Surgery after combination therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody in sarcomatoid hepatocellular carcinoma: case report and literature review.

Introduction: Although surgery is the preferred treatment for sarcomatoid hepatocellular carcinoma (SHC), the prognosis remains considerably poor due to early postoperative recurrence and metastasis. Reports on surgery after combined treatment with a tyrosine kinase inhibitor and anti-programmed cell death (PD)-1 antibody are unavailable. Case presentation: A 69-year-old male patient with SHC was admitted to our hospital for treatment of a liver tumor that was detected on ultrasonography. Abdominal computed tomography with triple-phase enhancement revealed a lesion in the right hepatic lobe that measured 86.0 mm × 75.0 mm × 71.0 mm. Biopsy revealed a pathological diagnosis of liver sarcoma or sarcomatoid carcinoma. The patient subsequently received transcatheter arterial chemo-embolization, as he did not consent to surgery. More than two months later, he received a combination of lenvatinib with camrelizumab, as computed tomography showed an increase in the lesion size (to 123.0 mm × 90.0 mm × 80.0 mm) and lateral growth posterior to the upper pole of the right kidney. Liver resection was performed after 6 months of systemic therapy; pathological examination confirmed a diagnosis of SHC and showed extensive necrosis of tumor cells. Combined treatment with lenvatinib and camrelizumab was continued for 6 months after surgery. The patient has survived for over 24 months after initial diagnosis and is currently tumor-free. Conclusion: Combined systemic therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody may represent a feasible treatment strategy for improving resectability in cases of unresectable SHC. The outcomes with this combination may also be explored in cases of resectable SHC that have a high-risk of recurrence; this may improve the therapeutic effect.

Solitary fibrous tumor of the liver: A case report and review of the literature.

BACKGROUND: Hepatic solitary fibrous tumor (SFT) is a rare neoplasm. Up to now, only 90 cases have been reported in the English language literature. This report describes a case of SFT of the liver misdiagnosed as hepatocellular carcinoma. CASE SUMMARY: A 42-year-old male had a two-year history of a gradually enlarging intrahepatic nodule. The preoperative imaging revealed a mass with a size of 2.7 cm × 2.3 cm located in the segment IV of the liver. The patient was subjected to the resection of the segment IV, such as the medial segment of the left lobe of the liver. The histological examination of the mass showed various spindled cells irregularly arranged in the stroma. The immunohistochemistry of this mass revealed a positive staining for CD34 and STAT6. The history of intracranial tumor and postoperative pathological results led to the diagnosis of SFT of the liver (SFTL) due to a metastasis from the brain. CONCLUSION: SFTL is an uncommon mesenchymal neoplasm that can be easily overlooked or misdiagnosed. The best treatment choice is the complete surgical resection of the mass. A regular follow-up after the surgery should be performed due to the poor prognosis of metastatic or recurrent SFT.

[Effects of gingival fibroblasts transfected with human transform growth factor-beta1 gene on improving the periodontal tissue regeneration].

OBJECTIVE: To evaluate the effects of gingival fibroblasts (GF) transfected with hTGF-beta1 gene on improving the periodontal tissue regeneration for the repair of degree II artificial furcation defects. METHODS: The gingival fibroblasts transfected with hTGF-beta1 gene was compounded to the cuttlebone-transformed nanometer hydroxyapatite (CBHA) material from the cuttlefish in vitro, the degree II furcation defects on the premolars of dogs were produced surgically, and the compound was to implanted into the defect (transfected group), and compared with the compound of periodontal ligament cells (PDLC) with nanometer HA material and the compound of untransfected GF with HA. The results were examined histologically 8 weeks after operation. RESULTS: In the transfected group and the positive control group, more new attachment was found compared with the negative control (P < 0.01), and the NC, NB and NC of the transfected group and the positive control group were: (2.97 +/- 0.50), (4.29 +/- 0.26) and (4.73 +/- 0.06) mm; (3.09 +/- 0.26), (4.46 +/- 0.25) and (4.69 +/- 0.10) mm, respectively. There was no significant difference between the two groups (P > 0.05). Although the alveolar bone regeneration was found in the untransfected group [NB = (3.46 +/- 0.32) mm], the root resorption was observed. The tracing experiment showed that the transfected GF were found in the new alveolar bone and the periodontal membrane. CONCLUSIONS: GF transfected with hTGF-beta1 gene can significantly improve the periodontal tissue regeneration in treatment of degree II furcation defects and is involved in the formation of the new alveolar bone and the new periodontal membrane.

Morphological measurement of biologic width in Chinese people.

This study evaluated the biologic width in a Chinese population. Ten autopsy specimens of human jaws from 5 male Han Chinese cadavers were collected. Block sections of the jaws were dissected at autopsy. Six-mum-thick, mesio-distal and bucco-lingual sections were cut and stained with hematoxylin and eosin. The widths of the junctional epithelium and connective tissue were measured with a micrometer microscope at the middle of the mesial, distal, buccal, and lingual sites. Differences in biologic width among the 4 measured sites as well as between anterior and posterior teeth were compared. The mean biologic width was 2.17 mm. The width of the junctional epithelium was 1.07 mm, and that of the connective tissue 1.10 mm. The biologic width varied among the 4 sites and the width of the posterior teeth was greater than that of the anterior teeth.

MMP-2, MMP-9 and TIMP-2 gene polymorphisms in Chinese patients with generalized aggressive periodontitis.

BACKGROUND: Aggressive periodontitis (AgP) has a genetic basis. It has been reported that the functional gene polymorphisms of matrix metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of metalloproteinase-2 (TIMP-2) alter their expressions in transcriptional level and they are involved in the tissue destruction of periodontitis. The study was carried out to analyse the association of functional polymorphisms in MMP-2, MMP-9 and TIMP-2 with generalized AgP (G-AgP) in a Chinese population. MATERIAL AND METHODS: The study population consisted of 79 Chinese patients with G-AgP and 128 healthy controls. DNA was obtained from oral mucosa swab samples. MMP-2 genotypes were determined by PCR-based denaturing high-performance liquid chromatography analysis while MMP-9 and TIMP-2 genotypes were identified by a PCR-based restriction fragment length polymorphism. Chi2 test after Yates' correction was used to investigate the possible association of the genotypes with the G-AgP. RESULTS: Although gene polymorphisms for MMP-2 and MMP-9 did not show any association with the G-AgP, the analysis of the TIMP-2 -418G to C gene polymorphism revealed significant differences between the patients and controls. Compared with controls, a significant increasing trend of TIMP-2 -418C carrier in the G-AgP patients occurred (p=0.013). CONCLUSION: It is suggested that the TIMP2 -418G to C gene polymorphism is associated with G-AgP in the Chinese subjects.

[Preliminary report on measurement of human periodontal biologic width].

OBJECTIVE: To observe and measure the biologic width in Chinese people. METHODS: Jaws of three male Han Chinese cadavers were collected. All specimens were taken as autopsy as block sections. A total of 174 mesiodistal and buccolingual sections in 6 microm thickness were cut and stained with hematoxylin and eosin. The biologic width was measured under microscope with a micrometer at the middle of the mesial, distal, buccal, and lingual sides. Differences in biologic width were compared among 4 measurement sites, as well as among anterior tooth, premolar, and molar groups. RESULTS: The mean of biologic width of measured teeth was 2.17 mm, with the average width of junctional epithelium being 1.07 mm and the average width of connective tissue being 1.10 mm. No statistic difference was found among 4 measured sites. The biologic width of premolars (2.23 mm) and molars (2.25 mm) was larger than that of anterior teeth (2.07 mm). CONCLUSIONS: The average biologic width of three Chinese people is 2.17 mm. The biologic width of posterior teeth is larger than that of anterior teeth.