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Objective To review our experience in the diagnosis and management of paralysis of the right hemidiaphragm after liver transplantation. Methods 60 adult patients received liver transplantation from February 2001 to March 2007 in Sun Yat-sen Memorial Hospital were retrospectively analyzed. The pathophysiologic changes, clinical progress, and management of serious respiratory complications caused by post-transplant paralysis of the right hemidiaphragm were studied. Results Among 60 patients, 40 developed postoperative respiratory complications, and 5 were due to paralysis of the right hemidiaphragm. The 5 patients presented with paradoxical respiration and the ventilator supporting times were 14, 16, 34, 45, and 60 days, respectively. Tracheostomy was performed in 4. These patients developed pneumonia in 5, atelectasis in 4, acute respiratory distress syndrome (ARDS) in 4, hepatopulmonary syndrome in 4, and pulmonay interstitial edema in 3. Among the 5 patients, 4 patients survived and 1 patient died of ARDS and multiple organs failure 31 days after the transplantation. Conclusions After liver transplantation, strict monitoring of the respiratory function and timely use of a respirator for patients with the paralysis of the hemidiaphragm is very important. For patients with suspicious hemidiaphragm paralysis, tracheostomy should be decisively performed.
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Objective To investigate the expression of multidrug resistance protein such as multidrug resistance-associated protein 1 (MRP1),lung-resistance related protein (LRP), P-glycoprotein (Pgp),glutathione s-transferase (GST-π) and topoismerase Ⅱ (TOPO Ⅱ ) in hepatocellular carcinoma (HCC), which would be supplied for the clinical chemotherapy of HCC. Methods Twenty-six cases of HCC who underwent hepatectomy were enrolled and immunohistochemical (IHC) staining was carried out on all specimens for the detection of expression of MRP1,LRP,Pgp,GST-πand TOPO Ⅱ and the data was analyzed by image analysis system. Results The expression of five multidrug resistance protein in HCC tissue were significantly higher than those in adjacent tissue beyond cancer (P ＜0.05). The significant differences were found in the expression of Pgp,TOPO Ⅱ and GST-π between HCC tissue and distant metastasis (P ＜ 0.05 ). The expression of the five multidrug resistance protein in poorly differentiated HCC tissue was higher than that in well-differentiated tissue,while the significant difference was only found in the expression of TOPO Ⅱ (P ＜ 0.05 ). The significant association was not found between the expressions of five multidrug resistance protein in HCC tissue and the size of tumor,AFP, the portal vein tumor thrombus,hepatic cirrhosis and liver function. Conclusions Five multidrug resistance protein overexpression in various degrees in HCC tissue, which relates to some biological behavior of the cancer. Combined detection is of much benefit to the choice of the drug of chemotherapy and to the prediction of prognosis.
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ObjectiveTo investigate the effectiveness of combined oxaliplatin regimen as adjuvant chemotherapy for hepatocellular carcinoma and to evaluate the efficacy of using adenosine triphosphate tumor chemosensitivity assay (ATP-TCA) for direction of individual chemotherapy.MethodsThe twenty-six patients with primary hepatocellular carcinoma were operated.Specimens were collected and adenosine triphosphate tumor chemosensitivity assay (ATP-TCA) was applied to evaluate the sensitiveness of chemotherapy agent(Adriamycin, Mitomycin, Mitoxantrone, Oxaliplatin, Irinotecan, 5-FU, Gemzar, Carboplatin, Cisplatin, Docetaxel and Etoposide).Sensitive group (SG) was from from 11 patients who were sensitive to oxaliplatin, and control group was from the other 16 patients who were not sensitive to oxaliplatin.All the twenty-six patients received oxaliplatin combined with 5-FU or capecitabine regimen chemotherapy.The effectiveness (CR,PR,SD,PD,ORR,OS and DFS) of the regimen according to RECIST criteria and WHO criteria for anticancer drugs toxicity and efficacy of ATP-TCA were evaluated.ResultsTwenty-six patients were successfully evaluated.In SG, six patients obtained complete remission(CR), three got partial remission(PR), one got stable disease (SD) and one patient got progression disease (PD).While in control group,four patients obtained CR,two patients got PR, five patients got SD and four got PD.No significant differences were found in overall survival (OS, P = 0.1116) and disease-free survival (DFS, P = 0.2328)between sensitive group and control group.But significant differences were found in overall response rate (ORR) (81.8％ vs 40.0％, P =0.0401) between two groups.Common toxicities were as follows:I to Ⅱdegree of myelosuppression was 53.8％, I to Ⅱ degree of gastrointestinal tract response was 50％, I to Ⅱ degree of liver function damage was 57.7％ and I to Ⅱ degree of neuropathy was 23.1％, respectively.Most of these toxicities were tolerable at grade 1 ～ 2.No significant differences were found in the toxicities between two groups.ConclusionsCombined oxaliplatin regimen might be an effective choice for adjuvant chemotherapy for HCC, which has with tolerable systemic toxicity.Application of ATP-TCA system might further improve the efficacy of this regimen by selecting right candidate.
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Objective To evaluate perioperative portal hemodynamic alterations in cirrhotic patients undergoing subtotal splenectomy,podicled spleen remnant retroperitoneal transplantation plus lower esophagus transection in the treatment of portal hypertension.Method Forty patients with cirrhotic portal hypertension were randomly allocated into 2 groups:splenic transplantation group (n = 20),in which patients underwent subtotal splenectomy with pedicled remnant spleen retroperitoneal transplantation and cardia-esophageal devascularization and transection,and control group (n = 20),in which splenectomy and cardia-esophageal devascularization and transection were performed.The cross section area,blood velocity and flow and collateral circulation of portal parameters were comparatively evaluated by 3D DEC MRA,and the size of remnant spleen,blood flow and collateral circulation of retroperitoneal transplanted spleen were comparatively assessed.Results At 6-month after operation,the disappearance of esophageal-gastric varices in two groups was similar,and the cross section areas of main portal vein (MPV) in two groups all decreased postoperatively,in study group it was (1.81±0.73) cm~2 vs.(1.20±0.52) cm~2,P ＜ 0.01;in control group it was (1.78±0.52) cm~2 vs.(1.30±0.12) cm~2,p ＜0.01.The mean blood velocity of MPV decreased postoperatively,in study group it was (9.86±0.10) cm/s vs.(7.06±1.92) cm/s,P ＜0.01;In control group it was (10.0 ±0.6)cm/s vs.(8.2±2.4) cm/s,P ＜0.01.The mean blood flow velocity of MPV in study group was lower postoperatively than that in control group(P＜0.01).The mean blood flow volume of MPV decreased postoperatively from (15.0±1.9) ml/s to (10.5 ±2.7)ml/s,P ＜0.01 in study group;and from (14.9±2.1) ml/s to (11.6±2.1) ml/s,P ＜ 0.01 in control group.The mean blood flow volume of MPV in study group was lower postoperatively than that in control group(P＜0.05).A significant collateral formation was observed around the retroperitoneally translocated pedicled remnant spleen.Conclusions Compared with splenectomy,subtotal splenectomy,retroperitoneal translocation of the pedicled remnant speen helps to preserve splenic function as well as to increase retroperitoneal collateral formation which is conducive to further decreasing the portal veinous pressure.
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Objective To compare the effect of pericardial devascularization with that of the modified Sugiura procedure in management of portal hypertension. Methods From 1990 to 2008, 236patients with portal hypertension underwent operations including pericardial devascularization in 147and modified Sugiura in 89 in our hospital. Results There were 12 perioperative deaths (8.2 % ), and 2 rebleedings (2 % ) in the pericardial devascularization group, and 7 perioperative deaths (7.9 % ) and 2 rebleedings(3.4 % ) in the modified Sugiura group. The follow-up rate was 91.9 % in the pericardial devascularization group and 87.8% in the modified Sugiura group respectively, in a period from 6 months to 19 years. The 1-, 3-and 5-year rebleeding rates were 5.7%,15.2% and 25.5% in the pericardial devascularization group and 6.9%, 16.3%, 29.5 % in the modified Sugiura group, respectively. The 1-, 3- and 5-year survival rates were 87.8% ,79.1% and 69.7% in the pericardial devascularization group and 95.8 %,85.0%, 76.9 % in the modified Sugiura group, respectively. Conclusion Modified Sugiura procedure and pericardial devascularization have differences in perioperative mortality as well as rebleeding and survival rates.
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BACKGROUND: Hemorrhage, hemostasis, and blood coagulation, as well as the application of hemostasis measures, in the liver transplantation have been poorly understood. There have been no protocols regarding routine hemostasis.OBJECTIVE: To investigate the hemorrhagic features in each phase and to observe the application efficacy of recombinant activated factor Ⅶ (rFⅦ a) during the liver transplantation.DESIGN, TIME AND SETTING: A retrospective case analysis, controlled observation experiment was performed at the Department of Common Surgery, Second Affiliated Hospital of Sun Yat-sen University between April 2001 and July 2006.PARTICIPANTS: Fifteen patients who received liver transplantation between April 2001 and March 2003 served as retrospective study subjects. An additional 28 patients who underwent liver transplantation between March 2003 and July 2006 were randomly and evenly divided into two groups: rFⅦ a and control.METHODS: The hemorrhage rule of 15 patients who received liver transplantation in the protophase was retrospectively analyzed and the hemorrhagic feature in each time period was localized. A comparative observation was performed in the 28 patients in the anaphase. The rFⅦ a group received an intravenous injection of 70-80 μ g/kg rFⅦ a for 3-5 minutes. Simultaneously, the control group was given 50 m/physiological saline in parallel.MAIN OUTCOME MEASURES: Hemorrhage volume of 15 patients that received liver transplantation in each phase; prothrombin time, activated partial thromboplastin time, and total hemorrhage volume prior to and 30 minutes after rFⅦa application in 14 patients who received liver transplantation.RESULTS: Extensive errhysis was a primary cause of hemorrhage in the liver transplantation. Hemorrhage pdmadly occurred in the phase of diseased liver resection (i.e., pre-anhepatic phase), rFⅦ a could well improve various coagulation functional indices, i.e., thromboelastography indices (reaction time, coagulation time, α angle, and maximum amplitude) and routine blood indices (prothrombin time and activated partial thromboplastin time). Compared with the control group, hemorrhage volume was obviously decreased and transplantation time was significantly shorter in the rFⅦa group. In addition, no thrombotic complications were found in the rFⅦa group during the observation period.CONCLUSION: The pre-anhepatic phase is a primary hemorrhage phase during the liver transplantation, rFⅦ a can be successfully applied for liver transplantation.
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BACKGROUND: Extensive liver resection or liver transplantation operated on patients with combined hepatic cirrhosis and other complications correlates with high morbidity and mortality.Child-Turcotte-Pugh scoring system is now widely used in the assessment of liver function.This classification scheme includes three clinical indicators and two biochemical indices;however,it seems difficulty on directly evaluating functional status of hepatocytes.OBJECTIVE: To explore the practicability of bioluminescence adenosine triphosphate (ATP) determination assay to assess the functional reserve of residual hepatocytes,DESIGN,TIME AND SETTING: Case contrast study,which was carried out in the Second Affiliated Hospital,Sun Yat-sen University from January 2005 to March 2006.PARTICIPANTS: Thirty-two patients who underwent major extra-and intra hepatic surgery including liver transplantation were randomly divided into three groups based on hepatic cirrhosis grading standard,including normal group (n=7),macronodular cirrhosis group (n=9),and micronodular cirrhosis group (n=16).METHODS: Routine examination and biochemical indexes of liver were performed preoperatively,including glutamic oxalacetic transaminase (GOT) and total bilirubin (TBIL).Liver specimens were delivered by aseptic technique during operation and enzymatic digested.Cell suspension was cultured and centrifuged.Hepatocytes were counted and dispensed cell suspension to be used for ATP extraction and measurement.MAIN OUTCOME MEASURES: ATP content,preoperative biochemical parameters of liver function,and correlation between biochemical parameters and ATP content.RESULTS: The ATP content in the macronodular cirrhosis group was significantly higher than that in the micronodular cirrhosis group and normal group (P=0.000 1,0.004).While,the ATP content in the micronodular cirrhosis group was also significantly higher than that in the normal group (P=0.004).ATP content (mole/cell) wassignificantly positively correlated with serum glutamic oxalacetic transarninase (r=-0.609 3,P=0.000 2) and TBIL (r=0.614 5,P=0.000 2).CONCLUSION: ATP assay can directly evaluate functional reserve of liver parenchyma and reflect high operative risk status (HORS) and course of postoperative recovery in major hepatic resection.
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Objective To investigate the feasibility and safety of autologous tumor tissue lysate loading den-dritic cells(DC) for the treatment of hepatocellular carcinoma (HCC). Methods The monocytes-derived DC were induced and antigen loaded with tumor tissue lysate to produce DC vaccine. Vaccination and clinical observation were conducted in 12 HCC patients for 41 times. Results The average output of DC was 1.69×107(1.69×107±9.44×106>) from 90 ml peripheral blood. 63.41% (26/41)patients appeared to develop delayed-type hypersensitivity after intradermal injection. After an average of 9 months follow up, 1 patient out of 4 recurrence and metastasis pa- tients survived for 17 months. The other three patients progressed. Out of 8 patients undergoing immunotherapy post- operatively,6 patients had no signs of recurrence and the others were found to have liver rceurrence and progression. Conclusion DC based immunotherapy is safe and feasible,with no side effects,which can be applied in the immu- notherapy strategy of HCC patients.
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Objective To explore the mechanism by which recombinant human growth hormone (rhGH) protects liver function and alleviates portal hypertension in rats with liver cirrhosis. Methods Male S.D. rats with thioacetamide-induced liver cirrhosis were randomly assigned to receive separately normal saline (NS, 0.5 ml) or rhGH(333 ng/kg body weight) daily by subcutaneous injection for up to 7 days. After the respective treatments, changes of GH-binding capacity (R T), GHRmRNA, relative content of collagen (RCC), malon-dialdehyde (MDA), superoxide dismutase (SOD) in liver tissue, serum albumin and ALT and portal vein pressure (PVP) were examined. Results R T (fmol/mg protein) of GHR was respectively 31?4, 40?7(P
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ObjectiveTo study the therapeutic efficacy of lamivudine in preventing the activity of hepatitis B virus in patients with hepatocellular carcinoma and hepatitis B virus infection. MethodsFrom March 1999 to March 2000,72patients with hepatocellular carcinoma and hepatitis B virus infection were divided into 2 groups in complete randomization. In group 1,38 patients were treated with lamivudine 100mg/qd during perioperative period. Before and after operation,we detected HBV DNA with assay of quantitative polymerase chain reaction (QPCR). The control group(2) wasn't given anti-hepatitis B virus treatment. ResultsThe results showed that in group 2,the copies of HBV DNA in sera one week,two weeks after operations were significantly higher than those before the operation(P<0.01);in group 1,the copies of HBV DNA in sera one week,two weeks after operations were significantly lower than those before operation(P<0.01),all within the safety threshold;between group 1 and group 2,the indexes of ALT in sera and Child status didn't significantly change before and after operation.The postoperative complications were significantly different two weeks after operation.Conclusion It suggests that surgical interventions may result in promoting the process of HBV replication,the activity of HBV infection should be treated in perioperation, and the replication of HBV can be inhibited by lamivudine safely to the safety threshold within a short time, though lamivudine doesn't improve the liver biochemistry significantly.
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Objective To investigate MDR1mRNA quantitative expression in patients with hepatocellular carcinoma( HCC) and its relation to pathologic features, chemotherapy sensitivity, metastasis and prognosis. Methods Total RNA extracted from 47 cases of HCC and 12 normal liver tissue were subjected to analysis of MDR1mRNA expression by fluoregenic probe quantitative RT-PCR(FQ-RT-PCR). Result The level of MDR1mRNA expression was 1.4?10 3～3.6?10 6copies/?g RNA .The positive rates observed in 72% of the tumor tissue was significantiy higher than in 51% of the adjacent liver tissue and in 42% of the normal liver tissue (P
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Objective To investigate the effect of chronic liver injury on the expression of uridine diphosphate glucuronosyltransferase(UGT) 1A1 mRNA in mice. Methods Chronic liver injury model was induced by feeding CCl 4 in mice.Thirty mice were randomly divided into three groups:control group,experimental group 1(CCl 4 was given for 1 month),and experimental group 2(CCl 4 was given for 2 months).The liver function was tested;and the expression of UGT1A1 mRNA in the 3groups was analysed by RT-PCR. Results There was significant difference in the expression of UGT1A1 mRNA between the 3 groups(P
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Objective To evaluate spleen autotransplantation with lower esophagus transection for the treatment of portal hypertension by three-dimensional dynamic contrast-enhanced magnetic resonance angiography (3D-DCE MRA). Methods Twenty-eight patients were randomly divided into study group undergoing splenic autotransplantation and cardia-esophageal devascularization plus lower esophagus transection and control group without splenic transplantation. The cross section area, blood velocity and blood flow of main portal vein (MPV) were measured by 3D-DCE MRA, and the blood flow, collateral circulation of transplanted spleen were assessed. Results The cross section areas (cm ) of MPV of the two groups decreased postoperatively ( study group 1. 80 ? 0. 69 vs. 1. 20 ? 0. 73 , t = 13.96, P = 0. 00; control group 1. 78 ? 0. 43 vs. 1. 29 ? 0. 57, t = 11. 38, P = 0. 00). The mean blood velocity ( cm/s) of MPV decreased postoperatively (study group 9. 85 ? 0. 09 vs. 7. 06 ? 1. 98, t = 18. 98 , P = 0. 00; control group 10. 01 ?0. 43 vs. 8. 19 ?2. 44, t =22. 32, P =0. 00) in the two groups, and the mean blood velocity ' of MPV in study group was lower postoperatively than that in control group ( t = - 8. 02, P = 0. 00 ) . The mean blood flow (ml/s) of MPV decreased postoperatively (study group 15. 05 ? 2. 43 vs. 10. 52 ? 2. 55, 1 = 16.93, P=0. 00; control group 14. 81 ?2. 29 vs. 11.58 ?2. 96, t = 15. 90, P=0. 00) , and the mean blood flow of MPV in study group was lower postoperatively than that in control group (t = - 2. 73, P = 0. 02). Extensive collateral circulation developed around the transplanted spleen. Conclusions 3D-DCE MRA clearly shows the autotransplantated spleen and portal hemodynamics. It is an important non-invasive way to evaluate the result of the procedures.
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Objective To observe the effect of somatostatin (SST) on the expression of metalloproteinase-2(MMP-2) and tissue inhibitor matrix metalloproteinase-2(TIMP-2) of implanted tumor in nude mice after partial hepatectomy.Method Nude mice were divided into group A(n=10) implanted by human hepatocellular carcinoma(HCC),group B(n=10, partial hepatectomy) and C(n=10,HCC implantation after liver resection). SST(250 ?g/kg,b.i.d) was given intraperitoneally in group C. Mice were sacrificed on 35th d, tumor was measured, the expression of MVD.MMP-2 and TIMP-2 was detected by immunochemical staining and quantitative image computer-analysis. Results In group B, the weight and volume and expression of MVD.MMP-2 of tumor tissue was markedly incressed than in group A(P
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ObjectiveTo study growth hormone activated regulation of growth hormone receptors (GHR) in cirrhotic hepatocytes. MethodsPrimary cultures of hepatocytes from cirrhotic rat were exposed to recombinant human growth hormone (rhGH) at different concentrations of 0, 13.3, 133.3,and 1?333?ng/ml, respectively. Thereafter the binding sites of hepatocytes were detected with radio-ligand binding assay. ResultsAfter culture with different rhGH concentrations, the binding sites (10 4/cell) of receptors on cirrhotic liver cells were respectively 0.73?0.13, 1.14?0.17, 1.23?0.21, and 0.68?0.10(P
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AIM: To investigate the immune stimulation capacity of B7-H1 blockade on immature dendritic cells (DCs) in vitro. METHODS: The human monocyte-derived dendritic cells were induced in the presence of cytokine GM-CSF and IL-4. The expression of B7-H1 was detected by FCM. On blockade of B7-H1, the maturation and endocytic activity, T cells stimulatory proliferation capacity, IL-12 production, T cell differentiation effect of DCs were detected by FCM, MTT assay, ELISA and ELISPOT, respectively. RESULTS: The expression of B7-H1 was increased with the induction of DCs. On day 7, the positive expression was 54.12%, and the TNF-? induced mature DCs had the positive expression rate of 83.64%. The blockade of B7-H1 on immature DCs had sharply increased their T cells stimulatory proliferation capacity and IL-12 production, and efficiently induced the development of Th1/Tc1 cells, but had no effect on their maturation and endocytic activity. CONCLUSION: The blockade of B7-H1 on immature DCs increases its immune stimulation activity. It is valuable to investigate the antitumor immune responses of DCs vaccine with B7-H1 blockade.
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AIM: To study the expression and change of growth hormone receptors in experimental cirrhotic liver in rats. METHODS: Thioacetamide-induced liver cirrhosis was developed in Sprague-Dawley rats. The expression of growth hormone receptor and its mRNA was investigated by radio-ligand binding assay, revere transcript-polymerase chain reaction (RT-PCR) and digital image analysis in liver tissue or hepatocytes taken from normal control or cirrhotic rats with different stages of cirrhosis. RESULTS: Growth hormone-specific singular binding sties, namely growth hormone receptors, were detected in liver tissue or hepatocytes from rat samples with cirrhosis. The binding capacity of growth hormone receptors in rat cirrhotic live tissue was significant lower than that in normal control, and it decreased gradually along with the accumulation of collagen in the process of formation and development of liver cirrhosis. The binding sites of growth hormone receptors in rat cirrhotic liver cells were significantly lower than that in normal control. The expression of growth hormone receptor mRNA in rat cirrhotic liver tissue was also significant lower than that in normal control. CONCLUSIONS: The growth hormone receptor was expressed in cirrhotic livers at a reduced level in isolated hepatocytes or live tissue of cirrhotic rats, and lesser expression of growth hormone receptors was found in later stage of cirrhosis. The suppressed expression of growth hormone receptor was partly due to the reduced expression of its mRNA in cirrhotic liver tissue.
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AIM: To investigate the expression of adhes i on molecules in human hepatocellular carcinoma (HCC), and analyze the correlatio n between the expression of adhesion molecules and chemosensitivity. METHODS: The surgical and needle specimens from 64 patients were tested by the ATP-TCA. The expression of adhesion molecules and multi-drug resi stance genes (MDR) of tumor tis sues of 64 cases and adjacent tissues of 12 cases of HCC were detected with RT-P CR. RESULTS: The expression level of E-cadherin, ICAM-1, CD 44, CD 44V, ? 5, ? 1 in liver cancer tissues was 1.24?0.54, 0.96?0.3 7, 0.62?0 .73, 0.86?0.33, 0.97?0.49, 1.41?0.24, respectively. There was a signif icant difference between CD 44 and E-cadherin, ? 1. The expression levels of MD R 1, MRP, GST-?, LRP, TOPO II mRNA in liver cancer tissues were 1.17?0.47, 1 .59?0.33, 1.18?0.48, 1.03?0.48, 1.00?0.31, respectively. The express ion level of adhesion molecule mRNA had positive Spearman correlation with the expression level of MDR mRNA. ICAM-1, ? 5 had positive Spearman correlation w ith MDR 1. E-cadherin and CD 44 had negative Spearman correlation with MDR 1. E-cadherin had negative Spearman correlation with MRP. ICAM-1 had positive Spearman correlation with LRP. E-cadherin and CD 44 had negative Spearman c orrelation with LRP. CONCLUSION: The expression levels of adhesion molecule mRNA ha ve correlation with the effect of chemotherapy and the expression of MDR genes .
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Objective:To investigate the most effective strategy for mature induction of dendritic cells.Methods:Human monocyte-derived dendritic cells were induced in the presence of cytokines GM-CSF and IL-4. On day 6, the immature DCs were pulsed with each of CD40L, LPS, TNF-? or a cocktail of cytokines(TNF-?, IL-6, IL-1?, PGE2). DCs were harvested after 24 h induction. The surface markers for maturation CD80,CD83,CD86 and HLA-DR were detected by FCM. FITC-Dextra endocytic activity was measured by FCM. IL-12 production was detected by ELISA. The capacity of DCs for T cell activation was detected by MTT assay.Results:CD40L,LPS,TNF-? and the cocktail of cytokines all could induce DCs’ maturation. The most effective scheme for induction of maturation was the cocktail of cytokines, and the expression rate of CD83 was up to 66.91%(P
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In order to investigate if the recombinant human growth hormone(rhGH) is suitable for hepatocellular carcinoma(HCC) treatment,we used radioreceptor assays to detect if growth hormone receptor(GHR) was presented in 32 HCC tissues.The results showed that the growth hormone specific singular binding site,namely GHR,was detected in 28 cases. The binding capacity(R T ) of GHR was 18 4300?4 1633fmol/mg.protein and affinity constant(Kd) was 0 6432?0 1961nmol/L R T was lower ( P 0 05). The R T of the GHR was negatively correlated to the tumor's size,but was not correlated with differentiation of tumor, or the co existence of cirrhosis,GHR was absent in 4 cases. This study showed that the majority of the HCC tissue still express a low level of GHR. Before their functions are well understood, rhGH should be very carefully used in HCC patients.