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Objective@#To study the application of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma with mild-to-moderate liver cirrhosis.@*Methods@#There are 14 patients with hepatocellular carcinoma underwent ALPPS at the Department of Hepatobiliary and Pancreatic Surgery, Hong Kong University-Shenzhen Hospital from April 2014 to December 2017. The clinical data was retrospectively studied. The studying objects consisted of 9 males and 5 females, aged from 26 to 71 years old with the average age of 51, all cases were of Child-Pugh grade A. The degree of liver cirrhosis, operation and postoperative complications were analyzed.@*Results@#All 14 patients completed the ALPPS, 1 patient died post stage 2 operation with liver failure. Comparing the groups with no liver cirrhosis (n=4) with the groups of mild liver cirrhosis (n=5) and moderate liver cirrhosis (n=5), the future liver remnant liver volume growth rates were 58%, 46% and 45.6%, respectively. The average operation intervals were 9.0, 11.2 and 12.8 days, respectively. Postoperative complications occurred in 4 patients: 2 patients with liver failure, 1 patient with intestinal obstruction, and 1 patient with hepatic ascites.@*Conclusion@#ALPPS for Child-Pugh grade A, hepatocellular carcinoma with mild-to-moderate liver cirrhosis treatment is safe and feasible.
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Objective@#To investigate the effect of platycodin D on the radiosensitivity of human hepatoma cell lines HepG2 and SMMC-7721 and related mechanisms of action.@*Methods@#MTT assay was used to analyze the effect of different concentrations of platycodin D with different treatment times on cell viability. The cells were pretreated with 5 μg/ml platycodin D for 24 hours followed by X-ray irradiation at different radiation doses. Colony-forming assay was used to measure the radiosensitizing effect of platycodin D on cells. The quasi-threshold dose (Dq), mean lethal dose (Do), extrapolation number (N), sensitizer enhancement ratio (SER), and survival fraction (SF) at different radiation doses were calculated, and the multi-target single-hit model was used to fit the cell survival curve according to the formula SF = l-(l-e-D/D0)N. Flow cytometry was used to investigate the distribution of cell cycle, and Western blotting was used to measure the changes in the protein expression of phosphorylated phosphatidylinositol 3’-kinase (pPI3K), phosphorylated protein kinase (pAkt), nuclear factor-κB (NF-κB), and phosphorylated nuclear factor inhibiting protein (pIκBα). A one-way analysis of variance, the t-test, or the least significant difference test was used for statistical analysis based on the type of data.@*Results@#Platycodin D reduced the viability of HepG2 and SMMC-7721 cells in a dose-dependent manner; the IC50 value for HepG2 cells was 24.2 ± 0.61 μg/ml at 24 hours and 7.68 ± 0.46 μg/ml at 48 hours, and that for SMMC-7721 cells was 23.8 ± 0.57 μg/ml at 24 hours and 8.63 ± 0.86 μg/mL at 48 hours. After the combined treatment with platycodin D and irradiation, there were significant reductions in Dq (P = 0.002), Do (P = 0.002), and N value (P = 0.003), the survival curve markedly shifted to the left, and SER was 1.347 ± 0.04 in HepG2 cells and 1.418 ± 0.05 in SMMC-7721 cells. In addition, platycodin D significantly inhibited the increase in the proportion of cells in G2/M phase, the increases in the protein expression of pPI3k (P = 0.002), pAkt (P = 0.003), and NF-κB (P = 0.002), and the reduction in the protein expression of pIκBα (P = 0.003).@*Conclusion@#Platycodin D can increase the radiosensitivity of HepG2 or SMMC-7721 cells, possibly by enhancing the growth inhibition effect of irradiation and inhibiting the activation of the PI3k/Akt and NF-κB pathways.
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Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treating hepatocellular carcinoma (HCC) under liver capsular. Methods Forty three patients with 62 lesions of HCC under liver capsular received TACE followed by CT?guided percutaneous RFA after 1 to 2 weeks were analyzed retrospectively. The subjects were observed and follow?up imaging with enhanced MRI was performed to evaluate the therapeutic efficacy after combined treatment. The patients were followed up for 10 to 69 months. The patients with residual lesions received a second RFA, the patients with recurrence or new lesions received another TACE combined with RFA. The overall survival rates, median survival time and median time to progression were calculated by using Kaplan?Meier. Results A total of 55 TACE and 68 ablations were performed in 43 patients with 62 lesions. The procedure was successfully accomplished in all patients. The complete ablation rate after the first ablation was 90.3%(56/62). The 1, 3, 5?year overall survival rates were 95.3%, 78.1%and 43.9%, the median survival time was 58 months and the median time to progression was 32 months. Conclution For the treatment of hepatocellular carcinoma under liver capsular, TACE combined with RFA is safe and effective.
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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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MicroRNA (miRNA) is a class of endogenous,single-stranded non-coding small RNA that contains 21 to 23 nucleotides and is widely distributed in eucaryon,miRNA plays an important regulatory role in cell proliferation,apoptosis,growth and development through the regulation of gene translation after transcription and expression,miRNA has a close relationship with pathogenesis and development of hepatocellular carcinoma.And in this process,part of miRNA acts as oncogenes or tumor suppressor genes.A number of miRNA,such as miR-30d,miR-221,miR-222 and miR-101,had been found to express abnormally in hepatoeellular carcinoma.Here we summarize the related progress in research of miRNA and hepatocellular carcinoma.
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Operation is always thought to be the soul way to cure hepatocelluar carcinoma(HCC),but there are only 30% patients who have the opportunity to receive the operation.Transcatheter hepatic arterial cheomoembolization is the most extensive non-surgery approach to treat hepatocelluar carcinoma which also has a lot of shortcoming and limitation.It is common sense that enhancement of effectiveness of liver cancer therapy largely depends on the combined therapy.
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Objective To study the effectiveness of microwave ablation in treating HCC.Methods A total of 98 nodules in 56 cases of HCC were treated via appropriate puncture approach ac-cording to the volume, amount and site of tumor nodules. Results Only 1 patient failed to finish treatment since he could not suffer the pain. The other 55 patients finished without a hitch. Clinical and imaging findings were analyzed for change of physiology. Conclusion The microwave ablation is effective for the treatment of HCC. Such therapy can be important supplement of direct surgical man-agement. Its effect mainly depends on accurate puncture approach and enough diametric range. Mean-while, reasonable puncturing method should be selected.
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The authors report here on a case of focal stricture in the common hepatic duct that was caused by ischemic bile duct injury after repeat TACE procedures for hepatocellular carcinoma, and the patient was successfully treated with a covered self-expandable nitinol stent.
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Humans , Alloys , Bile , Bile Ducts , Carcinoma, Hepatocellular , Chemoembolization, Therapeutic , Cholestasis, Extrahepatic , Constriction, Pathologic , Hepatic Duct, Common , Liver Neoplasms , StentsABSTRACT
0.05), and the 1- and 3-year survival rate of group A was significantly higher than that of group B (P