ABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical value of Lens culinaris agglutinin-reactive alpha-fetoprotein detected by microspincolum method for judgment of treatment response in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization.</p><p><b>METHODS</b>Twenty eight patients with HCC undergoing TACE follow-up in hospital were recruited. AFP and AFP-L3 were measured in all the patients before and after TACE, and correlations were analyzed between AFP-L3% and response to treatment.</p><p><b>RESULTS</b>Among the twenty eight patients with HCC undergoing TACE, 8 out 11 case in AFP-L3% descent group had well treatment response, 5 out 17 case in AFP-L3% elevated group had well treatment response(Chi2 = 4. 858, P < 0. 05).</p><p><b>CONCLUSIONS</b>The detection of AFP-L3 by microspincolum method is useful to judgment of treatment response in patients with HCC undergoing TACE.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Chemistry , Therapeutics , Chemoembolization, Therapeutic , Methods , Liver Neoplasms , Chemistry , Therapeutics , Treatment Outcome , alpha-FetoproteinsABSTRACT
BACKGROUND/AIMS: To investigate the expression of multi-drug resistance-related genes, MDR3 and MRP, in clinical specimens of primary liver cancer and their potential as prognostic factors in liver cancer patients. METHODOLOGY: A total of 26 patients with primary liver cancer were enrolled. The expression of MDR3 and MRP genes was measured by real-time PCR and the association between gene expression and the prognosis of patients was analyzed by the Kaplan-Meier method and COX regression model. RESULTS: This study showed that increases in MDR3 gene expression were identified in cholangiocellular carcinoma, cirrhosis and HBsAg-positive patients, while MRP expression increased in hepatocellular carcinoma, non-cirrhosis and HBsAg-negative patients. Moreover, conjugated bilirubin and total bile acid in the serum were significantly reduced in patients with high MRP expression compared to patients with low expression. The overall survival tended to be longer in patients with high MDR3 and MRP expression compared to the control group. MRP might be an independent prognostic factor in patients with liver cancer by COX regression analysis. CONCLUSIONS: MDR3 and MRP may play important roles in liver cancer patients as prognostic factors and their underlying mechanisms in liver cancer are worthy of further investigation.
Subject(s)
ATP Binding Cassette Transporter, Subfamily B/genetics , Carcinoma, Hepatocellular/genetics , Cholangiocarcinoma/genetics , Gene Expression , Liver Neoplasms/genetics , Multidrug Resistance-Associated Proteins/genetics , Adult , Aged , Bile Acids and Salts/blood , Bilirubin/blood , Carcinoma, Hepatocellular/blood , Carcinoma, Hepatocellular/pathology , Cholangiocarcinoma/blood , Cholangiocarcinoma/pathology , Female , Hepatitis B Surface Antigens , Humans , Kaplan-Meier Estimate , Liver Cirrhosis/complications , Liver Cirrhosis/genetics , Liver Neoplasms/blood , Liver Neoplasms/pathology , Male , Middle Aged , Prognosis , Proportional Hazards Models , Real-Time Polymerase Chain ReactionABSTRACT
BACKGROUND: Capillary leak syndrome (CLS) is a rare condition characterized by recurrent episodes of generalized edema and severe hypotension associated with hypoproteinemia. Interleukin-11 (IL-11) is a promising therapeutic agent for thrombocytopenia. A direct correlation between IL-11 and CLS has never been reported previously, particularly in patients with hepatic carcinoma. CASE PRESENTATION: We describe two cases of CLS after IL-11 administration in two males with thrombocytopenia. Case 1 was a 46-year-old man with recurrence of hepatic carcinoma who was treated with IL-11 (3 mg per day). After four days of therapy, hypotension and hypoproteinemia were detected. The chest X-ray and B ultrasound of the abdomen showed pleural effusion and ascites. IL-11 was then discontinued, fluid resuscitation was performed, and fresh frozen plasma and packed red blood cells were transfused into this patient. The patient had recovered after 19 days of treatment. Case 2 was a 66-year-old man who had undergone radiofrequency ablation (RFA) for hepatic carcinoma. He was treated with IL-11 (3 mg per day) for thrombocytopenia. After two days of therapy, this patient complained of dyspnea with bilateral edema of the hands. Laboratory values showed hypoproteinemia. IL-11 was stopped and human albumin was transfused at a rate of 10 g per day. On the 4th day, fluid resuscitation was performed. The patient had recovered after treatment for two weeks. CONCLUSIONS: The detection of IL-11-induced CLS supports the hypothesis that CLS could be a severe side effect of IL-11 treatment in some patients. These two case reports also demonstrate that patients with hepatic carcinoma who experience this rare form of CLS after treatment with IL-11 seem to respond to a therapeutic regimen that involves hydroxyethyl starch, albumin, and diuretic therapy. Liver cancer patients might be more susceptible to CLS because of poor liver function and hypersplenia. In addition, bleeding after RFA might be a further inducer of CLS.
Subject(s)
Capillary Leak Syndrome/chemically induced , Carcinoma, Hepatocellular/complications , Interleukin-11/pharmacology , Liver Neoplasms/complications , Thrombocytopenia/drug therapy , Thrombocytopenia/etiology , Aged , Capillary Leak Syndrome/diagnosis , Capillary Leak Syndrome/pathology , Capillary Leak Syndrome/therapy , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of the combination of oxaliplatin and ELF (VP16/CF/5-Fu) regimen in the treatment of patients with advanced gastric cancer.</p><p><b>METHODS</b>Oxaliplatin was given at a dose of 100 mg/m(2) i.v. 2 hours D1, calcium folinate (CF) 200 mg/m(2) i.v. 1/2 hour D1 approximately D3, 5-fluorouracil (5-Fu) 500 mg/m(2) i.v. 2 hours D1 approximately D3 and etoposide 100 mg/m(2) i.v. 3 hours D1 approximately D3. Cycles were repeated every 21 days. Efficacy and safety were evaluated every 2 cycles.</p><p><b>RESULTS</b>Sixty-nine patients were enrolled into the study. All cases were pathologically confirmed as gastric cancer (adenocarcinoma in 57 cases and signet ring cell carcinoma in 12 cases). 42 patients had newly diagnosed disease, and 27 patients had received previous chemotherapy. 62 patients were analyzed for response (7 complete responses and 25 partial responses) with total response rate 51.61%. The median time to progression was 5.7 months and the median overall survival was 9.2 months. The most common hematologic toxicities were anemia (29.0%), leucopenia (51.2%) and thrombocytopenia (21.2%). No grade 4 and grade 5 hematologic toxicities were observed. The most common non-hematologic toxicities were nausea (46.5%), vomiting (41.1%), peripheral sensory neuropathy (47.1%), and grade 2 alopecia (27.3%).</p><p><b>CONCLUSION</b>This oxaliplatin combined with ELF regimen shows good efficacy and acceptable safety in advanced gastric cancer patients. It is worthy to be proved as a suitable alternative regimen in this indication.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma , Drug Therapy , Pathology , Anemia , Antineoplastic Agents , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Carcinoma, Signet Ring Cell , Drug Therapy , Pathology , Etoposide , Therapeutic Uses , Fluorouracil , Therapeutic Uses , Leucovorin , Therapeutic Uses , Leukopenia , Levoleucovorin , Nausea , Neoplasm Staging , Organoplatinum Compounds , Remission Induction , Stomach Neoplasms , Drug Therapy , Pathology , Survival Rate , Thrombocytopenia , VomitingABSTRACT
<p><b>OBJECTIVE</b>To investigate the therapeutic efficacy and adverse reactions of Aidi Injection (AI) combined with percutaneous cool-tip radiofrequency ablation (CRFA) in treatment of primary liver cancer and to explore its effect on immune function.</p><p><b>METHODS</b>Eighty-nine patients with primary liver cancer at middle-late stage were assigned to the control group with CRFA alone and the treatment group treated with CRFA and intravenous dripping of AI 50 mL once every day for succesive 20 days.</p><p><b>RESULTS</b>Compared with those before treatment, the alanine aminotransferase (ALT) and albumin (ALB) levels showed no marked change, and CD4 subgroup of T lymphocyte and CD4/CD8 ratio elevated in the treatment group (P<0.01), while the ALT level elevated (P<0.05), ALB level decreased (P < 0.01), CD4 and CD4/CD8 ratio showed no change in the control group. The relapse rate was 20.0% (3/15) in patients with tumor more than 3 cm in diameter of the treatment group, which was obvious lower than that in the control group (55.0%, 11/20, P < 0.05).</p><p><b>CONCLUSION</b>AI treatment could relieve the impairment of CRFA on hepatic function, improve immune function and reduce relapse rate in patients with primary liver cancer.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , CD4-CD8 Ratio , Carcinoma, Hepatocellular , Allergy and Immunology , Therapeutics , Catheter Ablation , Methods , Combined Modality Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Infusions, Intravenous , Liver Neoplasms , Allergy and Immunology , Therapeutics , Phytotherapy , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To study the pharmacokinetic of 10-Hydroxycamptothecin HCPT by intraperitoneal administration.</p><p><b>METHOD</b>Six dogs were given HCPT by intraperitoneal perfusion: HCPT 2 mg x kg(-1), dissolved in 300 mL NS. During the course of experiments, peritoneal fluids and blood were sampled using a standardized protocol. The concentration of HCPT in all samples was determined by high performance liquid chromatography (HPLC).</p><p><b>RESULT</b>The area under the curve (AUC) of peritoneal fluids was significantly highly as compared to the AUC of femoral vein and portal vein (P < 0.001).</p><p><b>CONCLUSION</b>These experiments demonstrate that intraperitoneal chemotherapy has significant effect on the pharmacokinetics of IP route of HCPT administration. This method should be a more reasonable chemotherapy for the prevention of recurrence and liver metastasis of gastric cancer, colon cancer and ovary cancer after radical resection.</p>
