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Objective:To investigate the changes of liver volume and liver function in patients with extensive hepatic vein occluded Budd-Chiari syndrome (BCS) treated with transjugular intrahepatic portosystem shunt (TIPS).Methods:The clinical data of 29 BCS patients from Affiliated Hospital of Xuzhou Medical University during March 2016 to June 2019 were retrospectively collected and analyzed. The BCS was caused by extensive hepatic vein occlusion and patients were treated with TIPS. Pre- and postoperative abdominal CT/MRI images were collected and analyzed, and hepatic volume was measured with 3D-reconstruction. The liver volume and liver function during before and post the surgery were also collected and analyzed with preoperative value.Results:Patients including 8 males and 21 females, aged (33.3±6.3) years, were enrolled in this study. TIPS was successfully performed in all patients, with a technical success rate 100%. No serious complications related to TIPS occurred. Patients were followed up for 12-33 months (median, 16 months). Compared with preoperative [(2 124.6±420.9) cm 3] , the hepatic volume of time points after operation [1 week: (1 926.3±372.3) cm 3; 3 months: (1 480.6±183.1) cm 3; 6 months: (1 461.9±153.0) cm 3; 12 months: (1 469.3±148.5) cm 3] were all significantly reduced, and the differences were statistically significant ( P<0.05). Compared with preoperative values, the hepatic function indexes at each time point after operation were significantly improved ( P<0.05). The complete remission rate of ascites was 96.4% (27/28), 100.0% (28/28) and 100.0% (28/28) at 3, 6 and 12 months, respectively. Conclusion:The extensive hepatic vein occlusive BCS patients were benefit from TIPS therapy. Six months after operation, the hepatic volume and the hepatic function returned to normal level.
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Objective:To study the use of contrast-enhanced ultrasonography (CE-US) and contrast-enhanced MRI(CE-MRI) in evaluation of therapeutic effect of transcatheter arterial chemoembolization (TACE) on hepatocellular carcinoma (HCC).Methods:A retrospective study was conducted on 60 patients with HCC (with 114 lesions), who were treated with TACE in Affiliated Hospital of Xuzhou Medical University from January 2018 to December 2018. There were 53 males and 7 females, age ranged from 47 to 84 (mean age 61.9) years. CE-US, CE-MRI and digital subtraction angiography (DSA) were performed in all these patients within one week after TACE. Using DSA as the gold standard, the sensitivity, specificity and accuracy in the detection of residual lesions were compared between the two imaging methods. The consistency of results between CE-US and CE-MRI was analyzed.Results:CE-MRI and CE-US showed presence of active tumor foci (residual and/or recurrent lesion) in 78 lesions, and complete inactivation of HCC foci in 26 lesions. Ten lesions were diagnosed as active foci by CE-MRI, which were missed by CE-US. The diagnostic accuracy of CE-MRI was 100.0% (114/114), which was significantly better than the 91.2% (104/114) of CE-US ( P<0.05). The Kappa value between CE-US and CE-MRI was 0.781. The diagnostic coincidence between CE-MRI and CE-US was quite high. Among small lesions of less than 5 cm, the diagnostic accuracy of CE-MRI was 100.0% (78/78), which was significantly better than the 88.5% (69/78) of CE-US ( P<0.05). In large lesions of greater than 5 cm, the diagnostic accuracy of CE-MRI was comparable to that of CE-US. The difference was not significant ( P>0.05). The sensitivity of CE-MRI in detection of active lesions was higher than that of CE-US, and the specificity of the two imaging methods was consistent. The Kappa value between CE-US and CE-MRI was 0.747 for small lesions of less than 5cm, and 0.873 for large lesions of greater than 5 cm. The diagnostic coincidence between CE-MRI and CE-US was quite high. Conclusion:CE-MRI and CE-US can both be used as reliable imaging methods for evaluating the therapeutic effect of TACE for HCC.
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Objective To study the efficacy of combined transcatheter arterial chemoembolization(TACE)with iodine-125 seed implantation in treating hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT).Methods From January 2015 to January 2019,eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.A total of 71 patients were male and 9 were female.aged(53.1±9.9)years.The patients included 48 patients(group A)who were treated with TACE alone and 32 patients(group B)with TACE combined with iodine-125 seed implantation.The survival time and disease control rate(DCR)of the intrahepatic lesions and PVTY in the two groups were compared.Results There were 32 patients who were successfully implan-ted with portal vein iodine-125 seed and stents.The DCR of PVTT in group B was significantly better than in group A(90.6％ vs.81.3％,P＜0.05).The DCR of the intrahepatic lesions in the two groups was 77.1％(group A)and 90.6％(group B).There was no significant difference between the two groups(P＞0.05).The survival times of group A and group B were(8.0±0.6)and(16.0±2.1)months,respectively.The median survival times were(7.6±1.0)and(14.8±1.5)months respectively.Group B had significantly better survival time than Group A,(both P＜0.05).Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis(Regression coemcient:0.960,HR:0.383,95％CI:0.158-0.926,P＜0.05).125I treatment was a protective factor of prognosis(Regression coefficient:-1.525,HR:0.218,95％CI:0.100-0.473,P＜0.05).Conclusion For patients with HCC and PVTT.compared with TACE alone,TACE combined with iodine-125 seed implantation could safe-ly and effectively control portal vein tumor thrombus,and prolonged patient survival.
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Objective@#To study the efficacy of combined transcatheter arterial chemoembolization (TACE) with iodine-125 seed implantation in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).@*Methods@#From January 2015 to January 2019, eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. A total of 71 patients were male and 9 were female, aged (53.1±9.9) years. The patients included 48 patients (group A) who were treated with TACE alone and 32 patients (group B) with TACE combined with iodine-125 seed implantation. The survival time and disease control rate (DCR) of the intrahepatic lesions and PVTT in the two groups were compared.@*Results@#There were 32 patients who were successfully implanted with portal vein iodine-125 seed and stents. The DCR of PVTT in group B was significantly better than in group A (90.6% vs. 81.3%, P<0.05). The DCR of the intrahepatic lesions in the two groups was 77.1% (group A) and 90.6% (group B). There was no significant difference between the two groups (P>0.05). The survival times of group A and group B were (8.0±0.6) and (16.0±2.1) months, respectively. The median survival times were (7.6±1.0) and (14.8±1.5) months respectively. Group B had significantly better survival time than Group A, (both P<0.05). Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis (Regression coefficient: 0.960, HR: 0.383, 95% CI: 0.158-0.926, P<0.05). 125I treatment was a protective factor of prognosis (Regression coefficient: -1.525, HR: 0.218, 95% CI: 0.100-0.473, P<0.05).@*Conclusion@#For patients with HCC and PVTT, compared with TACE alone, TACE combined with iodine-125 seed implantation could safely and effectively control portal vein tumor thrombus, and prolonged patient survival.
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Objective To investigate the curative effect and clinical application value of ultrasound-guided low-power microwave ablation in treating liver cancer with special sites (including the leiosn near the gallbladder,diaphragmatic dome,gastrointestine, heart,blood vessels and hepatic portal canal with the shortest distance between the tumor and the organs or lumen less than 0.5 cm). Methods Forty patients with liver cancer with special sites including neighboring the gallbladder in 9 cases,diaphragmatic dome in 7 cases,gastrointestine in 5 cases,portal vein in 1 1 cases,hepatic vein in 3 cases,inferior vena cava in 3 cases and heart in 2 cases were selected as the treatment group and other 40 cases with primary liver cancer with common site were selected as the control group by stratified random selection,during the same period.Ultrasound-guided microwave ablation was performed,all patients were followed up at 6 months,12 months,18 months and 24 months,and the survival rate was calculated.Results The negative rate of AFP in the treatment group and control group was 83.0% and 82.0%,respectively.The survival rates of the treatment group and the control group at 6 months,12 months,18 months and 24 months were 100.0%,95.0%,90.0%,80.0% and 100.0%,97.5%,92.5%,85.0%. Conclusion Ultrasound-guided low-power microwave ablation in treating the liver cancer with special sites is very effective and safe. The curative effect is similar to that of liver cancer with common site and can be widely used in clinic.
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Objective@#To explore the clinical value of 3D-DSA technology in the diagnosis and treatment guidance of hepatic artery chemoembolization.@*Methods@#Liver cancer patients in the treatment groups were collected to receive 3D-DSA imaging guidance at the Affiliated Hospital of Xuzhou Medical University between March and May 2017. In addition, routine 2D-DSA imaging was selected for treatment-received group. Intra-operative blood vessels and tumor-like lesions were observed. The total exposure dose (CAK, unit mGy), cumulative irradiation intensity per unit area (DAP, unit mGy.cm2) and dosage of contrast agent (ml) were calculated separately for two groups of patients. The same senior physicians and technicians operated both groups of patients. Comparisons of measurement were analyzed by t-test and chi-square test was used for count data.@*Results@#Data of twenty patients were collected from the two groups. Tumor location, target vessels structure and shape of development were clear in all patients in the treatment group. The control group had 17 cases of tumor development and the target vascular structure was clear in 16 cases. CAK mean treatment group was lower than control group (554.11 + 38.87) mGy and (644.53 + 26.70) mGy, and DAP mean treatment group was lower than the control group (125.25 + 7.54) mGy·cm2 and (143.49 + 6.18) mGy·cm2. The two groups were compared (P value < 0.05), and the differences were statistically significant. The mean dose of contrast agent in the two groups were lower than control group (64.42 + 3.92) ml, (70.79 + 4.47) ml, and the differences between the two groups were statistically significant (P < 0.05).@*Conclusion@#3D-DSA imaging technology can provide effective diagnosis and guidance in the treatment of hepatic artery chemoembolization. It can effectively reduce the radiation exposure dose and radiation intensity, and it is of high clinical value for interventional embolization of liver cancer.
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Objective To study the safety and efficacy of accessory hepatic vein (AHV) stenting to treat primary Budd-Chiari syndrome (BCS).Methods The clinical data of 20 BCS patients with AHV ostial stenosis or occlusion were retrospectively analyzed.These 20 patients underwent balloon dilation and AHV stenting.Thirteen patients underwent AHV stenting via the right jugular vein approach,5 patients via the right femoral vein approach,and 2 patients via the percutaneous transhepatic combined with the right femoral vein approach.On follow-up,patency of the AHV stent was evaluated by color Doppler ultrasound.The cumulative primary and secondary patency rates were assessed with the Kaplan-Meier curves.Results AHV stenting was successful in 20 patients.Angiography showed that the AHV was patent after stenting.The mean pressure gradient between the AHV and the inferior vena cava reduced from (19.2 ± 4.8) cmH2O (1 cmH2O =0.098 kPa) before treatment to (4.5 ± 1.9) cmH2O after treatment (t =7.119,P ＜ 0.01).During the procedure,rupture of the AHV caused by balloon dilation occurred in one patient.This was treated successfully by a covered stent placement.On follow-up from 1 to 80 months [(32.1 ±27.4) months]after treatment for the 20 patients,re-stenosis of the AHV were found in 5 patients.They were treated successfully with re-dilation.The cumulative 1-,3-,and 5-year primary patency rates were 100％,85.1％ and 74.5％,respectively.The cumulative 1-,3-,and 5-year secondary patency rates were 100％,90.9％ and 90.9％,respectively.One patient died of hepatic failure 3 years after the treatment.Conclusion AHV stenting was a safe and efficacious treatment for BCS and it provided good mid-and long-term results.
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Objective To explore the endovascular treatment of Budd-Chiari syndrome (BCS) in young child. Methods The clinical data of one young child diagnosed with BCS and treated with endovascular therapy were retrospectively analyzed. Results The 23-month-old female suffered from repeated abdominal distension for 3 months and was diagnosed with BCS by vascular ultrasound Doppler and magnetic resonance examination. After confirmation of the diagnosis, endovascular treatment was performed. Then the occluded blood vessels resumed blood stream, urine output increased, and abdominal distension was significant relieved. Conclusions In young children, BCS is rare, the condition is complex, and endovascular therapy is effective.
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Objective@#To investigate the efficacy and clinical value of transcatheter arterial chemoembolization (TACE) combined with ultrasound-guided microwave ablation for the treatment of liver cancer in special sites.@*Methods@#The patients with liver cancer in special sites (the liver cancer was adjacent to the gallbladder, dome of diaphragm, gastrointestinal tract, heart, great vessels, and portal vein, with the shortest distance from the tumor to the organ/lumen < 0.5 cm ) were enrolled as treatment group, and the patients with primary liver cancer in normal sites treated in our hospital during the same period were randomly enrolled as control group. They underwent TACE combined with ultrasound-guided microwave ablation. The 6-month, 12-month, 18-month and 24-month survival rates of the patients in two groups were analyzed.@*Results@#The clinical data of 40 patients with liver cancer in special sites, including 9, 7, 5, 11, 3, 3, and 2 patients with liver cancer adjacent to the gallbladder, dome of diaphragm, gastrointestinal tract, portal vein, hepatic vein, inferior vena cava, and heart, respectively, and another 40 patients in control group were collected in the study. The negative rate of alpha-fetoprotein (AFP) was 83.3% in the treatment group and 82.8% in the control group. The 6-month, 12-month, 18-month, and 24-month survival rates were 100.0%, 95.0%, 90.0%, and 80.0%, respectively, in the treatment group, and 100.0%, 97.5%, 92.5%, and 85.0%, respectively, in the control group.@*Conclusion@#TACE combined with ultrasound-guided microwave ablation is as effective for liver cancer in special sites as for those in normal sites, with high safety, and is feasible in clinical application.
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Background and purpose: Peroxiredoxin Ⅱ (PrxⅡ) has the activity of peroxidase. The relevant studies found it played an important role in gastric cancer. This study aimed to investigate the expression of PrxⅡ in human gastric cancer tissues and cells, analyze its relationship with clinicopathological characteristics, and explore the relationship between PrxⅡ and the prognosis and the development of gastric cancer. Methods: The expression of PrxⅡmRNA and protein in gastric cancer tissues and the paired adjacent normal tissues from 45 patients was detected by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot. The same methods were used to detect the expression of PrxⅡ mRNA and protein in GES-1, MGC-803, MKN-45 and MKN-28. Tissue mi-croarray and immunohistochemistry were used to detect the expression of PrxⅡ protein in gastric cancer tissues and the paired adjacent normal tissues from 116 patients. The relationship between the results and clinicopathological char-acteristics was analyzed. The prognosis was analyzed. Results: According to results of RTFQ-PCR and Western blot, we found that PrxⅡ mRNA and protein in gastric cancer tissues were significantly higher than that in adjacent normal tissues (P<0.05). PrxⅡ mRNA and protein in gastric cancer cells were higher than that in normal gastric cells (P<0.01).Immunohistochemistry revealed that the expression of PrxⅡ protein in gastric cancer tissues (76.7％) was also significantly higher (P<0.01) than that in adjacent normal tissues (30.1％). The expression of PrxⅡ protein is significantly related to tumor size, histological differentiation, depth of invasion, TNM stage and lymph node metastasis (P<0.05), but had no significant relationship with the gender, age, tumor location and distant metastasis. Survival in patients with higher PrxⅡ expression significantly shorter than in those with lower expression (P<0.01). PrxⅡ is an independent prognostic factor of gastric cancer (P<0.05). Conclusion: PrxⅡ promotes the development of gastric cancer. It is one of the adverse prognostic factors of gastric cancer and may serve as a new therapeutic target for gastric cancer.
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Objective To evaluate the clinical effect of reduced glutathione in protecting the liver function for patients with hepatocellular carcinoma (HCC) after receiving international therapy.Methods The clinical data of 110 HCC patients,who were admitted to authors' hospital during the period from January 2010 to June 2013,were retrospectively analyzed.According to the random number table method the patients were divided into the control group (n=50) and the treatment group (n=60),and transcatheter arterial chemoembolzation (TACE) and transcatheter arterial infusion (TAI) were carried out in all patients.After the treatment,intravenous infusion of 2.0 g vitamin C,0.2 g vitamin B6,2.0 g inosine,and 250 ml branched chain amino acid was employed per day for one week for the patients of both groups,and additional intravenous dripping of 1.8 g reduced glutathione (added in 250 ml of 5％ glucose solution) was adopted for the patients of the treatment group.Various liver function indexes were tested before and one week after the treatment,the results were compared between the two groups.Results Before the treatment,no obvious differences in the hepatic functions and in the clinical condition existed between the two groups.One week after the treatment,in both groups the aminotransferase (ALT and AST) and total bilirubin (TBIL) were significantly increased when compared with the preoperative data (P＜0.05),while the serum pre-albumin (PA) was remarkably decreased when compared with the preoperative data (P＜0.05);these changes of various indexes in the treatment group were apparently better than those in the control group (P＜0.05).Conclusion The use of reduced glutathione can effectively relieve the liver function damage caused by interventional therapy in HCC patients,therefore,reduced glutathione has a very good clinical application value.
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<p><b>OBJECTIVE</b>To determine whether there are differences in both the right hepatic vein (RHV) morphology and the size of the angle between the inferior vena cava and the RHV in patients with membranous obstruction of the inferior vena cava (MOVC),in healthy individuals and in patients with cinhosis (HLC), in order to help guide development of an effective interventional treatment program.</p><p><b>METHODS</b>Consecutive patients (n=248) were divided into the following three groups: group A (control; n=94), group B (MOVC patients; n=68), group C (HLC patients; n=86). The angle between the hepatic vein and inferior vena cava was measured and defined as the T value. The morphology of the RHV was classified as N, U, or I. The difference of the constituent ratio was compared among the three groups for the T value and the angle type.Measurement data was calculated as x ± s,and groups were compared using one-way ANOVA; count data was calculated as relative number, and groups were compared using the chi-square test.</p><p><b>RESULTS</b>The average T value of group B was significantly higher than that of group A (56.1 ± 13.7 vs. 49.3 ± 7.8, P=0.010) and of group C (vs. 51.5 ± 10.0, P < 0.001); the difference was statistically significant (F=8.750, P < 0.001), but there was no significant difference between the groups A and C.N-type proportion of B group was 48.5% (33/68), greater than that of group A(16.0%,15/94) and C (16.3%, 14/86), x² = 20.1, x² =18.6.U-type proportion of B group was 11.8% (8/68), smaller than that of groups A (28.7%,27/94) and C (37.2%, 32/86), 2 2 = 6.70, x² =12.8, and the differences were statistically significant (P < 0.01). For groups A and C, the N and U types were not significantly different.</p><p><b>CONCLUSION</b>The angle between the RHV and the inferior vena cava in MOVC patients is morphologically different from that in healthy humans, with the angle value in MOVC patients being slightly larger. However, this difference is irrelevant to cirrhosis.</p>
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Humans , Hepatic Veins , Vena Cava, InferiorABSTRACT
Objective To explore the effect of sequential therapy of transcatheter arterial chemoembolization (TACE) followed by percutaneous microwave coagulation therapy (PMCT) in treating early-stage primary hepatocellular carcinoma (PHC), and to analyze the factors that may affect the prognosis. Methods During the period from Jan. 2011 to Apr. 2014, a total of 66 patients with early-stage PHC were admitted to authors’ hospital. TACE was carried out in all patients, which was followed by PMCT in 5 -7 days. All patients were followed up regularly. CT, MR, ultrasonography, AFP, liver function and other related laboratory tests were performed. Kaplan-Meier estimation was used for the analysis of disease-free survival time. The high-risk factors were analyzed by Chi-square test. Multivariate analysis was conducted by using logistic analysis method. Results After TACE the serum levels of ALT, TBIL and DBIL were increased significantly when compared with preoperative ones (P< 0.01). After sequential PMCT the serum levels of AST, ALT and DBIL were increased significantly when compared with preoperative ones (P< 0.01). When compared with TACE, after sequential PMCT the serum level of AST was increased (P< 0.01), while serum levels of TBIL and DBIL were decreased (P< 0.01). Compared with TACE and preoperative data, the post-PMCT AFP level was decreased (P < 0.01). During the follow-up period one patient died. The 3-year cumulative survival rate was 98.5%. Recurrence was seen in 19 cases. The one-year, 2-year and 3-year disease-free cumulative survival rate was 70.3%, 50.8% and 41.6% respectively. Univariate and multivariate analysis indicated that the risk factors of recurrence in early-stage PHC included AFP ≥ 100 μg/L, viral load≥103 copies/ml and irregularity of tumor border (P<0.05). Conclusion Sequential therapy of TACE followed by PMCT is an ideal treatment for early-stage PHC, sequential PMCT after TACE does not affect liver recovery process. AFP ≥ 100 μg/L, viral load ≥ 103 copies/ml and irregularity of tumor border are the risk factors of recurrence.
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diagnosing of primary hepatocelluar carcinoma , but GP73 combined with AFP detection can significantly improve the diagnostic accuracy , and some primary hepatocelluar carcinoma cases with AFP negative can be avoided missing efficiently by parallel diagnostic test.
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Objective To explore the influential factors of hospital management teaching and to apply new plans to improve quality of teaching. Methods Questionnaire survey was conducted among 94 students majored in health management in Xuzhou Medical College to investigate student' learning behavior as well as contents, applying value, procedures, and teaching effects of the course. Data was put in by Epidata 3.02, described and analyzed by SPSS 18.0. Continous variables were ana-lyzed by t test and classified variables were analyzed by X2 test. Results 25.6%(24/94) students were not interested in this course. 61.7%(58/94) students thought that the course was highly correlated with profession. 56.4%(53/94) students thought that the course was valuable. 35.1%(33/94) students thought that the course was not good in combining theory with practice in teaching. 19.1%(18/94) stu-dents thought that the course was deficient in interactive teaching and teaching methods. 62.8%(59/94) students were satisfied with the teaching effect. Conclusions Main influential factors of hospital man-agement teaching are learning interest, curriculum evaluation and teaching evaluation. To improve quality of hospital management teaching, it is necessary to communicate the importance of the course and to apply new teaching plans to arouse the interests of students.
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Objective To explore the therapeutic efficacy of endovascular embolization for the treatment of tiny intracranial aneurysms (≤3.0 mm) and to discuss its technical skill. Methods During the period from Dec. 2010 to July 2013, a total of 12 patients with tiny intracranial aneurysms (≤3.0 mm) were admitted to authors’ hospital to receive endovascular embolization therapy. Of the 12 patients, narrow-necked aneurysm (neck-to-body ratio ≤0.5) was seen in 7 and embolization with coils only was carried out, while wide-necked aneurysm (neck-to-body ratio > 0.5) was seen in 5 and stent-assisted coils embolization was adopted. Based on Raymond grading standard, the immediate therapeutic results were evaluated, and the procedure-related complications were recorded. Thirty days after the treatment , GOS grade was used to assess the results. Follow-up evaluation with angiography or through call was conducted. Results Successful embolization of the aneurysm was obtained in all the 12 aneurysms , with a success rate of 100%. Angiography performed immediately after the treatment showed that complete embolization was achieved in 8 aneurysms (66.7%) and residual aneurysm cavity was seen in 4 aneurysms (33.3%). GOS grading indicated that 12 cases belonged to grade V. The 12 patients were followed up for 1 - 12 months through telephone , and no re-bleeding occurred. Conclusion For the treatment of tiny intracranial aneurysms (≤ 3.0 mm), endovascular embolization is feasible although its safety and efficacy need to be further observed.
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As a newly - developed medical subject, interventional radiology has been widely popularized for recent years., Taking the first affiliated hospital of Xuzhou medical college for instance, this paper aims to discuss the following three major factors that influence the clinical practice of medical students in interventional radiology at present: the importance to clinical teaching, the changes of doctor-patient relationship and the professional ethic quality education. The perfection measures and countermeasures are also discussed.
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Objective To investigate the prognostic factors affecting the outcome of patients with intermediate-advanced hepatocellular carcinoma (HCC) receiving transcatheter arterial chemoembolization (TACE) combined with percutaneous microwave ablation (MWA). Methods During the period from January 2011 to July 2012 at authors’ hospital, a total of 64 patients with intermediate-advanced HCC were treated with TACE together with MWA. Fourteen potential variables which might affect the prognosis were colleted and were retrospectively analyzed. Kaplan-Meier model and log-rank test were used for single factor analysis, while Cox regression model was used for multiple factor analysis. Results The one-year, 1.5-year and 2-year overall survival rates were 75.8%, 48.4% and 33.9%, respectively. Single factor analysis and Cox regression analysis indicated that six factors, i.e. tumor size, number of tumors, portal vein tumor thrombus, serum α-fetoprotein level, tumor staging and oral administration of sorafenib, bore a relationship to the prognosis. Conclusion The tumor size, number of tumors, portal vein tumor thrombus, serum α-fetoprotein level and tumor staging are risk factors influencing the results of interventional comprehensive therapy , while oral administration of sorafenib is a protective factor for the prognosis.
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Objective To investigate the expression level of serum Golgi protein-73 (GP73) in patients with primary hepatocellular carcinoma (HCC), or accompanied with Budd-Chiari syndrome (BCS), and to discuss its clinical value in making early diagnosis. Methods The peripheral serum samples were collected in 490 individuals, including patients with HCC (n = 65), cholangiocarcinoma (CC, n = 35), Budd-Chiari syndrome accompanied with HCC (n = 40), type B virus hepatitis (n = 60), cirrhosis after B hepatitis (n = 60), Budd-Chiari syndrome complicated by cirrhosis (n = 60), other malignant lesions (n =50), benign hepatic lesions (n = 60) and healthy volunteers (n = 60). The expression levels of serum GP73 and AFP were determined by using Elisa and electrochemiluminescence methods separately. Results The expression level of serum GP73 in the patients with HCC , CC or BCS plus HCC were significantly higher than that in the other individuals (P 0.05). The area under ROC, sensitivity, specificity and the accuracy of GP73 for the diagnosis of CC were 0.774 , 88.6%, 72.7% and 73.9%respectively, and the optimal cut-off value was 45.40 ng/ml. Conclusion In diagnosing HCC, the expression level of serum GP73 is superior to AFP. It is hopeful that serum GP73 may be proved to be an early serum tumor marker for HCC.
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Objective To evaluate the safety and efficacy of interventional treatment of occlusion of the entire inferior vena cava (IVC).Methods The clinical data of 6 patients with entire IVC occlusion were analyzed retrospectively.All patients were diagnosed by color Doppler ultrasound and DSA.Venography was performed under local anesthesia via internal jugular vein and femoral vein approach.The occlusion of IVC and hepatic vein were treated with balloon dilatation and/or stent placement.Follow-up examination with color Doppler ultrasound was taken 1,3,6,12 months after treatment and annually thereafter to assess the patency of IVC and hepatic vein.The pressure gradient of hepatic vein-right atrium and IVC-right atrium before and after interventional treatment were compared with paired t test.Results In 5 cases,both IVC and 1 hepatic vein were recanalized successfully.In 1 case,recanalization of IVC failed,but the right hepatic vein was recanalized successfully.The mean pressure gradient of hepatic vein-right atrium decreased from (23.2 ± 2.0) cmH2O (1 cmH2O =0.098 kPa) before treatment to (8.7 ± 3.2) cmH2O after treatment in 6 cases (t =21.6,P ＜ 0.05).The mean pressure gradient of IVC-right atrium decreased from (26.6 ± 2.7) cmH2O before treatment to (9.4 ± 1.1) cmH2O after treatment (t =16.1,P ＜ 0.05).Abdominal pains occurred in 3 patients after stent implantation which disappeared in 24 hours.No other complications such as bleeding and death occurred.During a mean follow-up of(42 ± 27)months (16 to 90 months),hepatic vein patency was maintained in 6 cases and IVC patency was maintained in 5 cases.Conclusion Interventional treatment of occlusion of the entire IVC is a safe and effective method.