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Objective To investigate the characteristics of primary liver carcinoma (PLC) in patients with hepatitis B and to analyze the influencing factors. Methods The clinical data of 308 patients with hepatitis B in our hospital from March 2016 to March 2019 were selected to investigate the occurrence of PLC. Univariate analysis and Logistic regression were used to analyze the influencing factors of PLC in patients with hepatitis B. Results The results of this survey showed that 116 of the 308 patients with hepatitis B had PLC (37.66%). The single factor analysis showed that age, diabetes mellitus, family history of PLC, smoking, drinking, eating habits, hepatitis B virus load, e antigen, antiviral therapy, fatty liver and cirrhosis were the influencing factors of PLC in patients with hepatitis B (P 50 years old, diabetes mellitus, family history of PLC, smoking, drinking, poor diet, positive HBV load, positive e antigen, ineffective antiviral therapy, fatty liver and cirrhosis were independent risk factors for PLC in patients with hepatitis B (P < 0.05). Conclusion Patients with hepatitis B were at high risk of PLC. They were affected by various factors. It is important to strengthen the preventative care of patients over 50 years old, with diabetes mellitus, family history of PLC, smoking, drinking, poor diet, hepatitis B virus load positive, e antigen positive, ineffective antiviral therapy, fatty liver, cirrhosis and so on.
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OBJECTIVE:To observe therapeutic efficacy and safety of S-1 capsules combined with recombinant human end-ostatin in the treatment of middle and advanced primary liver carcinoma. METHODS:Totally 94 patients with middle and advanced primary liver carcinoma in the First College of Clinical Medical Science of China Three Gorges university during Feb. 2012-Dec. 2014 were divided into combination group(48 cases)and control group(46 cases)according to random number table. Both groups were given S-1 capsules 40-60 mg orally within 30 min after breakfast and supper. Combination group additionally received Recom-binant human endostatin injection 150 mg added into 0.9%Sodium chloride injection 210 mL with portable micro pump for continu-ous pump of 120 h. A course involved 14 d treatment and 7 d interval. Short-term objective therapeutic efficacy,clinical benefit re-sponse (CBR) and ADR were evaluated after 2 courses. Disease progression time and average survival period were compared be-tween 2 groups. RESULTS:Objective response rate,disease control rate,disease progression time and average survival period of combination group were 14.6%,66.7%,(5.5 ± 1.3) months,(10.7 ± 3.8) months;those of control group were 8.7%,45.6%, (4.8±1.2)months,(8.9±3.3)months,with statistical significance between 2 groups(P0.05). CONCLUSIONS:S-1 combined with recombinant human end-ostatin show good therapeutic efficacy and tolerance for patients with middle and advanced primary liver carcinoma,and do not in-crease the incidence of ADR.
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OBJECTIVE:To evaluate the effectiveness and safety of Shenqi fuzheng injection assisting TACE in the adjuvant treatment of primary liver carcinoma,and to provide evidence-based reference.METHODS:Retrieved from CJFD,Wanfang database,VIP and PubMed,randomized controlled trials (RCTs) about Shenqi fuzheng injection assisting TACE (trial group) vs.TACE alone (control group) in the treatment of primary liver carcinoma were collected.Meta-analysis was performed by using Stata 12.0 software after data extraction and quality evaluation according to improved Jadad scale.RESULTS:A total of 8 RCTs were included,involving 527 patients.Results of Meta-analysis showed that there was no statistical significance in response rate [RR=1.19,95％CI(0.97,1.46),P=0.091] and clinical benefit rate [RR=1.16,95％CI(0.90,1.48),P=0.251] of 2 groups.The rate of life quality improvement in trial group was significantly higher than control group [RR=2.26,95 ％ CI (1.64,3.10),P=0.001],while the incidence of above middle fever [RR=0.74,95％ CI (0.63,0.88),P=0.001],gastrointestinal reaction [RR=0.52,95％ CI (0.32,0.85),P=0.010] and leucocyte reduction rate [RR=0.75,95％ CI (0.62,0.92),P=0.005],were significantly lower than control group,with statistical significance.CONCLUSIONS:Shenqi fuzheng injection assisting TACE for primary liver carcinoma cannot improve therapeutic efficacy but improve the quality of life and reduce the incidence of gastrointestinal reaction and leucocyte reduction.
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OBJECTIVE:To evaluate the effectiveness and safety of Shenqi fuzheng injection assisting TACE in the adjuvant treatment of primary liver carcinoma,and to provide evidence-based reference.METHODS:Retrieved from CJFD,Wanfang database,VIP and PubMed,randomized controlled trials (RCTs) about Shenqi fuzheng injection assisting TACE (trial group) vs.TACE alone (control group) in the treatment of primary liver carcinoma were collected.Meta-analysis was performed by using Stata 12.0 software after data extraction and quality evaluation according to improved Jadad scale.RESULTS:A total of 8 RCTs were included,involving 527 patients.Results of Meta-analysis showed that there was no statistical significance in response rate [RR=1.19,95％CI(0.97,1.46),P=0.091] and clinical benefit rate [RR=1.16,95％CI(0.90,1.48),P=0.251] of 2 groups.The rate of life quality improvement in trial group was significantly higher than control group [RR=2.26,95 ％ CI (1.64,3.10),P=0.001],while the incidence of above middle fever [RR=0.74,95％ CI (0.63,0.88),P=0.001],gastrointestinal reaction [RR=0.52,95％ CI (0.32,0.85),P=0.010] and leucocyte reduction rate [RR=0.75,95％ CI (0.62,0.92),P=0.005],were significantly lower than control group,with statistical significance.CONCLUSIONS:Shenqi fuzheng injection assisting TACE for primary liver carcinoma cannot improve therapeutic efficacy but improve the quality of life and reduce the incidence of gastrointestinal reaction and leucocyte reduction.
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Objective:To investigate the onset of hepatic artery-portal vein shunts (HAPVS) in primary liver cancer (PLC) pa-tients through digital subtraction angiography (DSA) and to devise a suitable strategy for treating both lesions and shunt tracts. In the process, the therapeutic effect on such patients can be enhanced. Methods:A total of 769 PLC patients who accepted transarterial che-moembolization (TACE) were analyzed retrospectively. We examined the image characteristics of 112 cases with HAPVS based on shunt type. For patients with middle or severe fistula, we initially attempted to overpass the fistula. Then, we either embolized the tumor lesions or merely provided chemotherapy to the patients. For patients with mild peripheral fistula, we embolized the tumor and fistula si-multaneously. Then, the accompanying arterial-vein shunt and portal vein tumor thrombus (PVTT) were handled at the same time. Re-sults: DSA findings showed that portal veins were observed in the early stage of angiography. A total of 52 of the 112 cases with HAPVS involved mild shunts, 34 exhibited moderate shunts, and 26 reported severe shunts. Among these cases, 31 involved central-and central peripheral-type artery-portal vein fistula, whereas 81 involved peripheral-type artery-portal vein fistula. Seven cases were examined in combination with hepatic artery-liver vein shunts, and 50 cases were investigated in conjunction with PVTT. Tumor embo-lization was successful in 101 cases (90.1%). Moreover, catheters successfully overpassed shunt tracts and embolized the tumors in 48 cases (42.9%). Shunt tracts were successfully closed in 74 cases (66.1%), and no serious complication was observed. Conclusion:Pe-ripheral-type artery-portal vein fistula and mild-to-moderate shunts were easier to close than central-type artery-portal vein fistula and severe shunts were. Tumor embolization and shunt closure were successful in most patients. Therefore, TACE is a safe and reliable method for treating HAPVS in PLC.
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Objective To improve the clinical diagnosis and prognosis of the treatment of primary liver carcinoma with bone metastasis.Methods A retrospective study on diagnosis and treatment of bone metastasis from 55 cases of primary liver carcinoma was developed.Survival rates were calculated by Kaplan-meier meth-od,univariates analysed by Log-rank and multivariates analysed by Cox regression.Results The 1-,2-and 3-year cumulative survival rates of the cases from primary liver carcinoma were 54.5%,25.5%and 16.4%re-spectively.The mediate survival time was 13 months.And the cases with bone metastasis were 23.6%,10.9%and 1.8%respectively.The mediate survival time was 5.5 months.Factors such as metastasis to other organs,liv-er function,and the combined modality therapy were independent prognostic factors.While number of bone metas-tasis,AFP level and number of liver cancer had no significant relations with the survival rate.Conclusion The prognosis of bone metastasis from primary liver carcinoma is poor.It is important to take emphasis on combined mo-dality therapy,which may be benefit on reducing the symptom,improving the quality and prolong the life span.
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ObjectiveTo determine the risk factors and the optimal management of hepatic artery complications (HAC) after orthotopic liver transplantation.MethodsThe clinical data of 180 orthotopic liver transplantation patients performed between January 2005 and September 2007 was reviewed.The incidence of HAC between primary liver carcinoma and benign diseases of liver was compared.ResultsTwelve (6.7％) episodes of HAC were identified.3 were hepatic artery thrombosis (HAT) and 9 were hepatic artery stenosis (HAS).The incidence of HAC in patients with primary liver carcinoma (6/39) was higher than benign disease (6/141)(P＜0.05).ConclusionsThe keys to management of HAC after orthotopic liver transplantation are to diagnose the complication in time and to select the proper treatment based on the type of HAC.
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Objective To investigate the value of retention rate of indocyanine green at fifteen minutes(ICGR15)during hemihepatectomy for evaluation of residual liver reserve function in patients with primary liver carcinoma.Methods During hemihepatectomy,ICGR15 was tested in 44 patients after the hepatic artery and portal vein of resected side were ligated.Child-Pugh score,Child-Pugh classification,and MELD score before operation were tested.After operation,the liver function condition was estimated.Results The incidence of liver dysfunction was significantly lower in ICGR150.05).ICGR15 and MELD score in normal liver function group were statistical lower than those in mild insufficiency of liver function group and severe insufficiency of liver function group(P
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Objective To evaluate the value of MR imaging with a contrast enhanced multi phasic isotropic volumetric interpolated breath hold examination (VIBE) in diagnosis of primary liver carcinoma. Methods Thirty two consecutive patients with surgical pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two dimensional (2D) T1WI and T2WI images were acquired before administration of Gd DTPA for contrast enhancement. Then, contrast enhanced multi phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results 33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non enhanced T1WI, enhanced T1WI and enhanced 3D VIBE images ( P
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The subject of this study was a 64-year-old male. He had experienced a sensation of abdominal fullness during treatment for chronic hepatitis C at a neighborhood clinic. He was referred to our hospital for work-up upon discovery of elevated AFP.<br>Examination on admission revealed abdominal swelling, ascites and marked swelling of the liver. The AFP was 11, 535ng/m<i>l</i>. A tumor measuring 9 by 8 centimeters was revealed in the right lobe of the liver on the CT scan, and there were many metastatic lesion 1cm in diameter in both the lung field. Since the liver tumor was considered unresectable, in August 1992, MMC and ADM were administered intraarterially just once at doses of 10 and 20mg, respectively. At the end of August, oral administration of UFT at a dose of 600mg/day was started.<br>The patient was discharged after 3 weeks of treatment, but the administration of 300mg/day of UFT was continued, Since hepatic function tended to be aggravated, administration of Shosaiko-to (EK-9) was commenced at a dose of 6g/day. With the combination therapy, the symptoms were gradually relieved and the subjective symptoms disappeared. In September 1992 (8 months after initiation of Shosaiko-to administration), the shadows due to lung metastasis were absent on the chest x-ray examination, and the CT scan turned negative for the tumor in the right lobe. AFP and PIVKA-II decreased below 11.7ng/m<i>l</i> and 0.06AU/m<i>l</i>, respectively. As of December 1994, the patient is still on combination therapy consisting of Shosaiko-to and UFT. Neither adverse reactions such as weight loss have been induced nor has the tumor returned. The general condition of the patient is good.<br>The results obtained in this case suggest that Shosaiko-to and UFT in combination are effective in treating liver carcinoma.