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PURPOSE: Unplanned conversion is sometimes necessary during minimally invasive liver resection (MILR) of hepatocellular carcinoma (HCC). The aims of this study were to compare surgical outcomes of planned MILR and unplanned conversion and to investigate the risk factors after unplanned conversion.METHODS: We retrospectively analyzed 286 patients who underwent MILR with HCC from January 2006 to December 2017. All patients were divided into a MILR group and an unplanned conversion group. The clinicopathologic characteristics and outcomes were compared between the 2 groups. In addition, surgical outcomes in the conversion group were compared with the planned open surgery group (n = 505). Risk factors for unplanned conversion were analyzed.RESULTS: Of the 286 patients who underwent MILR, 18 patients (6.7%) had unplanned conversion during surgery. The unplanned conversion group showed statistically more blood loss, higher transfusion rate and postoperative complication rate, and longer hospital stay compared to the MILR group, whereas no such difference was observed in comparison with the planned open surgery group. There were no significant differences in overall and disease-free survival among 3 groups. The right-sided sectionectomy (right anterior and posterior sectionectomy), central bisectionectomy and tumor size were risk factors of unplanned conversion.CONCLUSION: Unplanned conversion during MILR for HCC was associated with poor perioperative outcomes, but it did not affect long-term oncologic outcomes in our study. In addition, when planning right-sided sectionectomy or central bisectionectomy for a large tumor (more than 5 cm), we should recommend open surgery or MILR with an informed consent for unplanned open conversions.
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Humans , Carcinoma, Hepatocellular , Disease-Free Survival , Informed Consent , Length of Stay , Liver , Postoperative Complications , Retrospective Studies , Risk FactorsABSTRACT
BACKGROUND/AIMS: Tenofovir disoproxil fumarate (TDF) is potentially nephrotoxic in chronic hepatitis B patients. Hepatocellular carcinoma (HCC) patients treated using transarterial chemoembolization (TACE) are at an increased risk of renal injury. The aim of this study was to determine whether TDF is associated with more renal adverse events than entecavir (ETV) in HCC patients treated with TACE. METHODS: In this retrospective single-center study, we selected 53 HCC patients who were treated with TDF from January 2012 to July 2013 and had their first TACE procedure in the same period. These patients were matched by age and sex to patients treated with ETV. RESULTS: There were no significant differences in baseline characteristics, including HCC factors, and nephrotoxic drug use, between the two groups. The median follow-up period was 17.0 and 20.0 months for the TDF and ETV groups, respectively. There was no difference during the follow-up period between the TDF and ETV groups in the increase in creatinine over 0.5 mg/dL (17.0% and 17.0%, P=1.00, respectively) and the decrease in eGFR over 25% (43.4% and 41.5%, P=0.84, respectively). Multivariate analysis revealed that Child-Pugh class over B (hazard ratio [HR], 7.30; 95% confidence interval [CI] 2.79–19.10; P<0.01) was associated with increase in creatinine, and Child-Pugh class over B (HR, 82.74; 95% CI 12.31–555.83; P<0.01) and Barcelona-Clinic Liver Cancer stage over B (HR, 14.93; 95% CI 1.60–139.51; P=0.02) were associated with decrease in eGFR. CONCLUSIONS: TDF has comparable safety to that of ETV for HCC patients undergoing TACE.
Subject(s)
Humans , Antiviral Agents , Carcinoma, Hepatocellular , Creatinine , Follow-Up Studies , Hepatitis B, Chronic , Kidney Diseases , Liver Neoplasms , Multivariate Analysis , Retrospective Studies , TenofovirABSTRACT
Objective: To detect the expressions of enhancers of zeste homolog 2 (EZH2), matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in hepatocellular carcinoma (HCC) tissues, analyze the correlation of EZH2, MMP-2 and MMP-9 expressions in HCC tissues with the clinicopathological factors of HCC to explore the role of EZH2 in the invasion and migration of HCC cells and the regulatory effects of EZH2 on MMP-2 and MMP-9. Methods: The expressions of EZH2, MMP-2 and MMP-9 in HCC tissues was detected by qRT-PCR. We analyzed the relationship of EZH2, MMP-2 and MMP-9 with the clinicopathological factors of HCC. Pearson correlation was used to analyze the correlation between EZH2, MMP-2 and MMP-9 expressions in HCC tissues. SMMC-7721 HCC cell lines with down-regulated EZH2 expression were constructed by small interfering RNA transfection. Transwell assay was used to observe the effects of EZH2 on invasion and migration of SMMC-7721 cells. qRT-PCR was used to detect the regulatory effects of EZH2 on MMP-2 and MMP-9 in HCC cells. Results: EZH2, MMP-2 and MMP-9 expressions were increased in HCC tissues, and they were correlated with adverse clinicopathological factors. There was a significant correlation between the expressions of EZH2 and MMP-9 in HCC tissues. Deletion of EZH2 significantly inhibited the invasion and migration of HCC cells and inhibited MMP-9 expression in HCC cells. Conclusion: EZH2, MMP-2 and MMP-9 are all closely associated with HCC progression, and they can be potential biomarkers and therapeutic targets for HCC.
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We report two cases of needle-tract seeding after cryoablation and radiofrequency ablation for hepatocellular carcinomas. The seeding nodule appeared 6 and 12 months on the follow-up computed tomographic scan, respectively. In both cases, the seeding nodules were solitary in the chest wall, and could be completely resected.
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Ablation Techniques , Carcinoma, Hepatocellular , Catheter Ablation , Cryosurgery , Follow-Up Studies , Thoracic Wall , ThoraxABSTRACT
Objective To observe Hedgehog signaling pathways of liver cancer cell growth and the influence of the metastatic potential targeted inhibit Hedgehog.Methods Construction of Smo shRNA plasmid,The stable and low-expressed Smo-expressing HCC QGY-7701 cell line was screened after lipofection.The stable and low-expressed Smo-expressing HCC QGY-7701 cell line was screened,The cell cycle,apoptosis,invasion and metastasis of QGY-7701 cells were detected by Western blot,flow cytometry,CCK8 and transwell assay.Subcutaneous implantation of hepatocarcinoma cells in nude mice.Study on the growth and metastasis of hepatocarcinoma cells with low expression of Smo in.The ultrastructural changes of hepatoma cells with low expression of Smo were observed under electron microscope.Results RT-PCR and Western blot showed stable shR-Smo cell line was successfully constructed.Cell cycle test showed that compared with the control group,G0/G1 cells increased in shR-Smo,cells in S phase decreased;apoptosis,CCK8 and Transwell tests showed that Smo-gene silencing could significantly increase the apoptosis percentage of the hepatic cancer cells to (5.46％ ± 1.46％),proliferation activity decreasedand and the migration rates reduced to (7.82％ ±2.14)％;nude mice model showed that Smo-gene silencing could inhibit the growth of hepatocellular carcinoma cells in vivo,electron microscopy revealed that lysosomes increased significantly in Smo-gene silence cells.Conclusions Blocking Hh signaling pathways,liver cancer cells in vitro malignant degree of decline.Hedgehog in treating liver cancer have hidden meaning.
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Objective To investigate the potential prognostic factors in patients with hepatocellular carcinoma (HCC) complicate by portal vein tumor thrombosis (PVTT) who are treated with transcatheter arterial chemoembolization (TACE). Methods The complete clinical data of a total of 46 patients with HCC complicate by PVTT, who were treated with TACE during the period from January 2010 to March 2016, were retrospectively analyzed. Clinical material database was established. Kaplan-Meier test was adopted to analyze the survival rate and the COX risk ratio model was used to screen out the independent prognostic factors. Life table method was employed to calculate the survival time. Results The 6-, 12-, 18- and 24-month survival rates were 51. 2％, 28. 9％, 23. 4％ and 10. 2％, respectively. The median survival time was 6. 7 months. According to mRECIST standard, complete remission (CR) was obtained in one patient (2. 1％), partial remission (PR) in 11 patients (23. 9％), stable disease (SD) in 16 patients (34. 8％) and progress disease (PD) in 18 patients (39. 2％). Multivariate analysis indicated that local tumor response, ascites, cholinesterase, and arteriovenous fistula were the independent factors affecting the prognosis. Conclusion The independent prognostic factors that affect the survival time of HCC patient include local tumor response, ascites, cholinesterase and arteriovenous fistula. (J Intervent Radiol, 2018, 27: 266-271)
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Objective To investigate the impact of combined postoperative transcatheter arterial chemoembolization (TACE) with antiviral therapy in hepatitis B-related hepatocellular carcinoma (HBV-HCC) patients with high risks of recurrence.Methods Fifty-three consecutive patients who underwent curative resection of HBV-HCC between January 2014 to February 2016 were enrolled.These patients were assigned to either the adjuvant antiviral therapy combined with TACE group (n =32),the treatment group or the no adjuvant treatment group (n =21,the control group).The recurrence-free survival (RFS) and overall survival (OS) were analyzed.Results There was no significant difference between the two groups in clinical characteristics (P＞0.05).The recurrence-free survival (RFS) (mean±S.D.) was (20.1 ± 1.8) months in the treatment group and (18.7±2.4) months in the control group (P=0.752).The 1-,2-and 3-year RFS rates of the treatment group and the control group were 65.6％ vs.57.1％,31.3％ vs.28.6％ and 15.6％ vs.14.3％,respectively (P＞0.05).The overall survival (OS) (mean±S.D.) was (26.8± 1.7) months in the treatment group and (21.1±2.2) months in the control group (P=0.037).The 1-,2-and 3-year RFS rates were 65.6％ vs.57.1％,31.3％ vs.28.6％ and 15.6％ vs.14.3％ in the treatment group and the control group,respectively.The 1-,2-,and 3-year OS rates were 87.5％ vs.66.7％,59.4％ vs.38.1％ and 43.8％ vs.19.0％ in the treatment group and the control group,respectively.Conclusion Antiviral therapy in combination with TACE did not decrease the RFS rate,but it improved the OS rate in HCC patients with high risks of recurrence.
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In recent years, a rapid development has been achieved in the clinical prevention of hepatocellular carcinoma recurrence after liver transplantation, especially in perioperative management, which are supported by the results of evidence-based studies.However, due to the complicated procedures and varied risk factors for liver transplantation, the prevention of postoperative carcinoma recurrence remains a challenge and a focus of research in liver transplantation.This study reviews the perioperative measures for the prevention of hepatocellular carcinoma recurrence after liver transplantation, aiming to shed some light on this aspect for graduates and clinicians of surgery.
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Objective To investigate the factors that may affect the prognosis of patients with moderate-advanced hepatocellular carcinoma (HCC) who are receiving sorafonib therapy.Methods The clinical data of 38 HCC patients,whose diagnoses were confirmed by pathology or clinical imaging and were in accord with the Barcelona Clinic Liver Cancer (BCLC) staging criteria,were retrospectively analyzed.Sorafenib 400 mg was orally given twice everyday,and according to modified RECIST criteria the tumor response was evaluated once every 4-6 weeks,the adverse events were recorded,and the drug toxicity was evaluated by grading standard 3.0 edition for common adverse reactions formulated by American National Cancer Institute.Results Among the 38 patients,one patient developed hepatic encephalopathy after took sorafenib for two weeks,and medication had to be stopped.Of other 37 patients,14 patients developed pancreatic atrophy in different degrees (positive group),the median progression free survival (mPFS) was 9.0 months,and the median overall survival (mOS) was 25.8 months;pancreatic atrophy didn't occurred in the remaining 23 patients (negative group),the mPFS was 3.3 months,and the mOS was 8.4 months.The differences in mPFS and in mOS between the two groups were statistically significant (P＜0.01 and P=0.025respectively).The main adverse events included hand-foot skin reaction,diarrhea,fatigue and weight loss,which were relieved after symptomatic treatment,and no severe untoward effect occurred.Conclusion Certain correlation exists between pancreatic atrophy and the curative effect of sorafenib.For patients who develop severe diarrhea associated with pancreatic atrophy,a longer survival time as well as a longer stable state of disease can be expected.(J Intervent Radiol,2017,26:258-262)
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To study the expression of microRNA-544 (miR-544) in hepatocelluar carcinoma (HCC) tissues and its effect on proliferation, apoptosis, colony formation and sphere-forming potential of HCC cells, so as to explore the role of miR-544 in carcinogenesis and development of HCC. Methods Quantitative real-time PCR was used to detect the expressions of miR-544 in liver tissues from rats treated with diethylnitrosamine (DEN), in HCC and adjacent non-tumor tissues from patients, and in HCC spheres after sphere-forming culture. After HCC cell line Hep3B being transfected with miR-544 mimic or miR-544 inhibitor, cell counting kit-8 (CCK-8) was used to detect the proliferation of the HCC cells, colony-formation assay was used to observe the colony-formation ability of the HCC cells, and flow cytometry was used to analyze the cell apoptosis of HCC cells with propidium iodide staining. The sphere-formation assay was performed to determine the sphere-forming potential of HCC cells transfected with miR-544 mimic. Results MiR-544 expression was significantly down-regulated in the HCC tissues of DEN-treated rats (versus the control rats without modelling, P<0.05) and HCC tissues of patients (versus adjacent non-tumor tissues, P<0.01). Overexpression of miR-544 significantly inhibited proliferation (P<0.05, P<0.01) and colony-formation potential (P<0.05) of HCC cells, and also significantly promoted the apoptosis of HCC cells at 72 h (P<0.01). While inhibition of miR-544 in HCC cells significantly promoted the cell proliferation (P<0.01) and colony-formation potential (P<0.05). MiR-544 expression was significantly down-regulated in sphere-forming HCC cells during enrichment culture of liver cancer stem cells (P<0.05), and overexpression of miR-544 inhibited the sphere-formation of HCC cells (P<0.05). Conclusion MiR-544 expression is reduced in HCC tissues and can inhibit the malignant biological behaviors of HCC cells, indicating its inhibitory roles in the development and progression of HCC.
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BACKGROUND/AIMS: Gastric hepatoid adenocarcinoma (GHA), a rare type of primary gastric cancer, is characterized by a histology resembling hepatocellular carcinoma. Previous case studies reported that patients with GHA have a poor prognosis due to early lymph node or liver metastasis, but information concerning GHA is still limited. Therefore, we aimed to evaluate the clinicopathological features of GHA. MATERIALS AND METHODS: We reviewed the medical records of 9 patients who were diagnosed as having GHA between January 2011 and December 2016. The clinicopathological characteristics of these patients were retrospectively analyzed. RESULTS: The median age of the patients at diagnosis was 68.9 years. Seven of the 9 patients were male. Serum AFP levels were elevated in 3 of 4 patients. All the tumors were >4 cm (range, 4~12 cm), and 7 tumors were located at the lower third of the stomach. Five tumors were classified as Borrmann's type 3, with a purple, berry-like surface. Of the 6 patients without distant metastasis, 5 received curative-intent surgery and 3 received adjuvant chemotherapy. Three patients with distant metastasis received either palliative operation and/or chemotherapy. Their median survival time was 11.8 months (range, 1~36 months). Two patients with elevated serum CEA levels had poor outcomes. CONCLUSIONS: GHA is a rare subtype of gastric cancer that is prone to liver metastasis. All GHAs are advanced gastric cancer with a purple, berry-like surface at diagnosis. Although the prognosis of advanced-stage GHA is poor, active multimodality treatment might provide some benefit.
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Humans , Male , Adenocarcinoma , Carcinoma, Hepatocellular , Chemotherapy, Adjuvant , Diagnosis , Drug Therapy , Endoscopy , Liver , Lymph Nodes , Medical Records , Neoplasm Metastasis , Prognosis , Retrospective Studies , Stomach , Stomach NeoplasmsABSTRACT
Objective: To evaluate vascular endothelial growth factor (VEGF) levels in hepatocel-lular carcinoma patients before and after transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) and its relation to treatment response. Methods: A total of 40 patients with unrespectable hepatocelluar carcinoma were assessed clinically. Twenty patients were suitable to be treated by TACE, while other 20 patients were treated with PEI. Serum VEGF levels were measured before and 1 month after each procedure by ELISA. Response was assessed after 1 month according to Union Internationale Contre le Cancer evaluation criteria based on change in tumor size as measured by ultrasound. Results: There was no significant difference between TACE and PEI groups with regard to age, sex, tumor size, response to local therapy, or VEGF and alpha-fetoprotein before and after therapy. VEGF levels after TACE were significantly higher than before TACE [(298.1 ± 123.6) pg/mL vs. (205.8 ± 307.3) pg/mL;P=0.001]. Also, VEGF levels were significantly higher after PEI than before PEI [(333.8 ± 365.6) pg/mL vs. (245.3 ± 301.8) pg/mL;P=0.000]. Non-responders of both groups had significantly high VEGF levels than responder's, both before [(985.0 ± 113.2) pg/mL vs. (117.1 ± 75.3) pg/mL;P Conclusions: Both TACE and PEI were associated with an increase in serum VEGF in hepatocelluar carcinoma patients. Higher levels of VEGF before and after therapy were found in non-responders, suggesting that VEGF is a useful marker in predicting treatment response.
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Objective: To evaluate vascular endothelial growth factor (VEGF) levels in hepatocellular carcinoma patients before and after transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) and its relation to treatment response. Methods: A total of 40 patients with unrespectable hepatocelluar carcinoma were assessed clinically. Twenty patients were suitable to be treated by TACE, while other 20 patients were treated with PEI. Serum VEGF levels were measured before and 1 month after each procedure by ELISA. Response was assessed after 1 month according to Union Internationale Contre le Cancer evaluation criteria based on change in tumor size as measured by ultrasound. Results: There was no significant difference between TACE and PEI groups with regard to age, sex, tumor size, response to local therapy, or VEGF and alpha-fetoprotein before and after therapy. VEGF levels after TACE were significantly higher than before TACE [(298.1 ± 123.6) pg/mL vs. (205.8 ± 307.3) pg/mL; P = 0.001]. Also, VEGF levels were significantly higher after PEI than before PEI [(333.8 ± 365.6) pg/mL vs. (245.3 ± 301.8) pg/mL; P = 0.000]. Non-responders of both groups had significantly high VEGF levels than responder's, both before [(985.0 ± 113.2) pg/mL vs. (117.1 ± 75.3) pg/mL; P < 0.001] and after therapy [(1. 330.6 ± 495.7) pg/mL vs. (171.0 ± 94.7) pg/mL; P = 0.000)]. Conclusions: Both TACE and PEI were associated with an increase in serum VEGF in hepatocelluar carcinoma patients. Higher levels of VEGF before and after therapy were found in non-responders, suggesting that VEGF is a useful marker in predicting treatment response.
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For a small hepatocellular carcinoma (HCC), liver resection shows most favorable outcome in case which liver transplantation is not available, although it has also substantial recurrence rate. Here, we report a case of recurred HCC with multiple intrahepatic metastasis at 5 months after surgical resection for small HCC was done. A 55-year-old man with chronic HBV infection received subsegmentectomy for HCC less than 2 cm. A follow-up computed tomography (CT) at 5 months from operation revealed that there were multiple enhancing nodules in entire remnant liver. Intra-arterial injections of adriamycin mixed lipiodol and gelfoam particles were instituted through hepatic artery. We assume that poorly differentiated cellular feature would be attributable to this kind of very early and aggressive recurrence of HCC.
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Humans , Middle Aged , Carcinoma, Hepatocellular , Doxorubicin , Ethiodized Oil , Follow-Up Studies , Gelatin Sponge, Absorbable , Hepatic Artery , Injections, Intra-Arterial , Liver , Liver Transplantation , Neoplasm Metastasis , RecurrenceABSTRACT
Objective To observe the therapeutic effects and comphcations of treatment by using transcatheter arterial chemombolization(TACE) combined with functional splenic embolization(FSE) on patients with primary hepatocelluar carcinoma (HCC) combinded with hypersplenism.Methods Eighty HCC patients with hypersplenism were randomly divided into two groups by computer program.Observation group was treated with TACE and FSE,while control group was treated by only TACE.The iodine oil deposition,blood routine parameters and related complications were observed.Results (1) After one-month' s treatment,abdominal CT scan showed that 38 cases(79.17％) of patients in the observation group and 27 cases (84.38％) of patients in control group had iodine oil deposition in over 50％ of the tumor area.(2) The white blood cell counting in observation group were (7.65 ± 2.3) × 109/L,(5.89 ± 1.9) × 109/L,(5.02 ± 1.7) × 109/L in the follow-up examination 1 week,1month and 3 month after splenic embolization,respectively,which were significantly increased from the preoperative level of (2.21 ± 1.1) × 109/L(P ＜ 0.05).Platelets counting were (93 ± 29)× 109/L,(127 ± 32) × 109/L and (119 ± 26) × 109/L in observation group at 1 week,1 month and 3 month after splenic embolization,respectively,which were significantly higher than the preoperative level of (39 ± 20)× 109/L (P ＜ 0.05).In the control group,there were no statistically significant difference between the preoperative and postoperative levels (P ＞ 0.05).(3) Both of the the two groups showed no serious complications.Conclusion TACE combined with FSE is a safe and an effective method to treat hypersplenism combined in HCC patients.
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Objective To study the results of repeat hepatectomy,followed by transcatheter arterial chemoembolization (TACE) and percutaneous microwave coagulation therapy (PMCT),but with or without portal vein chemotherapy (PVC) in patients with recurrence of hepatocelluar carcinoma (HCC) after partial hepatectomy.Methods The data of 33 patients were analyzed retrospectively.All these patients received repeat hepatectomy.They were then divided into two groups:the PVC group (n =19) was treated with PVC + TACE + PMCT,and the non-PVC group (n =14) with TACE + PMCT.Results For the 33 patients,13 (39.4％) developed tumor recurrence ＞2 years from the initial resection while 20 patients (60.6％) developed recurrence within ≤ 2 years.The tumor recurrence consisted of local recurrence in 14 patients (42.4％),and heterochronous recurrence in 19 patients (57.6％).There was a significantly difference in the cumulative survival rates between the two groups (x2 =4.319; P =0.038).The 1y,3y,5y survival rates were 84.2％,42.1％,31.6％ in the PVC Group,and 71.4％,28.6％,14.3％ in the Non-PVC Group respectively.28 sessions of PMCT and 97 sessions of TACE were performed postoperatively (the medians were 1,0.5; 3,3 respectively,the mean ranks were 17.68,16.07; 15.05,19.64 respectively,and the P values were 0.612,0.163 respectively between the two groups).Conclusions For patients with recurrence of HCC after hepatic resection,after repeat hepatectomy PVC + TACE + PMCT gave better survival than those with TACE + PMCT but without PVC.
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Objective To retrospectively analyze the effect of interventional embolization for hepatocelluar carcinoma (HCC) associated with arteriovenous shunting (AVS), and to discuss the factors influencing the therapeutic results. Methods The clinical data of 62 cases with HCC associated with AVS , who were treated with interventional chemoembolization , were retrospectively analyzed. Based on the type and extent of AVS identified by angiographic manifestations, appropriate obstruction of the shunt and Lipiodol chemoembolization of HCC were conducted. The curative effect of the shunt embolization was assessed by DSA at one or two months after the treatment. The relevant factors influencing the prognosis of embolization were analyzed by using univariate and multivariate Cox regression analysis methods. Results Of the 62 patients, arterioportal shunting (APS) was detected in 44, hepatic arterio-venous shunting (HAVS) in 11, APS together with HAVS in 4, and hepatic artery-pulmonary artery shunting (HAPAS) in 3. Re-examination with DSA was carried out in 53 patients at 1 - 2 months after the treatment , which showed that the shunting disappeared in 18 cases, obvious reduction of the shunt flow was seen in 19 cases, the lesion remained stable in 9 cases and the disease became worse in 7 cases. Univariate analysis indicated that the kind of embolic material and the presence of tumor thrombus could affect the obstructive result of the shunt , while multivariate Cox regression analysis showed that portal tumoral thrombus was an independent risk factor. The embolization effect of polyvinyl alcohol (PVA) particles and Lipiodol-ethanol mixture, used as the embolic agents, was better than that of gelatin sponge particles. Conclusion To ensure a successful interventional chemoembolization for HCC combined with AVS the procedure should be individualized according to the type and extent of the arteriovenous shunting. The type of embolic materials used for embolization can affect the results to a certain degree.
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Objective To assess the association between polymorphisms in HIF1α gene and prognosis of advanced hepatocelluar carcinoma.Methods We collected prognosis data from a cohort of 448 advanced HCC patients treated by transarterial chemoembo-lisation,and used 5ml peripheral blood from patients for extraction DNA.Three SNPs (rs2301 1 13、rs2057482 and rs1 957757 )in HIF1αgene were selected and genotyped.Multivariate Cox proportional hazards model,Kaplan-Meier curve and log-rank test were used for prognosis analyses.Results The variant-containing genotypes (WV+VV)of SNP rs2301 1 13 exhibited a significant associ-ation with a better overall survival in HCC patients who had tumor size smaller than 5 cm (hazard ratio [HR],0.58,95% confidence interval [CI],0.35-0.96,P =0.036).In the patients taken single tumor subgroup,the variant-containing genotypes (WV+VV) of SNP rs2301 1 13 exhibited a significant association with a better overall survival (log-rank P =0.048),comparing to those carrying wild-type genotype.Conclusion Our results suggest that polymorphisms in HIF1αgene may serve as an independent prognosis bio-marker for advanced HCC patient.
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Metastases from hepatocellular carcinoma to the bones of the hands or feet are rare. They are usually a late manifestation of a disseminated tumor but may also be the primary manifestation of an occult cancer. Clinically, the metastasis may mimic benign tumors or non-neoplastic osteoarthritic conditions; thus, resulting in misdiagnosis and improper treatment. We report a case of acrometastasis to the right first metatarsal bone in a 70-year-old man with hepatocellular carcinoma.
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Carcinoma, Hepatocellular , Diagnostic Errors , Foot , Hand , Hydrazines , Metatarsal Bones , Neoplasm MetastasisABSTRACT
No abstract available.