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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 evaluate the risk factors of residual tumor after thermal ablation in patients with small hepatocellular carcinoma.Methods:This was a retrospective study recruiting 107 patients diagnosed as single hepatocellular carcinoma with maximum diameter ≤3 cm from December 2009 to August 2015 in National Cancer Center. The cohort enrolled 81 males and 26 females, including 83 patients younger than 70 years old. All patients were treated with radiofrequency ablation or microwave ablation, and evaluated by CT or MRI after 4-6 weeks compared with baseline data. Potentially related factors were analyzed such as patients′ characteristics, tumor location and adjacent, ablation pattern, hepatitis B/C infection. A multivariate logistic regression analysis was conducted for the independence of risk factors.Results:Six patients (5.6%) with residual tumor was detected in the whole population of 101 cases. Univariate analysis suggested that tumor adjacent to vascular structure, poor differentiation, AFP≥200 μg/L were the risk factors of residue disease (all P<0.05). Multivariate logistic regression suggested that pathological type of poorly differentiated tumor was the only independent risk factor ( HR=2.26,95% CI 0.25-20.50, P=0.030). Conclusions:Poorly differentiated pathology is an independent predictive factor for residual disease in small hepatocellular carcinoma after thermal ablation. Such patients should be routinely followed up after operation.
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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: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: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 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 investigate the biological mechanism of curcumin inhibiting the invasion and metastasis in hepatocellular carcinoma. METHODS: The cytotoxicity of curcumin was detected by Am-Blue assay. Cell-based luciferase assay was used to detect the change of the microRNA-21 expression level. qRT-PCR was used to detect the expression of mRNA of pri-miR-21, pre-miR-21 and microRNA-21. The protein expression levels of PTEN, PDCD4 and EMT markers were detected by Western blot. Wound healing assay and transwell assay were used to detect cell invasion and migration. RESULTS: Curcumin can significantly inhibit the expression of microRNA-21, while inhibiting the mRNA expression of the precursors pri-miR-21, pre-miR-21 and mature microRNA-21. Curcumin can significantly enhance the expression levels of microRNA target proteins PTEN and PDCD4. Curcumin inhibited the epithelial-mesenchymal transition (EMT) process, in which the expression of E-cadherin and β-catenin was increased, and the expression of N-cadherin and vimentin was decreased. Curcumin can inhibit the invasion and metastasis of hepatocellular carcinoma. CONCLUSION: Curcumin inhibits the invasion and metastasis in hepatocellular carcinoma by inhibiting the expression of microRNA-21.
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@#[Abstract] Objective: To explore the regulatory relationship between enhancer and miRNA and the characteristics of the enhancers that regulate miRNA in hepatic carcinoma and normal hepatic tissues, and to screen the differentially expressed miRNAs regulated by enhancers as well as their association with the treatment targets in liver cancer. Methods: Based on the TCGA and FANTOM5 databases, Co-expression and 3D genomic analysis were performed on 417 samples of enhancers and miRNAs in liver cancer and normal liver tissues. The difference in signal value of the enhancer that regulates miRNA was analyzed by ChIP-seq data of histone modification and transcription factor in liver cancer and normal liver tissues in ENCODE database. The differentially expressed miRNAs regulated by enhancers were screened out, and the correlation analysis was performed on the patient's survival and treatment targets. Results: 93 and 40 pairs of enhancer-miRNA were identified in liver cancer and normal liver tissues, respectively. ChIP-seqdata comparison analysis found that the signal of H3K27ac, H3K4me1 and sH3K4me3 histone modification in the region of enhancers regulating miRNA was significantly higher than that in the region of enhancers not regulating miRNA (|rho|>0.3, P<0.05). Moreover, the enrichment of multiple transcription factors in liver cancer-related enhancers was significantly lower than that in normal liver tissue-realted enhancers (|rho|>0.3, P<0.05). Differential expression analysis of enhancer-regulated miRNAs identified 6 miRNAs related to the survival of liver cancer patients(hsa-miR-4664, hsa-miR-5003,hsa-miR-1915,hsa-miR-3619,hsa-miR-4745, hsa-miR-6728),and found that these miRNAs were significantly associated with 87 genes for targeted therapy and 8 tumor immune checkpoint genes (|rho|>0.1, FDR<0.05). Conclusion: The enhancer-miRNA regulatory pairs and the characteristics of the enhancer that regulates miRNA were successfully identified in liver cancer. The miRNAs regulated by enhancers and related to the therapeutic targets and survival of patients with liver cancer were also screened out. It provides a valuable preliminary basis for future in-depth basic and clinical research in hepatic carcinoma.
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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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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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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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Aim To investigate the effect of sanguina-rine on regulating the pathway of cell apoptosis by in-ducing reactive oxygen species (ROS) in HepG2 cells. Methods MTT method was used to detect the cell viability of HepG2 cell after the treatment of san-guinarine. The changes of ROS were observed by indi-cator DCFH-DA and DHE staining. The apoptosis was detected by Hoechst 33342 and Annexin V/PI stai-ning;Rhodamine 123 staining was used to detect mito-chondrial membrane potential. Western blot was used to detect expressions of key cell-apoptotic protein. Re-sults The cell viability of HepG2 cells showed a de-creasing trend with the increasing concentration of san-guinarine. Sanguinarine could significantly increase cellular ROS,decrease mitochondrial membrane poten-tial in HepG2 cell, and promote apoptosis of HepG2 cells. The expression of Bax, cleaved-caspase-3 and cytoplasmic Cyt-C significantly increased after the treatment of sanguinarine, however, the expression of Bcl-2 was inhibited. Conclusion Sanguinarine could activate mitochondrial pathway of apoptosis mediated by cellular uncontrolled ROS and promote apoptosis of HepG2 cells.
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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 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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Objective: To investigate the application of conventional ultrasound and 16-slice CT examination in clinical diagnosis of hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia. Methods: To choose 94 cases patients were receiving treatment in our hospital who were diagnosed as hepatic focal lesion through percutaneous biopsy of hepatocyte or histopathological examination of postoperation, and then take conventional ultrasound and 16-slice CT, respectively, to detect them. To compare and analyze the two methods in series of indicator, such as accuracy, the number of lesion size and the imageology character. Results: Conventional ultrasound diagnosis of benign tumor lesions was consistent with spiral CT results, and the difference was not statistical significance (x2=0.5556, P>0.05). The accuracy of spiral CT for hepatic carcinoma was higher than that of conventional ultrasound, and the difference was significant (x2=8.1987, P<0.05). The consistent rate of the spiral CT group with real result for micro-miniature carcinoma (the diameter less than 1 cm) was higher than that of conventional ultrasound group, and their difference was significant (x2=14.4028, P<0.05). The disappear and persist time of hepatic carcinoma patients were longer than that of non-hepatic carcinoma patients, and the difference between them was significant (t=9.7531, P<0.05). Conclusion: It is higher accuracy that 16-spiral CT can diagnose malignancy lesions in earlier stage.
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Objective:To explore the effects and mechanism of anti IL-9 antibody on malignant ascites ( MA) of hepatic carci-noma in mice.Methods:A mouse model of MA was established by mouse H 22 cell line.45 mice were divided randomly into experi-mental group,negative control group and blank control group at 24 hours after modeling,with 15 mice in each group.The experimental group was injected intraperitoneally with anti IL-9 antibody;the negative control group was injected with isotype IgG antibody;the blank control group was injected with normal saline .The weight and behavior of the mice were measured before each injection .Five mice of each group was sacrificed at 24 hours after the last injection to measure the volume of MA .The level of VEGF,MMP-2,IL-9 and IFN-γin MA were determined with ELISA assay;the survival time of rest mice were recorded and compared .Results:The mean volume of MA of experimental group,negative control group and blank control group were (6.70±1.52)ml,(10.28±1.75)ml,(10.36±2.30) ml,respectively,the MA volume of experimental group were lower as compared to negative control group and blank control group ( P0.05 ) .Conclusion:Intraper-itoneal injection anti IL-9 antibody on H22 ascites-bearing mice can effectively inhibit the generation of the MA .The mechanism may be related to the inhibition of the expression of the VEGF and IL-9.