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Objective:To explore the effects of Jianpi Huaji Fuzheng Decoction supplemented with conventional chemotherapy on Traditional Chinese Medicine (TCM) syndromes scores, cellular immunity and coagulation-fibrinolysis function in patients with primary hepatic carcinoma of spleen-deficiency syndrome.Methods:Prospective cohort study. A total of 85 patients with primary hepatic carcinoma of spleen-deficiency syndrome who met the inclusion criteria in the hospital between March 2018 and March 2021 were divided into 42 cases in control group and 43 cases in observation group according to the random number table method. The control group was given conventional western medicine chemotherapy, and the observation group was given Jianpi Huaji Fuzheng Decoction on the basis of the control group. Both groups were treated for 3 months. Before and after treatment, the TCM syndromes were scored. The levels of CD4 + and CD8 + were detected by flow cytometry with indirect immunofluorescence, and the ratio of CD4 +/CD8 + was calculated. The plasma prothrombin time (PT), fibrinogen (Fg) and coagulation factor Ⅶ (CFⅦ) were detected by automatic blood coagulation analyzer. The toxic and side effects of chemotherapy during treatment were recorded and the clinical efficacy was evaluated. Results:The total effective rate of syndrome efficacy was 95.35% (41/43) in observation group and 78.57% (33/42) in control group ( χ2=3.92, P=0.047). After treatment, the scores of flank pain, lumps, fatigue and jaundice and total score in observation group were significantly lower than those in the control group ( t=2.60, 2.64, 2.85, 2.91, 3.79, P<0.01). The level of CD4 + [(37.68±3.72)% vs. (35.92±3.61)%, t=2.21] and CD4 +/CD8 + [(1.44±0.22) vs. (1.31±0.23), t=2.66] in observation group were significantly higher than those in the control group ( P<0.05), while the level of CD8 + [(26.20±2.72)% vs. (27.44±2.16)%, t=2.32] was significantly lower than that of the control group ( P<0.05). The levels of Fg [(3.11±0.85) g/L vs. (2.74±0.72) g/L, t=2.16] and CFⅦ [(1.76±0.44) mg/L vs. (1.58±0.37) mg/L, t=2.04] were significantly higher than those in the control group ( P<0.05). PT [(14.65±2.72) s vs. (15.91±3.03) s, t=2.02] was significantly shorter than that of the control group ( P<0.05). During treatment, the incidence rate of toxic and side effects of chemotherapy was 11.63% (5/43) in observation group and that in control group was 30.95% (13/42) ( χ2=4.75, P=0.029). Conclusion:Jianpi Huaji Fuzheng Decoction supplemented with conventional chemotherapy can improve the clinical symptoms, promote the recovery of cellular immune function and coagulation-fibrinolysis function, reduce the incidence rates of toxic and side effects of chemotherapy, and enhance the clinical efficacy of patients with primary hepatic carcinoma.
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Objective:To investigate the value of serum thymidine kinase-1 (TK1) and matrix metalloproteinase-9 (MMP-9) level in prognosis evaluation of patients with primary hepatic carcinoma (PHC).Methods:100 PHC patients treated in Panjin Central Hospital from December 2015 to December 2017 were retrospectively selected and divided into survival group ( n=73) and death group ( n=27) according to the prognosis. The clinical characteristics and serum TK1 and MMP-9 levels of the two groups were compared. The relationship between serum TK1 and MMP-9 levels and the clinical characteristics and prognosis of PHC was analyzed. Receiver operating characteristic (ROC) curve was drawn to analyze the value of TK1 and MMP-9 in evaluating the prognosis of PHC. Results:The proportion of multiple lesions, low differentiation, tumor node metastasis (TNM) stage Ⅲ-Ⅳ, extrahepatic metastasis and microvascular invasion in the survival group were lower than those in the death group, and the levels of serum TK1 and MMP-9 were also lower than those in the death group (all P<0.05); The levels of serum TK1 and MMP-9 had no significant correlation with gender, age, tumor length and diameter and child Pugh liver function grade of PHC patients (all P>0.05), but were closely related to the number of lesions, degree of differentiation, TNM stage, extrahepatic metastasis and microvascular invasion (all P<0.05). The areas under the ROC curve of serum TK1 and MMP-9 levels predicting the prognosis of PHC were 0.859 and 0.830. The 3-year survival rate of PHC patients with high level of TK1 and MMP-9 was significantly lower than that of low level patients (all P<0.05). Conclusions:The serum TK1 and MMP-9 levels are correlated with the condition and prognosis of patients with PHC, and can be used as reference indexes for early prognosis evaluation.
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ObjectiveTo investigate the molecular mechanism of cordycepin inhibiting proliferation and promoting apoptosis of human hepatoma cells （HCCs）. MethodGlioma-associated oncogene homolog 1 （Gli1） gene was silenced by small interfering RNA （siRNA） and transfected into SMMC-7721 cells， and then cell proliferation was detected by cell counting kit-8 （CCK-8） assay and cell cloning assay. SMMC-7721 cells were treated with different concentration of cordycepin， and the cell proliferation and apoptosis were examined. The expression of Gli1 and the downstream related genes was determined by Real-time polymerase chain reaction（PCR） and Western blot. ResultThe mRNA and protein expression of Gli1 in SMMC-7721 cells was higher than that in normal liver cells （P<0.01）. The proliferation rate of SMMC-7721 with silenced Gli1 decreased at 72 and 96 h （P<0.05， P<0.01）， and the colony-forming capacity lowered （P<0.01） compared with those in the blank group. Compared with the control， 80 μmol·L-1 and 120 μmol·L-1 cordycepin significantly inhibited the proliferation of SMMC-7721 cells at 72 and 96 h （P<0.05， P<0.01）， and promoted the apoptosis of them （P<0.01）. Moreover， 80 and 120 μmol·L-1 cordycepin restrained the mRNA and protein expression of Gli1 in SMMC7721 cells （P<0.05， P<0.01）. At 120 μmol·L-1， cordycepin led to the decrease in the mRNA and protein levels of B-cell lymphoma-2 （Bcl-2） and c-Myc （P<0.05， P<0.01）， and the increase in the mRNA and protein expression of cysteine-aspartic acid protease-3 （Caspase-3） （P<0.05）. ConclusionGli1 is highly expressed in HCCs， and cordycepin can suppress the proliferation and enhance the apoptosis of HCCs by regulating Gli1 and the downstream apoptosis-related factors.
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Objective:The aim of this study was to analyze the relationship between the changes of pre- and post-operation PET/CT metabolic parameters and prognosis for liver cancer patients.Methods:A retrospective study was carried out among 92 patients with liver cancer who received liver transplantation and PET/CT examination in our hospital from October 2013 to May 2017.According to Deauville criteria, the lesions were classified into PET negative, weak positive, and strong positive. The metabolic parameters including SUV max, SUL, MTV, TMR, TLR, TLG, UVP of normal liver parenchyma, liver cancer lesions and mediastinum were measured or calculated. The relationship between metabolic parameters and recurrence was analyzed. The relationship of Deauville score and metabolic parameters and the changing characters of metabolic parameters between the PET/CT of pre and post transplantation were analyzed. Results:Thirty cases did not relapse after LT, among which 16, 7 and 7 cases had Deauville score of 3, 4 and 5 respectively in pre-operation PET/CT. The recurrence time of 62 patients in recurrence group was (10.90±10.30) months. MTV, TLG, UVP-M, UVP-LB in recurrence group were significant higher( P<0.05). Patients with low metabolic parameters show better prognosis than patients with high metabolic parameters. Metabolic parameters of 5 score group were higher than that of 4score. The metabolic parameters of recurrence group were higher than those in non-recurrence group. MTV, TLG, UVP-M, UVP-LB in post-operation PET/CT were lower than those in pre-operation PET/CT, however, SUV max, TMR, TLR, SUL had no significantly difference. Conclusions:PET/CT metabolic burden parameters should be evaluated before LT to select patients with better prognosis. For liver transplantation patients with high metabolic parameters, PET/CT examination should be performed early after surgery to improve the detection of recurrence and metastasis, and relevant treatment should be timely conducted.
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Objective:To systematically evaluate the efficacy of oral Chinese herbal prescriptions combined with transcatheter arterial chemoembolization （TACE） against primary hepatic carcinoma （PHC） and screen the basic Chinese herbs，in order to provide certain reference for clinical medication. Method:The randomized controlled trials concerning the treatment of PHC with oral Chinese herbal prescriptions plus TACE were retrieved from CBM，China National Knowledge Infrastructure （CNKI），Chongqing Weipu Database for Chinese Technical Periodicals （VIP），and Wanfang Data Knowledge Service Platform.The quality of the included trials was evaluated by Cochrane handbook，and the Meta-analysis was performed using RevMan 5.3.The enumeration data were expressed by odds ratio （OR），the measurement data by mean difference （MD） or standardized mean difference （SMD），and the effect size by 95% confidence interval （CI）.The data of oral Chinese herbal prescriptions involved in trials were sorted out and subjected to association rule analysis and frequency analysis based on the Traditional Chinese Medicine Inheritance Support System （TCMISS），for exploring the basic Chinese herbs and their dosages against PHC. Result:A total of 75 randomized controlled trials were included，involving 7 406 cases. As revealed by the Meta-analysis，oral Chinese herbal prescriptions combined with TACE was significantly better than TACE alone in improving the short-term curative effect ［OR=2.05，95%CI（1.83，2.29）］，decreasing alpha fetoprotein （AFP） ［MD=-59.02，95%CI（-79.03，-39.01）］，ameliorating liver function ［SMD=-1.23，95%CI（-1.58，-0.88）］，boosting immunity ［SMD=1.08，95%CI（0.84，1.32）］，adjusting Karnofsky Performance Status （KPS） scale score ［OR=2.7，95%CI（1.11，11.02）］，elevating survival rate ［OR=2.31，95%CI（1.96，2.71）］，and reducing adverse reactions ［OR=0.38，95%CI（0.34，0.43）］.Data mining results showed that the basic Chinese herbs against PHC were Bupleuri Radix，Paeoniae Alba Radix，Atractylodis Macrocephalae Rhizoma，Poria，and Glycyrrhizae Radix et Rhizoma，with their clinical dosages listed as follows：6-15 g for Bupleuri Radix，10-15 g for Paeoniae Alba Radix，9-15 g for Atractylodis Macrocephalae Rhizoma，10-15 g for Poria，and 3-10 g for Glycyrrhizae Radix et Rhizoma. Conclusion:The oral Chinese herbal prescriptions combined with TACE produce better effects in treatment of PHC as compared with TACE alone.These five basic Chinese herbs have anti-cancer effect，and their dosages are within the ranges stipulated in 2020 edition of <italic>Chinese Pharmacopoeia.</italic>This Meta-analysis has provided certain reference for clinical medication.
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OBJECTIVE：To systematically evaluate th e efficacy and safety of Compound banmao capsules combined with different chemoradiotherapy in the treatment of primary hepatic carcinoma （PHC）. METHODS ：Retrieved from CBM ，CNKI， Wanfang database ，VIP，PubMed，Embase and Cochrane Library during the inception to Sept. 2020，randomized controlled trial （RCTs），cohort study about Compound banmao capsules combined with different chemoradiotherapy plans （trial group ）versus different chemoradiotherapy plans （control group ）were collected. After literature screening and data extraction ，the quality of included RCTs were evaluated with bias risk evaluation tool recommended by Cochrane system evaluator mannual 5.1.0. Newcastle Ottawa scale was used to evaluate the quality of cohort 502） studies；Rev Man 5.3 software was used for Meta-analysis ；TSA 0.9.5.10 Beta software was used for trail sequential analysis，and GRADE Profiler 3.6.1 software was used for evidence quality evaluation of RCT and cohort studies . RESULTS：A total of 15 RCTs were included ，involving com 1 148 patients. Meta-analysis showed that effective rate of trial group was significantly higher than that of control group [RR ＝0.80，95％CI（0.73，0.88），P＜0.000 01]. The results of subgroup analysis according to different chemotherapy plan showed that the effective rate of trial group combined with TACE and three dimensional conformal radiotherapy were significantly higher than control group （P＜0.05）. The survival rate of trial group was significantly higher than control group [RR ＝0.81，95％CI（0.74，0.89），P＜0.000 1]；the results of subgroup analysis according to different survival time showed that 1-year，2-year and 3-year survival rates of trial group were significantly higher than control group（P＜0.05）. The incidence of myelosuppression in trial group was significantly lower than control group ，and the natural killer cell count and T cell count of trial group were significantly higher than control group （P＜0.05）. There was no statistical significance in AFP content and liver function index between 2 groups（P＞0.05）. Trial sequential analysis showed that there was definite evidence for better effective rate of Compound banmao capsules combined with TACE. GRADE evaluation results showed that the evidence level of effective rate was intermediate ，the evidence level of survival rate and incidence of myelosuppression was low，and other indicators were very low. CONCLUSIONS ：Compound banmao capsules combined with different chemoradiotherapy in the treatment of PHC has significant efficacy and good safety ，especially in combination with TACE ，and the evidence level of effective rate is intermediate.
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Objective@#To explore the diagnostic value of single or combined detection of serum tumor markers alpha-fetoprotein (AFP), α-fetoprotein (AFP)-L3 and abnormal clotting (PIVKA-II) in the primary hepatic carcinoma.@*Methods@#Serum AFP, AFP-L3 and PIVKA-II of 56 cases with primary hepatic carcinoma, 46 cases with cirrhosis, 45 cases with other liver disease and 41 healthy persons (control group) were examined by chemiluminescence method, and the differences in the levels of AFP, AFP-L3 and PIVKA-II in each group were compared.@*Results@#Serum level of AFP, AFP-L3 and PIVKA-II in patients with primary liver cancer was significantly higher than that of the cirrhosis, other liver disease and control groups, and the difference was statistically significant (P < 0.05). The receiver operating characteristic curve analysis showed that the areas under the curve for the diagnosis of primary hepatic carcinoma by AFP, AFP-L3 and PIVKA-II were 0.887, 0.846 and 0.885, respectively. The combined use of the three tumor markers for the diagnosis of primary hepatic carcinoma increased the area under the curve to 0.899. Among the single detection, AFP had the highest sensitivity of 91.07% and PIVKA-II had the highest specificity at 88.63%. In the combined detection, AFP/PIVKA-II combination had the highest sensitivity of 94.64 %, while the AFP + AFP-L3 + PIVKA-II combination had the highest specificity at 98.48%.@*Conclusion@#Combined detection of AFP, AFP-L3 and PIVKA-II could improve the diagnostic specificity and the sensitivity of primary hepatic carcinoma; thereby make up the deficiency of single detection and improve the early diagnosis rate.
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@#Primary hepatic carcinoma（PHC）is the second leading cancer that caused death in the world. The morbidity of PHC is increasing year by year,which threaten people's lives and health. Chronic hepatitis B is considered to be an independent risk factor for PHC,and the incidence of PHC is higher in patients who have progressed to liver cirrhosis. We reviewed the domestic and abroad literatures about the risk factors for hepatitis B cirrhosis progressing to PHC from the year of 1992 to 2018,and concluded that HBV-DNA,HBsAg,HBeAg expression,antiviral treatment time,different antiviral drugs,degree of cirrhosis,alanine transaminase and family history were related to the development of PHC from cirrhosis.
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Professor WU Liang-cun is good at the treatment of primary hepatic carcinoma. He views that the main pathogenesis of primary hepatic carcinoma is liver and kidney deficiency. Therefore, treatment should be based on enriching water to nourish wood, with soothing the liver and regulating qi, clearing the gallbladder and removing dampness, promoting blood circulation for removing blood stasis, detoxicating and resolving masses.
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Objective: To explore the effect of transcatheter arterial chemoembolization(TACE) combined with high intensity focused ultrasound (HIFU) ablation on patients with middle and advanced liver cancer and to analyze its anti-tumor value. Methods: 126 patients with middle and advanced liver cancer who received palliative treatment were selected in the research. According to the different treatment program, they were divided into TACE groups (66 cases) which patients received TACE and TACE combined with HIFU ablation group (60 cases) which patients received the treatment of TACE combined with HIFU ablation. After 4 weeks of treatment, the therapeutic effect of solid tumor and the change of immune function indicator of the two groups were compared. At the same time, the results of follow-up visit were recorded, and adverse reaction of antineoplaston and survival situation were further compared. Results:After treatment, the immune function both of two groups were enhanced, and the cluster of differentiation (CD)3+, CD4+, and CD4+/ CD8+of TACE combined with HIFU ablation group was significantly higher than that of TACE group (t=6.303, t=6.049, t=2.148, P<0.05). While the clinical benefit rate of TACE combined with HIFU ablation group was significantly higher than that of TACE group (Z=2.975, P<0.05), and the survival rate of 1 year and survival rate of 2 years of TACE combined with HIFU ablation group were significantly higher than that of TACE group (x2=3.99, x2=4.33, P<0.05), respectively. On the other hand, the differences of complications, included skin burn, liver function damage and abdominal discomfort, between the two groups were no significant (x2=2.235, x2=0.847, x2=0.019, P>0.05). Conclusion:The technique of TACE combined with HIFU ablation can enhance immune function and the therapeutic effect of antineoplastic, and its advantages includes obvious effect of antineoplastic and safety of usage. Therefore, its application value should be paid higher attention in oncotherapy of solid tumor as this paper's suggestion.
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Objective To evaluate the expression and role of serum CXC chemokine ligand 13 (CXCL13) in Primary hepatic carcinoma (PHC) patients and explore the clinical value of PHC diagnosis and prognosis . Methods Serum samples were collected from 80 patients with PHC ,80 patients with chronic hepatitis B (CHB) and 36 healthy controls (HC) .Serum levels of CXCL13 in patients were measured by enzyme-linked immunosorbent assay (ELISA) .The relationship between clinicopathological features and laboratory parame-ters was analyzed by statistical software .The correlation between CXCL13 level and prognosis of liver func-tion were tested by spearman correlation analysis ,the diagnostic value of CXCL13 and AFP to PHC were ana-lysed by ROC curve .Results The levels of serum CXCL13 in patients with PHC were significantly higher than those in CHB and HC groups .The levels of serum CXCL13 in patients with advanced PHC (Ⅲ - Ⅳ) were significantly higher than those in patients with early PHC (Ⅰ - Ⅱ) .Serum levels of CXCL13 in patients with tumor diameter more than 5cm were significantly higher than those tumor diameter less than or equal 5 cm .Patients that metastatic serum levels of CXCL13 were significantly higher than without tumor metastasis in patients .The level of serum CXCL13 in patients with ascites was significantly higher than that in patients without ascites ,all the data were statistically significant (P＜0 .05) .Serum levels of CXCL13 in patients with PHC were correlated with hemoglobin ,serum albumin ,cholinesterase ,and international normalized ratios . There was a positive correlation between serum CXCL13 concentration and Child-Pugh score in PHC patients (r＝ 0 .459 ,P＝ 0 .001) ,and negatively correlated with serum albumin and cholinesterase (r＝ -0 .319 ,-0 .259 ,P＝0 .004 ,0 .008) .CXOC13 and AFP combination of the ROC curve were 0 .938 .Sensitivity and spe-cificity were 82 .8% and 100 .0% .Conclusion High expression of serum CXCL13 in PHC is closely related to tumor grow th and metastasis ,and has important clinical value in the diagnosis ,treatment and prognosis evalu-ation .
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Objective To investigate the value of ultrasound contrast in differential diagnosis of liver alveolar hydatid disease and hepatic malignant tumor.Method Totally 36 cases of liver alveolar hydatid disease and 31 cases of hepatic malignant tumor were retrospectively analyzed,who visited the Ultrasound Department of Qinghai Red Cross Hospital from March 2010 to September 2013,the performance characteristics of gray-scale ultrasound and contrast-enhanced ultrasound (CEUS) on hepatic malignant tumor and liver alveolar hydatid disease were compared.Results Gray-scale sonography of 36 liver alveolar hydatid diseases showed clear boundary,heterogeneous hypoechoic nodules,and the maximum area was (5.06 ± 2.46) cm2 in 49 lesions;gray-scale sonography of 31 hepatic malignant tumors showed unclear boundary,hypoechoic nodules,and the maximum area was (7.29 ± 5.83) cm2.CEUS of liver alveolar hydatid disease showed non-enhancement in three phases,and rim enhancement was seen synchronized with the liver parenchyma.CEUS of hepatic malignant tumor showed hyperenhancement in arterial phase,equal-enhancement or hypo-enhancement in portal phase and delayed phase,and abnormal perfusion areas were clear.Conclusion Liver alveolar hydatid disease is different in the performance of CEUS from hepatic malignant tumor,CEUS has a great value in the differential diagnosis of liver alveolar hydatid disease and hepatic malignant tumor.
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Objective To explore the association between syndrome types of primary hepatic carcinoma(PHC) and coagulation function.Methods From Jan.2015 to May.2016,a total of 176 cases of PHC patients were enrolled to analyze the correlation between syndrome types and coagulation function.Results The liver stagnation and spleen deficiency syndrome(34.66%) was the most common syndrome in all patients,followed by wet and heat resistance syndrome(22.73%) and qi stagnation and blood stasis syndrome(17.05%).Prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT) and D-dimer(D-D) levels of patients were significantly increased,with significant differences between liver stagnation and spleen deficiency group and wet and heat resistance syndrome group,liver and kidney Yin deficiency syndrome group(P0.05).Conclusion Coagulation function in PHC patients with spleen and kidney Yang deficiency syndrome,wet and heat resistance syndrome and liver and kidney Yin deficiency syndrome could be poor,but that in patients with qi stagnation and blood stasis syndrome and liver stagnation and spleen deficiency could be relatively good.Increasing of PT,APTT,TT and D-D could be with certain significance to identify liver stagnation and spleen deficiency syndrome with other syndrome types.
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Objective:To develop a simple,effective,low-cost,time saving chemiluminescent protein microarray to detect the serum CA19-9 level of patients with primary hepatic carcinoma.Methods:A protein microarray was developed for detecting CA19-9 levels in the serum samples after spotting mouse-derived CA19-9 monoclonal antibody on an aldehyde-based chip.Serum from primary hepatic carcinoma (n=46) and healthy controls (n=32) were tested by using this assay.Results:The results showed that 24 out of 46 patients with primary hepatic carcinoma had serum CA19-9 levels above 37 U/mL,and 22 out of 46 patients with primary hepatic carcinoma had serum CA19-9 levels under 37 U/mL.In healthy control,30 out of 32 total cases were under 37 U/ml.Only two healthy controls were 37 U/mL.The sensitivity,specificity and AUC of protein microarray were 52.17％,93.75％,0.688 [95％ CI:0.566,0.811].Conclusion:A chemiluminescent protein microarray method was established for detection of CA 19-9 in serum.
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Objective To explore the performance of serum AFP-L3 and PIVKA-Ⅱ in differential diagnosis of benign and malignant liver disease in high risk population.Methods The serum levels of AFP-L3 and PIVKA-Ⅱ in 48 patients with primary hepatic carcinoma,43 patients with cirrhosis and 81 patients with chronic hepatitis B were analyzed retrospectively.Results There was no statistically different significance among the median levels of serum AFP in primary hepatic carcinoma patients,cirrhosis patients and chronic hepatitis B patients (x2=4.014,P=0.134).Both median level of AFP-L3 and PIVKA-Ⅱ in primary hepatic carcinoma patients were higher than cirrhosis patients and chronic hepatitis B patients (x2 =33.93,52.33,both of P values were below 0.001).The specificity (92.74％) of AFP-L3 and the sensitivity (79.17％) of PIVKA-Ⅱ were all higher.The accuracy (84.88％) of combined detection in series was the highest,with its 47.92％ of sensitivity and 99.19％ of specificity.Conclusion Combined detection PIVKA-Ⅱ and AFP-L3 series will help to differential diagnosis of benign and malignant liver disease in high risk population.
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OBJECTIVE:To observe therapeutic efficacy and safety of oxaliplatin combined with tegafur in the treatment of ad-vanced primary hepatic carcinoma after transcatheter arterial chemoembolization(TACE). METHODS:120 patients with advanced primary hepatic carcinoma were selected from our hospital during Apr. 2011-Apr. 2013,and then divided into control group and ob-servation group according to random number table,with 60 cases in each group. Both groups received TACE. Control group was given Oxaliplatin injection 0.08 g/m2 after surgery via catheter arterial puming,within 4 h;observation group was additionally giv-en Tegafur capsules 40 mg/m2,po,bid,on the basis of control group. Both group received treatment for 4 months. Clinical efficacy, hepatic function indexes [ALT,AST,TBIL,DBIL] and alpha-fetoprotein(AFP)level were observed in 2 groups;the occurrence of ADR during treatment was recorded as well as 1-year,2-year,3-year follow-up survival rates. RESULTS:Before treatment, there was no statistical significance in hepatic function indexes and AFP(P>0.05). After treatment,disease control rate(78.33%) and clinical benefit rate(93.33%)of observation group were significantly higher than those of control group(48.335,71.67%), with statistical significance (P0.05). 1-year,2-year,3-year fol-low-up survival rates of observation group were significant higher than control group,with statistical significance(P<0.05). CON-CLUSIONS:Oxaliplatin combined with tegafur is effective for advanced primary hepatic carcinoma after TACE with good safety.
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Objectives To compare the dose distribution of the whole body γ-knife and three-dimensional conformal radiotherapy (3D-CRT) in the treatment of primary hepatic carcinoma to provide evidence for clinical treatment choice.Methods Totally 35 patients with primary hepatic carcinoma treated with whole body γ-knife from March 2014 to July 2015 underwent three-dimensional conformal radiotherapy planning,and dose volume histograms were used to evaluate the dose distribution of target volumes and normal tissue,and moreover conformity index (CI) and homogeneity index (HI) were analyzed.Results Between the two treatment plans,D98 and the mean dose Da of GTV were higher in whole body γ-knife plan than those in three-dimensional conformal radiotherapy plan.For PTV,the V95 of γ-knife and three-dimensional conformal radiotherapy were (95.05±0.02)％ and (90.00±0.03)％ (P=0.00) respectively.Target coverage of whole body γ-knife was better.For organ at risk,γ-knife showed better protection of normal tissue.Three-dimensional conformal radiotherapy showed better HI (GTV:0.11±0.15 vs 0.23±0.02,PTV:0.14±0.04 vs 0.21±0.03),while more normal liver tissue received excessive exposure.The whole body γ-knife increased dose of target volumes and decreased dose of normal tissue,while three-dimensional conformal radiotherapy showed better HI.Conclusion Compared with three-dimensional conformal radiotherapy,the whole body γ-knife shows advantage in dose distribution but HI of target volumes.For clinical using,appropriate treatment needs to be chosen according to the patients' actual situation.
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Objective To discuss the clinical significance of the changes in plasma D-dimer levels in patients with primary hepatic carcinoma (PHC) after receiving transcatheter arterial chemoembolization (TACE).Methods The clinical data of 69 PHC patients were collected.According to mRECIST criteria,the patients were divided into disease-controlled group,i.e.(CR+PR+SD) patients,(group A,n=41) and disease progression group,i.e.PD patients,(group B,n=28).The plasma D-dimer levels were determined before and after TACE in all patients.The differences in plasma D-dimer levels were determined with ranksum test,and receiver operating characteristic (ROC) curve was used to evaluate the potency of D-dimer levels in judging TACE efficacy.Results The pre-TACE and post-TACE plasma D-dimer levels in group A were 124.00 μg/L (88.00-212.00 μg/L) and 190.00 μg/L (75.00-273.00 μg/L) respectively,the difference was not statistically significant (P＞0.05),while those in group B were 261.50 μg/L (138.25-559.50 μg/L) and 554.50 μg/L (398.25-1 080.00 μg/L) respectively.The pre-TACE plasma D-dimer level in group B was significantly higher than that in group A (P＜0.05),besides,in group B the plasma D-dimer level showed a further rise after TACE,the difference was statistically significant when compared with the pre-TACE level (P＜0.05).ROC curve analysis showed that the areas under ROC of pre-TACE and post-TACE plasma D-dimer levels used to determine the postoperative efficacy were 0.737 and 0.907 respectively.When taking 181.5 μg/L and 339.0 μg/L as the cut-off values,the sensitivity and specificity for judging the postoperative efficacy were 71.4％,70.7％ and 85.7％,87.8％,respectively.Conclusion The changes in plasma D-dimer levels have certain value in assessing PHC patient's condition as well as in evaluating the curative effect of TACE.The increase in plasma D-dimer level means that the patient's condition is serious and TACE efficacy will be poor.
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Objective To compare the clinical efficacy and postoperative liver function in patients with primary hepatic carcinoma treated by transcatheter arterial chemoembolization(TACE) or TACE combined with portal vein chemoembolization.Methods 48 patients with primary hepatic carcinoma, randomly divided into 2 groups (hepatic artery group in 25 cases and dual interventional group in 23 cases),underwent interventional treatment.The hepatic artery group underwent conventional hepatic artery interventional therapy, while the dual interventional group underwent hepatic artery and portal vein interventional treatment.The postoperative clinical efficiency, liver volume and liver function between the two groups'' patients were compared.Results To the endpoint of observation,the clinical efficacy and tumor reduction degree of dual interventional group were better than that of hepatic artery group.Compared with hepatic artery group, the postoperative ALT, AST and TBIL of dual interventional group were higher on the first and third days.On the seventh and fourteenth days, the statistical difference was not significant.The volume of non-embolization part in dual interventional group was larger than that in preoperative volume to different degrees.The most obvious change of liver volume happened in the 4th weeks after treatment.There was no treatment-related death or severe adverse reaction in two groups.Conclusion The treatment of TACE combined with portal vein chemoembolization is a safe and effective method, which may effectively inhibit the growth and reduce the volume of tumor, and result in compensatory hypertrophy of non-embolization part.
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Golgi protein 73(GP73) was closely correlated with primary hepatic carcinoma(PHC). GP73 had a higher sensitivity and specificity than alpha fetal protein(AFP), so GP73 had a great diagnostic value for early PHC. Although there were many related research reports in the domestic and foreign, their conclusions were inconsistent. This article reviewed these studies results.