Effect of radiation therapy and prognostic factors in hepatocellular cancer patients with cardiophrenic angle or superior diaphragmatic lymph nodes metastasis / 中华放射医学与防护杂志

Objective:To study the effects of radiotherapy and the prognostic factors in hepatocellular cancer (HCC) patients with cardiophrenic angle or superior diaphragmatic lymph nodes metastasis (LNM).Methods:We retrospectively analyzed 56 HCC patients with cardiophrenic angle or superior diaphragmatic LNM who were treated with or without external beam radiation therapy (EBRT) in Zhongshan Hospital of Fudan University from Jan 2010 to Aug 2020. Patients were divided into two groups according to whether they received radiotherapy, EBRT group and non-EBRT group, and each group had 28 patients. Radiation fields included or excluded primary tumor in EBRT group, and the cardiophrenic angle or superior diaphragmatic LNM did not receive any local treatment in non-EBRT group. The response rate, survival rate, local control rate, prognostic risk factors of the two groups were studied.Results:After EBRT, the partial response rate and complete response rate were 32.1%(9/28) and 32.1%(9/28). The median survival rate of EBRT group was 16.1 months (95% CI 9.00-23.21, RR=3.63) vs. 6.9 months (95% CI 4.63-8.77, RR=1.06) for the non-EBRT group, with statistically significant difference ( χ2=15.53, P<0.05). Cardiophrenic angle or superior diaphragmatic lymph nodes 1-year local control rate for EBRT group and non-EBRT group were 37.0% vs. 10.7%, with statistically significant difference ( χ2=5.28, P<0.05). Since diagnosis of cardiophrenic angle or superior diaphragmatic LNM, 4 patients (14.3%) in the EBRT group vs. 13 patients (46.4%) in the non-EBRT group had higher alpha-fetoprotein (AFP) level after 3 months compared with the AFP before EBRT ( χ2=6.84, P<0.05). Multivariate analysis showed that multiple intrahepatic tumors, maximal diameter of intrahepatic tumors >5 cm, AFP≥400 μg/L, no EBRT were poor prognostic factors. Conclusions:EBRT can prolong overall survival and improve the control rate of lymph node of HCC patients with cardiophrenic angle or superior diaphragmatic LNM. Patients with multiple intrahepatic tumors, maximal diameter of intrahepatic tumors >5 cm, AFP≥400 μg/L and no EBRT have poor prognosis.

Role of gut microbiota in chronic liver disease and its potential therapeutic strategies / 中国药理学通报

An increasing number of studies have shown that intestinal microbes play an important role in maintaining liver homeostasis. The liver is closely linked to the intestine through the portal vein, and the transfer of intestinal microbcs, and their metabolites to the liver can affect the normal physiological function of the liver. Willi the deepening of research on intestinal microbes in recent years, a large number of studies have found that intestinal microbes play an important role in the development of chronic liver diseases. and more and more studies have shown that the regulation of intestinal microbes may be a potential therapeutic target for chronic liver diseases. This article summarizes the role of intestinal microbes in the development of chronic liver diseases and its related mechanisms in recent years, aiming to provide a reference for the prevention and treat-ment of chronic liver diseases.

Detect or not to detect very early stage hepatocellular carcinoma? The western perspective

Very early stage hepatocellular carcinoma (HCC) is defined as a single tumor with the largest diameter of the lesion measuring 2 cm or less according to Barcelona Liver Cancer staging system. Detection of very early stage HCC is clinically important as it confers an excellent prognosis with the 5-year survival rates over 60 to 80% after patients receive curative treatments. While diagnosing HCC at a very early stage is crucial, it is technically challenging and may come with the physical or psychosocial harms related to diagnostic tests. It is further complicated by the fact that patients with very early stage HCC are not prioritized for liver transplant (LT) in the United States organ allocation system. When LT-eligible patients present with an indeterminate lesion measuring between 1 and 2 cm on the multiphasic computed tomography or magnetic resonance imaging, clinicians often observe patients carefully until the lesion grows up to 2 cm so that patients can be eligible to receive a Model for End-Stage Liver Disease (MELD) exception score for HCC in the United States. The European guideline recommends a routine biopsy of such lesion. In conclusion, attempting to detect very early stage HCC is difficult to achieve and controversial. Clinicians should take into account of the risk and the benefit of diagnostic tests, LT candidacy of patients and the local organ allocation system.

The 150 most important questions in cancer research and clinical oncology series: questions 86-93 : Edited by Chinese Journal of Cancer / 癌症

Since the beginning of 2017, Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology, which spark diverse thoughts, interesting communications, and potential collaborations among researchers all over the world. In this article, 8 more questions are presented as follows. Question 86. In which circumstances is good supportive care associated with a survival advantage in patients with cancer? Question 87. Can we develop animal models to mimic immunotherapy response of cancer patients? Question 88. What are the mechanisms underlying hepatitis B virus-associated non-hepatocellular cancers? Question 89. Can we more precisely target tumor metabolism by identifying individual patients who would benefit from the treatment? Question 90. What type of cranial irradiation-based prophylactic therapy combination can dramatically improve the survival of patients with extensive small-cell lung cancer? Question 91. How can postoperative radiotherapy prolong overall survival of the patients with resected pIIIA-N2 non-small cell lung cancer? Question 92. What are the key molecular events that drive oral leukoplakia or erythroplakia into oral cancer? Question 93. How could we track the chemotherapeutics-driven evolution of tumor genome in non-small cell lung cancer for more effective treatment?

Mechanism for the regulation of hepatocyte growth factor receptor c-Met on epithelial-mesenchymal transition in hepatocellular cancer / 中华肝胆外科杂志

Hepatocyte growth factor receptor c-Met and epithelial-mesenchymal transition (EMT) are closely related to the hepatocellular cancer.Recent researches have found that the mechanism of c-Met regulating EMT may play an important role in the carcinogenesis of hepatocellular cancer,which becomes a new research hot topic,Now we overviewed the progress on the mechanism of c-Met regulating EMT in hepatocellular cancer.

Research on the association between U2-dependent spliceosome gene and hepatocellular cancer / 中华流行病学杂志

Objective To determine the association between U2-dependent spliceosome related 8 key genes and hepatocellular cancer (HCC).Methods A two-stage case-control study was conducted.Twenty-two candidate tag single nucleotide polymorphisms (taggNPs) were genotyped by TaqMan Openarray assay in a screened population that living in Central China (378 HCC incident cases and 461 controls).Frequencies of 4 SNPs (rs2074733,rs9608886,rs7288947 and rs5994293) showed significant difference between cases and controls in the screened population and then genotyped by TaqMan real-time polymerase chain reaction in the validation Chinese Han population from Beijing (428 cases and 647 controls).Results The rs5994293 in SF3A1 gene showed a significant association with HCC in both screened population and combined population.Subjects with G allele had a lower risk of HCC,compared to those with the TT genotype.OR appeared to be 0.70 (95％ CI:0.58-0.84,false discovery rate adjusted P=0.000 5) for the combined population.An additive interaction between smoking,drinking alcohol and rs5994293 TT was observed in HBsAg negative subjects of the combined populations.Conclusion Our results showed an association existing between SF3A1 rs5994293 and HCC.These findings should be confirmed by further independently large-scale population studies and functional analysis.

Transcatheter arterial chemoembolization combined with surgical resection for the treatment of ruptured hepatocellular carcinoma / 中华肝胆外科杂志

ObjectiveTo study the efficacy of transcatheter arterial chemoembolization (TACE) combined with surgical resection in the treatment of ruptured hepatocellular carcinoma (HCC).MethodsThe clinical data of 26 patients who presented with ruptured HCC to our hospital from January 2008 to December 2011 were retrospectively studied. These patients received TACE (n=19),surgical resection (n=7),and surgical resection after TACE (n=8).ResultsShock in the 19 patients who received TACE was promptly corrected and the vital signs were stabilized.On subsequent CT,the tumors shrunk in size.Salvage liver resection was carried out in 8 patients 1 month after TACE.After treatment,AFP decreased or became normalized,thus the treatment results were good. A one-stage liver resection was carried out in 7 patients. One patient died after operation and peritoneal metastases occurred in 4 patients. Conclusions TACE stopped bleeding from ruptured HCC efficaciously,reduced the need for open exploration,and improved the rate of resection of HCC.TACE combined with surgical resection significantly lowered the rate of abdominal tumor metastases.

Surgical treatment of hepatocellular cancer with hypersplenism / 中华肝胆外科杂志

Objective To determine the efficacy of liver cancer resection combined with splenectomy for patients with hepatocellular carcinoma with hypersplenism.Methods Among 35 patients with hepatocellular cancer and hypersplenism treated from March 2004 to January 2006 at our hospital,12 patients accepted simultaneous liver cancer resection and splenectomy (the splenectomy group)and 23 only accepted liver cancer resection (the non-splenectomy group).The liver function,platelets and white blood cells were analyzed retrospectively.Results All the operations were successfully carried out.Within 1 week after operation,the white blood cell count increased from (3.2 ± 1.7) × 109/L to (8.5±-5.3) × 109/L,the platelet count increased from (52.6±23.7) × 109/L to (245.3±94.6) ×109/L(P＜0.01) in the group of patients with combined splenectomy,while little change occurred in the non-splenectomy group.The liver function in the splenectomy group recovered to the preoperational value within 1 week.Two years after operation,7 (58.3％) patients were still surviving in the splenectomy group and the mean tumor-free survival was (16.4 ± 4.3) months compared with (14.3 ±5.2) months in 10 (43.5％) patients in the non-splenectomy group,(P＜0.005).Conclusion Liver cancer resection combined with splenectomy was efficacious to hepatocellular cancer with hypersplenism.

The use of SPECT-CT in determining 90Y microspheres distribution post selective internal radiation therapy

Hepatocellular carcinoma and metastatic colorectal carcinoma are amongst the more common causes of cancer-related mortality worldwide. Selective internal radiation therapy (SIRT) with 90y microspheres is usually indicated in patients with nonresectable status and extensive colorectal liver metastases that are refractory to chemotherapy or target therapy. Several examinations, including CT, MRI or PET, serum chemical analyses, hepatic angiography and liver-lung shunting study with Tc-99m MAA, are done to ensure appropriateness and safety of therapy. Herein, three cases (two with hepatocellular carcinoma and one with metastatic colorectal cancer), which qualified for SIRT and underwent SPECT-CT, are presented. All of them underwent the necessary pre-therapy work-ups. The CT and PET-CT scans identified the hepatic lesions. The blood tests showed nearly normal hepatic and renal functions, except for the third case with elevated bilirubin level. The hepatic angiograms revealed no significant gastrointestinal shunting. The liver-lung shunting studies computed 10% hepatopulmonary shunt. Together with the patient with an elevated bilirubin level, they received a reduced dose of 90Y microspheres by 20%. After SIRT, bremsstrahlung planar imaging and SPECT-CT were performed to localize the distribution of the 90y microspheres, the findings of which correlated well with the results of the pre-therapy scans. The use of SPECT-CT is recommended for better anatomic localization and functional correlation.

The Effectiveness of Liver-soothing and Spleen-strengthening Traditional Chinese Medicine Combined with Intra-arterial Infusion of Chemical Medicine for Advanced Primary Hepatocellular Cancer Patients / 中国中医药信息杂志

Objective To observe the effectiveness of liver-soothing and spleen-strengthening traditional Chinese medicine combined with intra-arterial infusion of chemical medicine for advanced primary hepatocellular cancer patients.Methods One hundred and twenty primary hepatocellular cancer patients were randomly assigned to treatment group(60 patients) and control group(60 patients).The treatment group was treated by traditional Chinese medicine combined with intra-arterial infusion of chemical medicine,while only intra-arterial chemical medicine was applied to the control group.The intra-arterial chemical medicine was applied every four weeks.Each group received at least two courses of treatment.Aspects such as treatment effectiveness,quality of life,immune function and the condition of blood coagulation were observed.Results Clinical stable rate of the treatment group was 80.8%,higher than the control group obviously(P

Some biochemical disorders among patients with hepatocellular carcinoma

The biochemical changes among patients with hepatocellular carcinoma were various and common in which reduction of albumin synthesis (61%), reversion of A/G ratio (58%), bilirubinemia (21%), increases of SGOT (91%) and SGPT (82%) and these increases were direct proportional with progress of disease

Investigation of serum markers of hepatitis C virus in the hepatocellular carcinoma

100 patients with HCC, diagnosed by the clinical, Alpha Foetoprotein, imaging and cytological criteria; 50 patients in the control group. Anti HCV are performed by the techniques of EIA. HCV RNA is detected by RT PCR (reverse transcriptase PCR). The molecular biological techniques are performed at the Central Bio-medical laboratory in Hanoi Medical School. The frequency of serum anti HCV(ELISA) and especially of HCV RNA (RT-PCR) in the patients with HCC is also significantly higher than the one in the group of control: Anti HCV and HCV RNA.The co infection HBV-HCV is not significant in the hepatocarcinogennesis in our study. This study showed that hepatitis B virus is an important etiologic factor in the hepatocarinogenesis in Thua Thien Hue. The role of HCV is also remarkable and the co infections HCV-HBV are not significant in our study

Sonographic characteristics of hepatocellular carcinoma (HCC) lesions

144 HCC patients diagnosed histopathologically/cytologically with fine needle aspiration under sonographic leading were studied ultrasonically. 52.08% of patients had 1 lesion, 44.45% had more 2 lesions and only 3.47% had dispersive lesions. Of 75 cases with 1 lesion, 21 had under 5cm lesion, 42 from 5 to 10cm and 12 above 10cm. The relation between dimention of the lesion and its ultrasonic echo-pattern was investigated

Hepatocellular carcinoma- risk factors and survival duration after the treatment

A study on 523 patients with hepatocellular carcinoma in Central Army hospital during 1994-2002 has shown that average ages was 52,4+/- 13,2. The main etiology of hepatocellular carcinoma was hepatitis B virus. The survival duration in 5 groups of patients with hepatocellular carcinoma treated with PEIT, TOCE, surgery, chemotherapy and symptomatic treatment were 19,67; 11,3; 7; 9,2 and 2,7 months, respectively

Prognosis and monitoring significant of lectin affinity Alpha-fetoprotein in patients with hepatocellular carcinoma treated by transcatheter oil chemoembolization (TOCE)

20 patients selected from 60 patients with hepatocellular carcinoma who treated by transcatheter oil chemoembolization (TOCE). The patients diagnosed by cytology or history, with size of tumor (5cm), without portal venous thrombosis. The results have shown that the rate of ephafetoprotein (AFP)- L3 after the treatment by TOCE related closely with relapsing time of cancer and survival duration and image of CT scanner after the treatment.

Primarily results of chemico-embolization of hepatic artery for treatment of the primary hepatocellular cancer

Study on 47 rounds of chemicoembolization of hepatic artery in 24 patients with 26 hepatocellular tumors has shown that the hepatic arterial chemicocellular was interventive treatment with a very little damage for health hepatic tissues in the treatment of the primary hepatocellular cancer. The primarily results of this included embolization changed the tumor into the region without blood artery and vein, this method can be applied for the big tumor that obtained the good efficacy for local or systemic lesion.

Primarily application of treatment of hepatocellular cancer by ethanol injection

The hepatocellular cancer is the fourth position among cancer, the morbidity rate is increasingly. According to the size of tumor, an operation was implemented for tumor removal and hepatic arterial legation. For recent years, the army central hospital 108 have implemented to inject the ethanol for treatment of hepatocellular cancer for hepatic tumors with diameter of 3 cm and the tumors with diameter of 5 cm which found that the survival rate after 3 years of the ethanol injection was 90%. Recently the ethanol injection has been implemented by guidance of ultrasound for 6 patients (male: 5, female: 1) with ages of 54 - 75, and tumor’s diameter of 2.6-7cm and has obtained the results: pain free, appetite, weight gain, free fever (if having fever), less jaundice, normal or reduced alpha FP, and 1 patients lived more 13 months and 1 patient lived more 20 months after the treatment. These results suggested that ethanol injection was effective, economic solutions and lasts the life of patients.

Primarily study on the features of ultrasound Doppler images in patients with hepatocellular cancer (HCC)

Authors implemented the study to find characteristics of Doppler ultrasonic images in patients with HCC. This is a prospective study and carried out in B¹ch Mai Hospital. In the study on 15 patients, who had positive diagnosis of HCC, were selected. All of them underwent Doppler ultrasound and hepatic arteriography. Intra-tumoral and peri-tumoral flow is found with Doppler U.S 86.6% of tumors compared to the results of hepatic arteriography. The average peak velocity of hepatic artery and intratumoral artery is 83.3 and 57.2 cm/s respectively. The resistive Index is from 0.4 to 0.88 in intratumoural vessels.

Hepatocellular carcinoma in HuÕ hospital during 1990-1995 and 2000

A study on patients with hepatocellular carcinoma in HuÕ hospital during 1990-1995 and 2000 has shown that the disease was increasingly during 1990-2000, the morbidity rate was predominant higher than this in women, and average age of patients was reduced. The major etiological agent was hepatitis B virus. The alcohol played a combined role with hepatitis B virus in the hepatocellular carcinoma. The role of hepatitis C virus was not statistical significant.

Comparative study on some features of 2 patient groups of hepatocellular carcinoma with possitive HBV DNA and HCV RNA

A study carried out on patients with hepatocellular carcinoma in Hue hospital during 2000-2001. The obtained results as following: the average age of patients with hepatocellular carcinoma with positive HBVDNA was lower than this of patients with the hepatocellular carcinoma with positive HCVRNA. While the rate of male/female among group of hepatocellular carcinoma with positive HBVDNA was higher than this among group of hepatocellular carcinoma with the positive HCVRNA. The clinical and biological symptoms and ultrasound related with the cirrhosis in the group of hepatocellular carcinoma with the positive HCVRNA were more frequent than these in the group of hepatocellular carcinoma with positive HBVDNA were. There was difference of survival rate in the end of the sixth month between 2 groups but there was no difference in the end of the ninth month.