Prognostic Factors of Radiofrequency Ablation plus Systemic Chemotherapy for Unresectable Colorectal Cancer with Liver Metastasis.

INTRODUCTION: Survival outcomes in patients with unresectable colorectal cancer (CRC) liver metastasis treated by radiofrequency ablation (RFA) combined with systemic chemotherapy and correlation with potential prognostic factors were investigated. Material and Methods. A retrospective cohort study was conducted on 61 CRC patients with unresectable liver metastasis who underwent liver tumor-directed percutaneous RFA combined with conventional systemic chemotherapy between October 2013 and September 2018. Survival analyses were conducted using the Kaplan-Meier method, and the log-rank test was used to characterize differences in the median survival time and the 1-year, 3-year, and 5-year overall survival rates of subgroups to identify prognostic factors. RESULTS: Median overall survival and progression-free survival of all patients were 32 and 14 months, respectively. The cumulative survival rates at 1-, 3-, and 5-years were 93.2%; 44.5%, and 38.2%, respectively. Univariate analysis revealed that pre-RFA serum CEA levels, Eastern Cooperative Oncology Group (ECOG) status, number of liver lesions, the size of the largest lesion, and the total lesion size were prognostic factors. However, multivariate analysis demonstrated that only the number of liver lesions and the size of the largest lesion were independent prognostic factors for survival. CONCLUSION: RFA plus systemic chemotherapy provides an encouraging survival outcome for patients with unresectable CRC liver metastasis. Multivariate analysis demonstrated that the number and size of liver metastatic lesions are independent prognostic factors for survival.

Evaluation of the anti-East Asian CagA-specific antibody for CagA phenotyping.

The determination of the cagA genotype is generally based on sequencing the variable 3' region of the cagA gene. In a previous study, we successfully generated an anti-East Asian CagA-specific antibody (anti-EAS Ab) immunoreactive only with the East Asian CagA and not with the Western CagA. In a small number of Japanese patients, anti-EAS Ab appeared to be a useful tool for phenotyping CagA immunohistochemically. The present study was conducted to validate the anti-EAS Ab immunohistochemistry method in a larger number of patients from Vietnam and Thailand. A total of 385 Vietnamese and Thais were recruited. Helicobacter pylori status was determined by a combination of three methods, including culture, histology, and immunohistochemistry with anti-H. pylori antibody. The sensitivity, specificity, and accuracy of the anti-EAS Ab immunohistochemistry method for the diagnosis of CagA phenotype were calculated based on the results of the cagA sequencing as the gold standard. The sensitivity, specificity, and accuracy of our immunohistochemistry method were 96.7%, 97.9%, and 97.1%, respectively. Moreover, anti-EAS Ab was not cross-reactive with noninfected gastric mucosa. In conclusion, immunohistochemistry with anti-EAS Ab appears to be a good method for determination of CagA phenotype.

Emercency ligation of varices for treatment of esophageal varices bleeding

52 patients (46 males, 6 females) with esophageal varices bleeding, age from 19-84 years, who were treated at the Central Military hospital 108 from September 2002 to September 2003. The level of breakdown via endoscopy and the number of esophageal varices breakdown on 52 patients included: 5 cases with mild level, 13 cases with average and 34 cases with severe level; 7 patients at grade II, 45 grade III; 59.6% of patients in the first time of bleeding, 21.6% secondly and 19.2% ≥3 times. Treatment results: 71.2% patients had a complete hemostasis; recurrent rate was 57.7%, in which the rate was 9.6% during first month. For 2 years of followed up, mortality rates one month and 2 years after were 13.3% of 57.7%, respectively. The results indicated that the endoscopic varices ligation have good effectiveness in urgent hemostatic cases but ineffectiveness in long-term outcome.

Clinical, paraclinical pictures and causes of acute pancreatitis

In the study, 166 patients (125 men, 41 women) with acute pancreatitis were treated at Central Military Hospital 108 from August 2003 to August 2005. The common clinical symptoms of acute pancreatitis were epigastrium severe pain 100%, continuous or interrupted pain; localize or spread; fever 51.2%; vomiting 35.5%; abdominal gas 92.8%; peritoneal hypersensitive 92.8%. Among the patients, 90.4% were mild and average; 9.6% were severe. Paraclinical features included a high concentrate of serum and urine amylase (96.4 and 94%, respectively) at different levels that was not relative with the severity; 50% of the patients had big pancreas in ultrasonography. The common causes of acute pancreatitis were big meal with drinking 24.1%, bile stones 13.2%, ascarid in bile tract 9.6% and some other causes; unknown causes 38.7%

The value of fine needle aspiration cytopuncture in diagnosis of hepatocellular carcinoma

In this study, fine needle aspiration cytopuncture (FNAC) was done for 220 patients with liver tumors. The findings showed that FNAC was of high value in diagnosis of Hepatocellular Carcinoma (HCC). Successful first time of FNAC was 93.2%. The accurate rate 97.7%, sensitivity 97.3% and specificity 100%. 19.6% patients were in well differentiated; 47.7% average differentiated and 32.7% poor differentiated. 86.7% tumor under 3cm in diameter with well-differentiation and 86.7% tumor over 9cm in diameter with poor-differentiated. The FNAC is simple, easy performing and safe method

Clinical and paraclinical features and the factors related to irritable bowel syndrome

A prospective study on 50 patients with irritable bowel syndrome (IBS) at Gastroenterology Department of Central Military Hospital 108 between June 2003 and June 2005. Results showed that the common clinical features of IBS were: abdominal pain (100%), untaste in abdominal cavity (96%), bowel disturbance (100%), flatulence (72%). The relative factors causing IBS consisted of intellectual work (72%), eating much lipid (36%), stinking food (30%) and smoking (16%). The Rome II criteria were applied effectively in the diagnosis of IBS. Three main criteria with very high rates were: 92% pain relieve of bowel movement, 68% pain related to the change of bowel movement frequency and 96% pain related to the change of faeces shape

Thymosin-a 1 for treatment of chronic hepatitis B

A study on 56 patients with chronic hepatitis B who were divided into 2 groups: study group and control group. The study group including 31 patients was treated with Thymosin-α1 1.6mg/day, twice a week for 6 months. The control group with 25 patients of same clinical data was treated with common liver-protective drugs. Both groups were monitored and assessed after 24 months. The results showed that the study group with treatment of Thymosin-α1 is better than control one in all aspects of ALT normalization, sero-conversion and decrease of HBV-DNA<5 copies/ml

The value of clinical examination, ultrasound, AFP, CT scanning, fine needle aspiration cytopuncture and combination of these methods in the diagnosis of hepato cellular carcinomas

In this prospective study, 685 patients with hepato cellular carcinomas were diagnosed and treated in the Central Military Hospital 108 for 4 years from Mar 2001 to Feb 2005. The resulst as: hepato cellular carcinomas often occured in males, 7 times higher than in females. The most common symptoms are pain on lower right side (80.9%), fatigue (45.5%), swollen liver (79.6%). 70.9% of patients were detected by ultrasound, 70.6% of patients were detected by computer tomography among which 51.8% with one single tumor; 38.7% with 3 or more tumors; 51% with tumors on right liver. Nearly 70% of patients had high AFP, 26.3% of patients had AFP>1000ng/ml. The accuracy of diagnosis increased to 97.5% by combination of all methods of clinical examination, ultrasound, AFP, CT scanning and fine needle aspiration cytopuncture

Nexium, Ospamox and Klacid (NOK) triple therapy for treatment of gastric ulcer with positive Helicobacter pylori

56 patients with gastric ulcers were treated by triple therapy with Nexium, Ospamox and Klacid (NOK).45 days after treatment, 89.3% patients had no gastric pain; 92.8% patients had ulcer healing, HP eradication rate 94.6% at 6 months and 12 months after treatment, 95% and 93.8% patients had ulcer healing; HP eradication rate was 90% and 90.6%; gastric pain and ulcer recurrence was 7.5% and 6.3%, respectively; HP-positive return rate was 10% and 9.4%

Combination of Transcatheter Oily Chemoembolization and ? 1-Thymosin in treating HCC

The aim of this study is to evaluate the therapeutic potential of the immunostimulating adjuvant in patients with HCCs¬¬¬.46 patients with HCCs were divided into 2 groups: group I (30pts) treated by Transcatheter Oily Chemoembolization (TOCE alone), group II resulted in a better clinical improvement, decreased AFP and tumor size, and a longer mean survival time versus group I. Combined treatment demonstrated a significant increase in lymphocytes expressing CD 16-CD 56 with NK activity and followed by a rise in lymphocyte with morphological feature of cytotoxic lymphocyte ( CD8 positive) was observed