72 (68％) remission cases of T2DM in 106 patients,there were no significant differences of T2DM remission and BMI between 2 groups at 6 months after surgery (P =0.617).Conclusions LSG leads to significant weight loss and T2DM control.
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Objective To explore the feasibility of repairing porcine bile duct defect with decellularized rabbit abdominal aorta matrix scaffold.Methods Sodium dodecyl sulfate and Sodium deoxycholate were used to remove the cells in the blood vessel,and the residual DNA and RNA fragments were removed by nuclease.The prepared scaffold was implanted to repair defect of bile duct in swine,which were sacrificed after 45 days of surgery for histological evaluation.Results HE,Masson and elastic fiber staining showed that the composition and structure of the scaffold maintained their native features after dcellularization treatment.DNA content in acelllular scaffold (0.12 ± 0.01) μg/mg dry weight) was significantly decreased as compared with the native ones (2.31 ± 0.03) μg/mg dry weight,P ＜ 0.05).Collagen content was increased from (152 ±22) μg/mg dry weight in intact aorta to (177 ±21) μg/mg dry weight.Adipose derived mesenchymal stem cells with typical morphology survived well in the decellularized vascular matrix.It was observed that seeded ASCs penetrated into the inner wall of the scaffold.After transplantation,there was no leakage in the anastomosis and collapse of acellular blood vessel matrix.After 45 days of transplantation,repaired bile duct was harvested for histological evaluation.HE and Masson staining revealed that there were a large number of cells distributed in the inner wall of the scaffold,and some suspected epithelial cells and glands were found.Conclusion Decellularized aorta matrix scaffold hold great potential in serving as scaffold repairing defect of bile duct.
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Objective To explore the application of different approaches in single lateral endoscopic thyroidectomy.Methods Ninety one patients with single lateral thyroid nodule who underwent endoscopic thyroidectomy were divided randomly into bilateral axillo-breast approach group (n =45) and transaxillary approach group (n =46).The clinical data and cosmetic outcomes were compared.Results Procedures were successfully performed in 86 patients with no conversion to open surgery,5 patients in transaxillary group were excluded because of the malignant frozen pathology.The total operation time of transaxillary approach group was (61.6 ± 4.9) min,significantly shorter than that of the bilateral axillo-breast approach approach (90.0 ± 6.5) min,P ＜ 0.05.There was no significant difference in time of subcutaneous tunnel construction,muscles disposal,lateral dissection,lower pole resection,parathyroid identification,thyroid lobe resection and bleeding volume between two groups (P ＞ 0.05),while the time of work space creation,upper pole resection in transaxillary approach was significantly shorter than that in the bilateral axillo-breast approach (P ＜ 0.05).All patients of both groups were satisfied with cosmetic results.Conclusions The operation time in transaxillary approach group was shorter than that in bilateral axillo-breast approach group for the single lateral thyroid nodule,but the operation was more difficuh.
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Objective To analyze the risk factors for delayed gastric emptying (DGE) after pancreaticoduodenectomy.Methods Clinical data of 213 patients who underwent pancreaticoduodenectomy at our hospital from January 1996 to December 2011 was retrospectively analyzed.Results The overall incidence of DGE was 40.8％ (87/213).The incidence of grade A,grade B and grade C DGE was 14.1％ (30/213),14.5 ％ (31/213) and 12.2％ (31/213) respectively.Median postoperative hospital stay was significantly prolonged in patients with DGE:30.5,32 and 61 days for grade A,B and C respectively versus 21 days in patients without DGE (x2 =66.171,P =0.000).Univariate analysis showed that operation time (≥420 min),intraoperative blood loss (≥ 1000 ml),Child alimentary reconstruction and pancreatic fistula were risk factors for postoperative DGE.Multivariate analysis using Logistic regression identified three variables as independent risk factors associated with postoperative DGE,namely,Child alimentary reconstruction (OR =2.098),intraoperative blood loss (≥ 1000 ml) (OR =2.525) and pancreatic fistula (OR =4.821).Grade C DGE was more frequently seen in patients suffering from postoperative pancreatic fistula.Conclusions The incidence of DGE after pancreaticoduodenectomy is still high.DGE prolongs the postoperative hospital stay significantly.The incidence of DGE could be reduced by Roux-en-Y reconstruction and reducing intraoperative blood loss.Postoperative pancreatic fistula is significantly associated with DGE,especially grade C DGE.
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Objective To study the value of flow cytometry in identifying metastatic CK positive and negative nonhematopoietic neoplasms in bone marrow. Methods Twenty-six cell lines representing ten epithelial neoplasms, one lymphoma cell line and one human T cell lymphoblast-like cell line were purchased from American Tissue Culture Collection. From July 2009 to June 2010, five nonhematopoietic neoplasms,fifteen hematopoietic neoplasms and fifteen control patients with complete remession after hematopoietic stem cell transplantation were collected in Beijing Daopei Hospital. Cryopreserved cell lines were thawed and cultured until they entered log phase. After permeabilization, cell lines were analyzed by staining with cytoplasmic CK-FITC antibody using four-color flow cytometer. The percent CK positivity was measured by comparing with negative control. Bone marrow samples were stained with membrane and cytoplasmic antibodies according to our routine methods. Based on lineage markers and blast markers as well as CK expression, the relevant hematopoietic diseases were diagnosed or excluded according to 2008 World Health Organization diagnosis standards. Results All epithelial neoplasm cell lines expressed CK, with average positive percentage 81.1%. All the lymphoid tumor cell lines didn't express CK. Two epithelial neoplasms were CK positive, 100. 0% in thyroid carcinoma and 98. 2% in lung carcinoma, respectively. Hematopoietic tumor and control samples didn't express CK. They expressed relevant hematopoietic markers, such as CD45 as well as lineage markers, or CD138 and cytoplasmic immunoglobulin light chain. Three nonepithelial nonhematopoietic neoplasms didn't express CK. CK positive or negative nonhematopoietic neoplasms didn't express hematopoietic markers such as CD45, HLA-ABC and HLA-DR DP DQ, as well as lineage specific markers. Besides, CK positive might be helpful to suggest epithelial origin. Conclusion Flow cytometry with hematopoietic markers and CK can effectively exclude hematopoietic tumor and identify metastatic CK positive and negative nonhematopoietic neoplasms in bone marrow.
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Objective To analyze the prevention and treatment of postoperative hemorrhage after pancreaticoduodenectomy. Methods The clinical data of 142 patients undergoing pancreaticoduedenectomy from Jan 1995 to Dec 2008 were retrospectively analyzed. Results The incidence of postoperative hemorrhage was 14.1% (20/142), the mortality caused by this complication was 35% (7/20). Among these patients, intra-abdominal hemorrhage occurred in seven cases, and gastrointestinal hemorrhage occurred in 14 cases, with one case suffering both. There were three and four cases of early and delayed intra-abdominal hemorrhage respectively. Early and delayed gastrointestinal hemorrhage occurred in three and eleven cases respectively. Univariate analysis showed that operative blood loss, blood transfusion, infection and pancreatic fistula were significantly associated with postoperative hemorrhage. Multivariate analysis using Logistic regression identified two variables as independent factors associated with postoperative hemorrhage, namely, infection(OR=6.918) and pancreatic fistula(OR=3.948). Conclusions The incidence and mortality of hemorrhage after pancreaticoduodenectomy is still high. Skillful operation and prevention of pancreatic fistula, infection and stress ulcer are the key paints for reducing postoperative hemorrhage. Proper treatments should be used according to the site, onset and severity of hemorrhage.
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Objective To evaluate the therapeutic effect of microwave ablation in combination with TACE for the treatment of primary liver carcinoma (PLC). Methods From Jan. 2004 to Dec. 2008, 63 PLC patients underwent ultrasound-guided microwave ablation (percutaneous or open) under general anesthesia. Repeated microwave ablation or TACE was used when an incompleted ablation or recurrence was found during postoperative regular follow-up. Results These 63 PLC patients have received a total of 82 sessions of microwave ablation procedure (1 to 5 sessions for each patient). There were 2 early postoperative deaths with a procedure-related mortality of 3.2%. At the end of the follow-up, 22 patients were alive and 38 died,and the other one was lost to follow-up. The survival rates in 1,2 and 3 years were 63.3%,42.1% and 26.5%, respectively, with a median survival of 20 months for all patients. The survival for PLC patients with early stage (TNM Ⅰ and Ⅱ) was significantly longer than that of advanced stage (TNM Ⅲ and Ⅳ). The 1,2 and 3 year's cumulative survival rate was 93.3%,86.7% and 65.0% respectively in those 15 cases with only single tumor and the diameter≤3 cm, which were significantly longer than that of other PLC patients. Of 23 patients with recurrence,9 had solitary tumor without lymphnode and distal metastases, for which the survival rates in 1,2 and 3 years were 100%,88.9%, and 35.6%, respectively, whereas in other recurrent patients the survival rates in 1,2 and 3 years were 21.4%, 10.7% and 0%, respectively(P< 0.01). Conclusions Ultrasound-guided microwave ablation in combination with TACE is effective for PLC patients with early stage. In recurrent PLC patients after ablation therapy with solitary tumor and no lymphnode and distal metastases the survival is significantly longer than that of the others.
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Objective To evaluate the diagnostic procedures and treatment choice of primary malignant tumor of the duodenum.Methods The clinical data of 54 cases with primary malignant tumor of the duodenum at Peking University People's Hospital from 1995 to 2005 were analyzed retrospectively.Resuits Tumors located in the first,second,third and fourth parts in 6 cases(10%),44 cases(82%),2 cases(4%),and 2 cases(4%)respectively,and among them,tumors within papillary area accounted for 86%(38 cases)of all cases.Fifty cases(92%)were of adenocarcinoma,2 cases(4%)of mucinous adenoearcinoma carcinoid and undifferentiated carcinoma for 1 case each(2%)respectively.The main clinical presentations included jaundice,upper abdominal pain,weight loss,abdominal distention,nausea and vomiting.gastrointestinal obstruction and abdominal mass.The accuracy rate of duodenoscopy and ERCP in preoperative diagnosis was 94%,and 78%respectively.Preoperative associated cholecystopathy accounted for 37%.Panceaticoduodenectomy was performed in 38 cases,duodenectonmy in 1 ease,palliative resection of tumor in 9 cases,and tumor was inoperable in 6 cases.Resection rate was 89%,and radical resection rate was 72%.The postoperative 3-and 5-year survival rate was 41%and 22%respectively.Patients after palliative resection died from 3 months to 24 months and all patients who did not undergo a surgery died within 6 months.Conclusions Tumors located in papillary region account for the majority of primary malignant tumors of the duodenum and are mainly of adenocarcinoma.Specific signs on abdominal examination are few.The symptoms of advanced stage are complicated,associated cholecystopathy is relatively frequent.Endoscopy and ERCP examination are the main diagnostic tools.the pancreatoduodenectomy is the first choice of therapy for patients with primary duodenal carcinoma.
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Objective To investigate the effect of RNA interference connective tissue growth factor (CTGF)expression on Kulclffer cells(KC)induced activation of hepatic stellate cells(HSC).Methods Rat CTGF RNA interference vector Psilencer 3.1H1-Neo-CTGF was constructed and identified.HSC cell line rHSC-99 cells were divided into three groups,group A served as control,group B transfected with vector without CTGF interference.group C was RNA interferenee CTGF expression of HSC.RT-PCR was used to measure the expression of CTGF in HSC.Rat Kur)ffer cells were isolated and identified.and cocultured with HSC in the 3 groups respectively.MTT assay was used to evaluate the proliferation of HSC.RT-PCR was used to measure the expression of TGF-β1 and precollagen type I in HSC.Western blot was used to measure the expression of TGF-β1 in HSC.ELISA was used to detect the production of precollagen type I protein.Immunofluorescence was used to detect the expression of ot-smooth muscle actin(α-SMA)in HSC.Resuits After CTGF RNA interference vector transfection.CTGF expression of HSC decreased by 22%(P＜0.01).The yield rate of Kupffer cell was 5×107 and the cell viability exceeded 98%.In the HSC and KC co-culture system.the proliferation and activation of HSC were inhibited while RNA interferenee CTGF of HSC.As compared with control,HSC proliferation decreased by 29%(P＜0.01).Precollagen type I and ot-SMA expression decreased by 38%(P＜0.01).Production of precollagen type I protein in culture medium decreased bv 48%(P＜0.01).Conclusions Blockade CTGF expression of HSC inhibits KC induced activation of HSC.
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Objective To study the effect of peroxisome proliferator-activated receptor garama (PPARγ) ligand on hepatic fibrosis in rats. Methods Forty Wistar rats were randomly divided into two groups: the control group(20 rats) ,in which liver cirrhosis was induced by adding 0. 3‰ thioacetamide in the fodder for 6 months, and rosiglitazone group(20 rats) in which 200 ppm of rosiglitazone in combination with 0. 3‰ thioacetamide was added in the fodder. Liver tissue's mRNA expression of PPARγ, TGF-β1 ,type Ⅰ pro-collagen and α-smooth muscle actin(α-SMA) was detected by RT-PCR. The protein expression of PPARγ, TGF-β1 ,type Ⅰ collagen and α-SMA was detected by Western blot. The expression of collagenof liver histological section was evaluated by Van Gieson (VG) staining. Results The expression ofPPARγ at mRNA level significantly increased in rosiglitazone group compared with those in the control group ( t = 6. 93, P < 0. 01 ), while the expression of TGF-β1 ( t = 3. 89, P < 0. 01 ) and type Ⅰ pro-collagen ( t =5.67,P <0. 01 ) were lower than that in the control group. The protein expression of PPARγ, TGF-β1 and type Ⅰ collagen was in similar tendence with that of mRNA expression. The expression of α-SMA decreased significantly in rosiglitazone group compared with that in the control group (t = 3. 12,P < 0.01 ). The collagen stainings of liver histological section in rosiglitazone group was lower than those in the control group (t = 3.47, P < 0. 01 ). Conclusion PPARγ ligand inhibits the production of collagen in fibrofic livers in rats and prevents hepatic fibrosis in vivo.
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Objective To evaluate the experience in the diagnosis and surgical treatment of primary retroperitoneal tumor (PRT). Methods Clinical data of PRT 63 cases from January 1990 to March 2007 confirmed by pathology were retrospectively analyzed including clinical manifestation, surgical procedures, pathological examination and follow-up. Results Tumors were benign in 25 patients and malignant in 38. The main symptoms and signs were abdominal mass. The Youdon's index of CT examination for distinguishing benign from malignant tumors was 85%. The complete surgical resection rate was 88% for benign tumors and 68% for malignances. Removal of the involved organs or vessels was needed in 40% patients in complete surgical resection group. Postoperative recurrence was high in those the tumor was not completely removed and those the tumor was malignant. The 5-year survival rate for complete surgical resection of benign tumors was 83.6% ,and that of malignant tumors was 27.3%. After a median follow-up of 36 months (range 5 ～ 168)for the resection of malignant tumors, the local recurrence rate was 53%. Median time between initial surgery and recurrence was 25 months (range 3 ～ 108). For local recurrence of malignant tumor, the complete surgical resection rate was 62.5%. One patient died of intraabdominal hemorrhage in the first day after operation. Conclusion For PRT patients, early diagnosis is often difficult. Preoperative imaging results are essential to predict the surgical resectability. The optimal treatment of patients with PRT is radical resection, an bloc organ resection if necessary. Regularly postoperative follow-up is mandatory for early finding recurrence.
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Objective To investigate the precautionary effect of fibrin glue on postoperative bleeding and bile leakage when used in partial hepatic resection.Methods House-hold rabbit partial hepatectomy model was prepared and 40 rabbits were divided into sham operation(SO) group(n=10),control group(n=10) and protocol group(n=20) randomly.The SO rabbits received laparotomy only,while both the control and protocol group received partial hepatectomy.Fibrin glue was used in the protocol group following electric coagulation therapy while the control group received electric coagulation therapy only.The animals' diet,weight and adverse effects were observed then,and the celiac drainage volume,levels of hemoglobin(Hg),WBC and TBil in celiac outflow and ALT,AST,LDH and TBil in rabbit serum were checked on schedule after operation.Results The average blood loss volume and operation time in the protocol group were(16.0?2.7) ml and(23.7?2.9) min respectively,which were lower than those in the control group((20.8?3.5) ml and(27.3?2.9) min(P
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<p><b>OBJECTIVE</b>To investigate the possibility of using melanoma antigen-1 (MAGE-1) peptide as a tumor vaccine to treat hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>The expressions of MAGE-1 in 8 HCC cell lines and in liver cancer tissue from a patient were detected using RT-PCR. The type of human leucocyte antigen I(HLA I) of both 8 HCC cell lines and peripheral blood mononuclear cells of the patient was detected using a microcytotoxicity method to screen out target cell lines for the cytotoxicity assay. Peripheral blood mononuclear cells from the HCC patient pulsed with an MAGE-1 peptide (NYKCRFPEI) were used as antigen presenting cells. Autogenous peripheral blood mononuclear cells were stimulated with antigen presenting cells every 7 days for 4 times to elicit cytotoxic T lymphocytes. The phenotype of effector cells was analyzed using flow cytometry. The cytotoxicity of effector cells was detected with a lactate dehydrogenase releasing assay.</p><p><b>RESULTS</b>The expressions of both MAGE-1 and HLA-A24 were detected in BEL7405 cell line which were used as the positive target cell line in the cytotoxicity assay. The expression of MAGE-1 alone was detected in HLE, BEL7402, BEL7404, QGY7703 and SMMC7721 cell lines, and the expression of neither MAGE-1 nor HLA-A24 was shown in QGY 7701 and HpG2 cell lines. The last 7 cell lines could be used as negative target cell lines in the cytotoxicity assay. Peripheral blood mononuclear cells expanded 32 folds during 28-day culture. The ratio of CD3(+) T cells increased by 16% (from 54% to 70%), and the ratio of CD8(+) T cells increased by 20% (from 36% to 56%) during 28-day culture. When the ratio of effector cells to target cells was 10:1, effector cells exhibited 62.5% cytotoxicity against autogenous lymphoblasts pulsed with the peptide (NYKCRFPEI) of MAGE-1 antigen, 40.25% cytotoxicity against BEL7405 cells, compared with 17.88% cytolysis observed against autogenous lymphoblasts, 19.55% against HLE cells, and 1.6% against QGY7701 cells. When the ratio of effector cells to target cells was 3.3:1, the cytotoxicity of effector cells against the peptide pulsed autogenous lymphoblasts was 53.6%, which was much higher against autogenous lymphoblasts, HLE cells and QGY7701 cells at 15.6%, 13% and 1%, respectively.</p><p><b>CONCLUSION</b>The results demonstrate that cytotoxic T lymphocytes with the ability to specifically lyse target cells expressing both MAGE-1 and HLA-A24 could be successfully induced by the MAGE-1 peptide NYKCRFPEI in vitro. This indicates that a good result might be anticipated if this peptide is used as a tumor vaccine to treat HLA-A24 HCC patients.</p>
Subject(s)
Adult , Humans , Male , Antigens, Neoplasm , Cancer Vaccines , Allergy and Immunology , Carcinoma, Hepatocellular , Allergy and Immunology , HLA-A Antigens , HLA-A24 Antigen , Liver Neoplasms , Allergy and Immunology , Melanoma-Specific Antigens , Neoplasm Proteins , Genetics , Allergy and Immunology , RNA, Messenger , T-Lymphocytes, Cytotoxic , Allergy and Immunology , Tumor Cells, CulturedABSTRACT
<p><b>OBJECTIVE</b>To detect tumor cells in the peripheral blood of patients with hepatocellular carcinoma (HCC) by using the mRNA of the MAGE-1 and MAGE-3 genes as specific tumor markers.</p><p><b>METHODS</b>Peripheral blood was obtained from 25 HCC patients and 20 healthy volunteers. The mRNA of the MAGE-1 and MAGE-3 genes in the peripheral blood mononuclear cells (PBMCs) was detected by nested RT-PCR. The MAGE-1 and MAGE-3 transcripts in the tumor tissues of these HCC patients were also detected by RT-PCR.</p><p><b>RESULTS</b>Of the 25 HCC patients, MAGE-1 and MAGE-3 mRNA were positive in 44% (11/25) and 36% (9/25) of PBMCs respectively, and in 68% (17/25) and 56% (14/25) of HCC tissues respectively. In the PBMCs of the 25 HCC patients, 16 (64%) samples were detected to express at least one type of MAGE mRNA. MAGE mRNA were not detected in the PBMCs from the patients whose tumors did not express the MAGE genes, nor in the PBMCs from the 20 healthy donors. The positive rate of MAGE mRNA in the PBMCs was closely correlated with the TNM stages and the diameter of tumors, but there was no correlation between the positive rate of MAGE mRNA in PBMCs and tumor differentiation degree or serum alpha-FP level. Of 9 HCC patients whose serum alpha-FP was normal or slightly elevated (< 50 ng/ml), 6 were MAGE-1 and/or MAGE-3 mRNA positive in their PBMCs.</p><p><b>CONCLUSION</b>MAGE-1 and MAGE-3 mRNA could be specifically detected with high percentage in the PBMCs of HCC patients by our method. They can be used as specific tumor markers for the detection of the circulating HCC cells, and the detection results may be helpful to evaluate the prognosis of HCC patients.</p>
Subject(s)
Humans , Antigens, Neoplasm , Carcinoma, Hepatocellular , Genetics , Leukocytes, Mononuclear , Liver Neoplasms , Genetics , Melanoma-Specific Antigens , Neoplasm Proteins , RNA, Messenger , GeneticsABSTRACT
Objective To investigate the relationship between the expression of MAGE-1,SSX-1,and CTp11 mRNA in the peripheral blood of patients with hepatocellular carcinoma (HCC) receiving orthotopic liver transplantation (OLT) and the prognosis of these patients. [WT5”HZ]Methods The expression of the three genes in the peripheral blood mononuclear cells (PBMCs) was detected by nested RT-PCR,and a follow-up was carried out in 26 patients. Results Before OLT,the positive rate of MAGE-1,SSX-1 and CTp11 transcripts was 40.0% (14/35),37.1% (13 /34),and 31.4% (11/35),respectively in the PBMC samples of HCC patients;Sixty percent (21/35) of the PBMC samples were positive for at least one of the three gene transcripts. The follow-up of 26 patients showed that,the tumor recurrence/metastasis rate after OLT (75.0%) in 16 patients with positive preoperative PBMC samples of at least one gene transcripts was significantly higher than that of the other 10 patients who was negative preoperatively for gene transcripts (30.0%)( P = 0.043).Postoperative tumor recurrence or metastasis developed in 15 out of 20(75%) patients with persistently perioperative positive MAGE-1,SSX-1 and /or CTp11 transcripts in PBMC samples or swithing from negative to positive perioperatively,in contrast to no recurrence nor metastasis in the other 6 patients with the gene transcripts switching from positive to negative postoperatively,or negative perioperatively ( P =0.002). [WT5”HZ]Conclusions MAGE-1,SSX-1 and CTp11 transcripts may act as combined tumor-specific makers to detect tumor cells in the peripheral circulation of HCC patients,and the detection is valuable for selecting OLT candidates and predicting the postoperative prognosis.
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Objective To investigate the key steps of hepatic artery reconstruction and the factors influencing the outcome of hepatic artery reconstruction in orthotopic liver transplantation. Methods The clinical data of 107 consecutive orthotopic liver transplantation patients was retrospectively reviewed to assess the key steps in hepatic artery reconstruction. The risk factors and the diagnosis and treatment of vascular complications were also discussed. Results The incidence of hepatic artery related complications in orthotopic liver transplantation was associated with the quality of the donor hepatic artery,the method used for anastomosis and the use of microsurgical technique. The main hepatic artery related complications were hepatic artery thrombosis and stenosis. The incidence of the vascular complications was 6.54%,and the mortality rate was 85.7%. Conclusion The major influence factors of vascular complications were the quality of the donor artery,the reconstruction way of donor-recipient artery and the use of microsurgical technique .
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0 05) However, the positive expression of SSX genes in the PBMC had close correlation with prognosis of HCC patients Metastasis and/or recurrence took place in 50% (8 out of l6) patients with positive expression of SSX genes in their PBMC,while only 10 5% (2 out of l9) patients with negative expression of SSX genes in their PBMC developed metastasis and/or recurrence ( P =0 028) Conclusion SSX genes mRNA may be used as specific tumor markers for the detection of the circulating HCC cells