ABSTRACT
Hilar cholangiocarcinoma (HCCA) is a malignant tumor arising from the epithelium of the bile duct, which involves the common hepatic duct, the left and right hepatic ducts, and the confluence areas of these bile ducts. HCCA has an insidious onset and most patients are in the advanced stage when jaundice is observed, and therefore it is considered a difficult issue in the field of surgery. Radical resection is the optimal method for the treatment of HCCA and has great influence on recurrence rate of tumor and patients’ survival time. Therefore, preoperative evaluation of tumor resectability is an important step of HCCA treatment. At present, there are eight main methods for HCCA staging and typing, i.e., Bismuth-Corlette classification system, modified T staging system, TNM staging system, JSBS staging system, Gazzaniga staging system, International Cholangiocarcinoma Group staging system, Mayo staging system, and Blechacz staging system. Each staging and typing system has its own advantages and disadvantages in clinical practice. This article reviews the staging and typing methods for HCCA, with a focus on the clinical value of each staging and typing system in preoperative evaluation of radical resection and prognosis.
ABSTRACT
Objective@#To compare the Bismuth-Corlette typing, modified T-staging and Mayo staging system in predicting the radical resection rates and prognosis of patients with hilar cholangiocarcinoma (HCC).@*Methods@#The clinical data of 138 patients with hilar cholangiocarcinoma treated in the First Bethune Hospital of Jilin University were retrospectively analyzed. Three different staging methods were used.@*Results@#With increase in the classification level of the Bismuth-Corlette classification, the radical resection rate did not significantly decrease (P>0.05). The radical resection rates of stage T1, T2 and T3 in the modified T-staging system were 60.0% (27/45), 36.0% (10/28) and 14.0% (9/65) respectively (all P<0.05). The radical resection rates of patients in the stages I, II, III, IV of the Mayo Staging System were 86.0% (12/14), 50.0% (14/28), 29.0% (19/66) and 3/0% (1/30) respectively (all P<0.05). The overall survival time were no significant differences between the different Bismuth-Corlette and the modified T-staging system patients (P>0.05). However, there were significant differences among the survival rates in the various tumor staging levels using the Mayo Staging System.@*Conclusions@#The modified T-staging system and the Mayo staging system were more accurate than the Bismuth-Corlette typing system in predicting radical resection rates in patients with hilar cholangiocarcinoma. The Mayo staging system was superior to the Bismuth-Corlette typing system and the modified T-staging system in predicting prognosis of patients with hilar cholangiocarcinoma.
ABSTRACT
Presently, nonalcoholic fatty liver disease has become the most common pathogenic factor of chronic liver disease worldwide that can lead to the occurrence of hepatocellular carcinoma (HCC). Lipid metabolism in cancer cells is closely related to tumorgenesis, invasion and metastasis, and thus acts as one of the hallmark of cancer cells. Lipolipomics is an important branch of metabolomics, which has been adapted recently in the study of HCC for analysis of the structure and function of lipid components by chromatography and mass spectrometry. Fatty acids, glycerides, glycerophospholipids, sphingolipids, and sterol are significantly different in HCC tissues or serum. Therefore, it contributes to the diagnosis, determination of prognosis, mechanistic study and targeted therapy of HCC.
ABSTRACT
Objective To study the relationship between graft injury and expression of redox factor-1 in early period after liver transplantation in rats. Methods One hundred and fifty adult male Wistar rats were randomly divided into three groups: liver transplant group, sham surgery group and control group. Animals were sacrificed in each group at different time points: 3,6,9, 12,24 hour after liver transplantation. The changes and significance of the expression of Ref-1 were explored by immunohistochemistry, serology and histopathology. Results Compared with sham surgery group and control group, the expression of Ref-1 protein in transplant group was higher than that in other two groups in early period after liver transplantation ( P ＜ 0. 05 ). In pathology there were lots of inflammation cells infiltration around the portal veins, and cell damage of hepatic tissue, while that in sham surgery and control group was comparatively slight. Serum ALT and AST values reached the peak at 6 ～ 12 h, and decreaced significantly after 12 h ( P ＜ 0. 05 ). Conclusions Graft injury after liver transplantation during early period reaches peak at 6 hour and then decreased. Hepatic ischemic reperfusion injury promotes Ref-1 expression, which in turn compensates for programme cell death induced by the injury.
ABSTRACT
To study the telomerase expression in adrenal cortical tumors and its clinical signinificance. Telomerase expression was estimated in 8 cases of adrenal cortical carcinoma, 20 cases of adrenal cortical adenoma, 24 tissues adjacent to cancer, and 4 specimens of normal adrenal tissue by the PCR based telomeric repeat amplification protocol. Telomerase was found to be expressed positively in 7(87 5%) of 8 adrenal cortical carcinoma samples and 1(4 2%) of 24 tissues adjacent to tumor, while it was not expressed in all the 20 samples of adrenal cortical adenoma and normal adrenal tissue. The expression of telomerase in adrenal cortical tumors clearly demonstrated the malignant behavior of the tumor cells. Demonstration of telomerase expression appears to be a useful tool for the diagnosis of malignant adrenal cortical tumors.
ABSTRACT
Hilar cholangiocarcinoma (HCCA) is a malignant tumor arising from the epithelium of the bile duct, which involves the common hepatic duct, the left and right hepatic ducts, and the confluence areas of these bile ducts. HCCA has an insidious onset and most patients are in the advanced stage when jaundice is observed, and therefore it is considered a difficult issue in the field of surgery. Radical resection is the optimal method for the treatment of HCCA and has great influence on recurrence rate of tumor and patients’ survival time. Therefore, preoperative evaluation of tumor resectability is an important step of HCCA treatment. At present, there are eight main methods for HCCA staging and typing, i.e., Bismuth-Corlette classification system, modified T staging system, TNM staging system, JSBS staging system, Gazzaniga staging system, International Cholangiocarcinoma Group staging system, Mayo staging system, and Blechacz staging system. Each staging and typing system has its own advantages and disadvantages in clinical practice. This article reviews the staging and typing methods for HCCA, with a focus on the clinical value of each staging and typing system in preoperative evaluation of radical resection and prognosis.