Objective To evaluate the outcome of liver transplantation in patients with recurrent liver cancer after resection. Methods Data of 23 patients underwent liver transplantation for recurrent liver cancer from April 2001 to March 2008 were retrospectively collected and analyzed. Results Previous history of liver resection had little negative effect in subsequent liver transplantation in technical aspect. Liver function recovered uneventfully after transplantation in all cases. Alpha fetoprotein (AFP) recovered to normal value in 13 of 17 cases with elevated AFP before transplantation within one month after operation. Five cases (21.74%) had postoperative complications. Nineteen cases (82.61%) were followed up, average follow-up duration were 610 days. There were 5 cases (26.32%) of cancer recurrence and 6 deaths during follow-up, survival rate was 68.42%. Conclusion Liver transplantation is a reasonable treatment for recurrent liver cancer after resection.
Objective To explore the clinical value and experience of ultrasound guided combined with laparoscopic microwave ablation in treatment for special site liver cancer．Methods The clinical data of 9 patients with liver cancer treated by ultrasound guided combined with laparoscopic microwave ablation in our hospital from February 2008 to October 2010 were analyzed retrospectively．Results There were 6 cases of primary liver cancer， 3 cases of metastatic hepatic carcinoma. Eight cases of multiple tumors， 1 case of single tumor．There were one or more lesions invading liver capsular，a total of 13 lesions in all the patients． Among them，6 lesions located in diaphragm， 3 closed to bowel， 2 neared stomach，1 located in gallbladder bed and 1 in hilar．No serious complications and no death happened during operation．The following-up time was （9.2±4.7） months （4 to 18 months）， there were 2 lesions of part residual， including 1 case of microwave ablation again，1 case of percutaneous ethanol ablation， and 11 lesions of complete ablation （84.6%，11/13） 1 month after operation by CT examination．Four cases recurred 3 months after operation by CT examination， including 2 cases of microwave ablation again，1 case of percutaneous ethanol ablation，1 patient with pulmonary metastasis and giving up treatment，1 patient with poor liver function and died of liver failure 6 months after operation；1 patient with multiple lesions died of brain metastases 10 months after operation； the rest were still alive．Conclusions Ultrasound guided combined with laparoscopic microwave ablation is a safe and effective method in the treatment for special site liver cancer，the curative effect is good and worth of spread．
Objective To probe into the significance of tuftsin in patients with liver cancer. MethodsThe serum tuftsin level of 12 patients with liver cancer before and after the resection，20 cirrhostic and 20 normal controls were measured by radioimmunoassay (RIA). ResultsTuftsin level in preoperative group （449±106） ng/ml was much lower than that in postoperative group (588±129) ng/ml，cirrhotics group (580±187) ng/ml and control group (703±128) ng/ml (P＜0.01). The tuftsin level in postoperative group was also quite lower than that in control group (P＜0.01). Conclusion We should try our best to excise the liver cancer so that a higher tuftsin level might be obtained which can activate NK cell and T cell.
Objective To analyze the application of bipolar radiofrequency-assisted device or monopolar radiofre-quency-assisted ablation in treatment for liver cancer by operation. Methods From June 2008 to May 2012， 56 patients with liver cancer underwent operation with bipolar radiofrequency-assisted device （Habib group， n=22） or monopolar radiofrequency-assisted ablation （mRFA group， n=34） were selected retrospectively. The operation time， postoperative morbidity， hospital stay， hospital costs， intraoperative bleeding， and therapeutic effects were compared in two groups. Results The percentage of patients with liver cirrhosis was 85.7% （48/56）， with multiple tumors was 12.5% （7/56）， underwent laparoscopic operation was 16.1% （9/56）. Patients with the tumor diameter greater than 5 cm in the Habib group were more than that in the mRFA group （P=0.000）， the laparoscopic surgery proportion had no significant difference in two groups （P=0.074）. ① The intraoperative bleeding in the Habib group was more than that in the mRFA group （P=0.000）. Two patients were adopted a hepatic portal blocking and 3 patients with intraoperative blood transfusion in the Habib group. ② The operation time in the Habib group was longer than that in the mRFA group （P=0.021）， but there was no difference of the operation time in two groups patients with tumor diameter greater than 5 cm （P=0.191）. ③ The postoperative morbidity had no obvious difference in two groups 〔18.2% （4/22） versus 11.8% （4/34）， P=0.780〕. ④ Thehospital stay and the hospital costs in the Habib group were significantly more than those in the mRFA group （P=0.001， P=0.004）.⑤The tumor residuals were found in two patients with tumor diameter greater than 5 cm. Conclusions Treatment for liver cancer by operation with bipolar radiofrequency-assisted device or monopolar radiofrequency-assisted ablation is safe and effective. The monopolar radiofrequency-assisted ablation has advantages of less intraoperative bleeding， more minimal invasion proportion， less hospital stay and hospital costs for liver cancer patients with small tumor （diameter＜3 cm）， multifocal tumors and minimal invasion conditions as compared with bipolar radiofrequency-assisted device. Operation with bipolar radiofrequency-assisted device in patients with larger tumors （diameter≥5 cm） resection might be a better choice.
Objective To evaluate the suitability of the biodegradable microsphere encapsulation of adenovirus as a targeting vector for gene therapy of hepatocellular carcinoma. Methods Encapsulate the recombinant adenovirus in PLG 〔poly (lactic/glycolic)〕 copolymer by the solution evaporation method, the release test and the bioactivity of viruses incorporated in vitro were studied. Results More than 19.3% of adenovirus was encapsulated in PLG microspheres. The release test shows that the adenovirus was released for more than 200 h, 50% were shed within the first 100 h, and their activity was retained. Conclusion Recombinant adenovirus can be formulated in a polymer preparation of PLG with retention of bioactivity. It may be a valuable vector for the gene therapy of liver cancer.
ObjectiveTo systematically review the association between angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) therapy and digestive system neoplasms.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were searched from inception to February 2017 to collect studies about ACEIs/ARBs therapy and risk of digestive system neoplasms or survival of digestive system neoplasms patients. Two reviewers independently screened the literature, extracted the data and evaluated the risk of bias of included studies, then meta-analysis was performed using Stata 12.0 software.ResultsA total of 21 articles including 32 studies were included. The results of meta-analysis showed that ACEIs/ARBs therapy could reduce the risk of colorectal cancer (OR=0.92, 95%CI 0.86 to 0.99, P=0.023), but there were no relationships between ACEIs/ARBs therapy and the risk of liver cancer or gastric cancer. ACEIs/ARBs therapy could improve the survival of colorectal cancer patients (HR=0.79, 95%CI 0.63 to 0.98, P=0.031), but there was no association between ACEIs/ARBs therapy and the survival of pancreatic cancer patients (HR=0.75, 95%CI 0.50 to 1.13, P=0.165).ConclusionACEIs/ARBs therapy may reduce the risk of colorectal cancer, as well as improve the survival of colorectal cancer patients, but there are no significant relationships between ACEIs/ARBs therapy and the risk or the survival of other digestive system neoplasms, such as liver cancer, gastric cancer and pancreatic cancer. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
【Abstract】ObjectiveTo investigate whether tumor necrosis factor-α (TNF-α) enhance the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9(MMP-9) in hepatic cancer cell line HepG2 or not. Methods Cultured HepG2 cells were treated by TNF-α with various concentration and time. The morphological changes of HepG2 cells were studied microscopically and the proliferation of HepG2 were detected by methyl thiazolyl tetrazolium (MTT). The expression of VEGF and MMP-9 mRNA in cultured HepG2 were determined by relative quantitative reverse transcription polymerase chain reaction. The VEGF and MMP-9 protein level in supernatants and in cytoplasm were determined by enzymelinked immunosorbent assay (ELISA) and by immunocytochemical staining, respectively.Results There was a little morphological changes in HepG2 with TNF-α treatment, but no change of cell proliferation in corresponding time. The expression of VEGF and MMP-9 mRNA was enhanced gradually with the TNF-α concentration increasing, the VEGF and MMP-9 protein level in supernatants and in cytoplasm was elevated gradually with the concentration increasing. There was a dependance on the concentration when the concentration of TNF-α was lower than or equal to 104 U/L. Furthermore, the effect of promotion was close to peak when the TNF-α concentration up to 104 U/L; but no timeeffect pattern observed. Conclusion TNF-αJP can enhance the expression of VEGF and MMP-9 at the level of mRNA and protein in hepatic cancer cell line.
Objective To compare the application effects of three psychometric instruments including SF-36, FLIC and QOL-LC in measuring the quality of life of patients with liver cancer. Methods A total of 105 in-patients with liver cancer selected from 2010 to 2011 were included. The quality of life was measured by FLIC, SF-36 and QOL-LC, respectively, and the reliability, validity and responsiveness were calculated and analyzed. Results The reliability and validity of QOL-LC were better than those of SF-36 and FLIC. Both QOL-LC and FLIC showed significant differences in responsiveness based on the changes of physical function and overall quality of life (QOL-LC: t=5.08, P=0.000, t=3.16, P=0.002; FLIC: t=4.02, P=0.000, t=2.21, P=0.030). Except for general health and mental health, the other domains of SF-36 showed significant differences in changes after treatment (physical function: t=5.94, P=0.000; physical role: t=3.07, P=0.003; body pain: t=3.21, P=0.002; vitality: t=3.22, P=0.002; social role: t=2.60, P=0.012; emotional role: t=3.28, P=0.002). Conclusion QOL-LC is a specific scale for liver cancer, and it should be used preferentially. SF-36 and FLIC can measure the general state of quality of life and can be used in patients with liver cancer when specific scale is not available.
Objective To investigate the growth of tumors and the natural life length of the rats after the adriamycinethylcellulose microspheres(ADM-EC mc) were injected in the rats bearing transplantable liver cancer through their hepatic arteries.Methods ADM-EC mc were infused into the proper hepatic arteries of the Wistar rats (W256). All of the rats were divided randomly into five groups, group 1: control, group 2: normal saline, group 3: conventional ADM, group 4: placebo ethylcellulose microspheres, and group 5: ADM-EC mc. Results As compared with other four groups, the ADM-EC mc (group 5) showed the best inhibition of the growth of tumors and the longest mean life length of the rats. Conclusion Hepatic arterial infusion of ADM-EC mc can inhibit the growth of the tumor, aggravate the necrosis, and improve the effects of the chemotherapy of liver cancer.
Objective To study the interferencing and anti-tumor effects of lentiviral vector of siRNA targeting IGF1R and EGFR gene of the liver cancer cell. Methods The complementary DNA containing both sense and antisense Oligo DNA of the targeting sequence was designed, synthesized and connected to the pLVTHM vector, named pLVTHM-IGF1R, into whom the EGFR-siRNA expression frame containing H1 promotor synthesized by RT-PCR was cloned to generate pLVTHM-IGF1R-EGFR-siRNA. The 293T cells were cotransfected by 3 plasmids of pLVTHM-IGF1R-EGFR-siRNA, psPAX2 and pMD2G to enclose LVTHM-IGF1R-EGFR-siRNA, which was amplified in large amount and purified by caesium chloride density gradient centrifugation for measurement of virus titer. SMMC7721 cells infected by LVTHM-IGF1R-EGFR-siRNA were infection group, the untreated SMMC7721 cells and blank vector plasmid LVTHM were two control groups (SMMC7721 cell group and blank vector group). The effect of LVTHM-IGF1R-EGFR-siRNA on IGF1R and EGFR expressions of SMMC7721 cells were detected by RT-PCR and Western blot. The antitumor potential of LVTHM-IGF1R-EGFR-siRNA to SMMC7721 cells was evaluated by Cell Counting Kit-8 assay for cell growth and TUNEL for apoptosis respectively. Results LVTHM-IGF1R-EGFR-siRNA was constructed successfully. Functional pfu titers of LVTHM-IGF1R-EGFR-siRNA was 4.58×109 pfu/ml. Protein and mRNA expression of IGF1R and EGFR of infection group were less than those of blank vector group and SMMC7721 cell group （P＜0.05）, LVTHM-IGF1R-EGFR-siRNA was more effective to inhibit the proliferation and promote apoptosis of SMMC7721 cells （P＜0.05）. Conclusion LVTHM-IGF1R-EGFR-siRNA expressing IGF1R-EGFR-siRNA can inhibit the expression of IGF1R and EGFR, and may be used for further investigation of gene therapy of liver cancer.