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Hepatocellular carcinoma: current management and recent advances

Hepatobiliary & Pancreatic Diseases International 2008年第3期7卷 237-257页

作者： wan-Yee lau Eric C. H. Lai Faculty of Medicine The Chinese University of Hong Kong Prince of Wales Hospital Shatin New Territories Hong Kong SAR China

BACKGROUND: Hepatocellular carcinoma (HCC) is a major health problem worldwide. It is the fifth most common cancer in the world, and the third most common cause of cancer-related death. Without specific treatment, the prognosis is very poor. The goal of management is 'cancer control'-a reduction in its incidence and mortality as well as an improvement in the quality of life of patients with HCC and their families. This article aims to review the current management of HCC and its recent advances. DATA SOURCES: A MEDlinE database search was performed to identify relevant article using the keywords 'hepatocellular carcinoma', 'hepatectomy', 'liver transplantation', and 'local ablative therapy'. Additional papers and book chapters were identified by a manual search of the references from the key articles. RESULTS: Liver resection and liver transplantation remain the options that give the best chance of a cure. Recent evidence suggests that local ablative therapy may offer comparable survival results in patients with small HCC, and preserved liver function. Transarterial chemoembolization (TACE) is the most promising palliative modality for unresectable HCC, but other techniques, such as transarterial radioembolization (TARE), and local ablative therapy, have also shown comparable results. CONCLUSIONS: Early diagnosis of HCC remains a key goal in improving the prognosis of patients. During the last two decades, operative mortality and surgical outcome of liver resection and liver transplantation for HCC have improved. Progress also has been made in multi-modality therapy which can increase the chance of survival and improve the quality of life for patients with advanced HCC.

关键词： hepatocellular carcinoma hepatectomy liver transplantation local ablative therapy

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The first draft genome assembly and data analysis of the Malaysian mahseer (Tor tambroides)

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Aquaculture and Fisheries 2023年第5期8卷 481-491页

作者： Melinda Mei lin lau Leonard Whye Kit Lim Hung hui Chung Han Ming Gan Faculty of Resource Science and Technology Universiti Malaysia SarawakKota SamarahanSarawak94300Malaysia GeneSEQ Sdn Bhd Bandar Bukit BeruntungRawangSelangor48300Malaysia Centre for Integrative Ecology School of Life and Environmental SciencesDeakin UniversityGeelongVictoriaVIC3220Australia

The Malaysian mahseer(Tor tambroides),one of the most valuable freshwater fish in the world,is mainly targeted for human *** mitogenomic data of this species is available to date,but the genomic information is still *** the first time,we sequenced the whole genome of an adult fish on both Illumina and Nanopore *** hybrid genome assembly had resulted in a sum of 1.23 Gb genomic sequence from the 44,726 contigs found with 44 kb N50 length and BUSCO genome completeness of 87.6%.Four types of SSRs had been detected and identified within the genome with a greater AT abundance than that of *** protein sequences had been functionally annotated to public databases,namely GO,KEGG and COG.A maximum likelihood phylogenomic tree containing 52 Actinopterygii species and one Sarcopterygii species as outgroup was constructed,providing first insights into the genome-based evolutionary relationship of *** with other ray-finned *** data are crucial in facilitating the study of population genomics,species identification,morphological variations,and evolutionary biology,which are helpful in the conservation of this species.

关键词： Genome Gene annotation Tor tambroides Phylogenetic Functional annotation

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Potential use of nanofiltration like-forward osmosis membranes for copper ion removal

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Chinese Journal of Chemical Engineering 2020年第2期28卷 420-428页

作者： wan Nur Ain Shuhada Abdullah Sirinan Tiandee Woeijye lau Farhana Aziz Ahmad Fauzi Ismail Advanced Membrane Technology Research Centre(AMTEC) Universiti Teknologi Malaysia81310 SkudaiJohorMalaysia School of Chemical and Energy Engineering Universiti Teknologi Malaysia81310 SkudaiJohorMalaysia Faculty of Science and Industrial Technology Prince of Songkla UniversitySurat Thani Campus84000 Surat ThaniThailand

The discharge of industrial effluent containing heavy metal ions would cause water pollution if such effluent is not properly *** this work,the performance of emerging nanofiltration(NF)like-forward osmosis(FO)membrane was evaluated for its efficiency to remove copper ion from ***,copper ion is removed from aqueous solution via adsorption and/or ion-exchange *** engineered osmosis method as proposed in this work considered four commercial NF membranes(i.e.,NF90,DK,NDX and PFO)where their separation performances were accessed using synthetic water sample containing 100 mg·L-1 copper ion under FO and pressure retarded osmosis(PRO)*** findings indicated that all membranes could achieve almost complete removal of copper regardless of membrane orientation without applying external driving *** high removal rates were in good agreement with the outcomes of the membranes tested under pressuredriven mode at 1 *** use of appropriate salts as draw solutes enabled the NF membranes to be employed in engineered osmosis process,achieving a relatively low reverse solute *** findings showed that the best performing membrane is PFO membrane in which it achieved N 99.4%copper rejection with very minimum reverse solute flux of<1 g·m-2·h-1.

关键词： Nanofiltration Forward osmosis Copper Divalent salt Water flux

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A ruptured recurrent small bowel gastrointestinal stromal tumour causing hemoperitoneum

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Frontiers of Medicine 2015年第1期9卷 108-111页

作者： Eric C.H. Lai Kam Man Chung Stephanie H.Y. lau wan Yee lau Faculty of Medicine The Chinese University of Hong Kong Shatin Hong Kong SAR China Dr. K.M. Chung's Clinic Rm 807 Hang Seng Tsimshatsui Building 18 Carnarvon Road Tsimshatsui Hong Kong SAR China Department of Surgery Pamela Youde Nethersole Eastern Hospital Hong Kong SAR China Department of Surgery Queen Elizabeth Hospital Hong Kong SAR China

Hemoperitoneum is a rare and potentially life-threatening complication of GIST. We reported a 54- year-old man who developed disseminated intra-abdominal recurrence from a previously resected gastrointestinal stromal tumour （GIST） of the small bowel, and the patient presented with hemoperitoneum. Emergent debulking surgery was performed. A high dose imatinib was prescribed. Despite the presence of residual disease, the patient was well clinically 8 months after the operation. Even though, there is no evidence to support the routine use of debulking surgery in the management of GIST. In our patient, disease progression after second line targeted therapy and the absence of alternative treatment options for spontaneous rupture and hemoperitoneum prompted us to treat the patient aggressively. Resection of the ruptured GIST was carried out for control of bleeding and to prevent recurrent bleeding in this patient with good surgical risks. During the treatment decision-making, the patient＇s general condition, the risk of surgery and the extent of dissemination were taken into consideration. In this patient who presented with spontaneous rupture of a small intestinal GIST, the novel use of targeted therapy and aggressive surgical treatment produced reasonably good survival outcome.

关键词： gastrointestinal stromal tumour hemoperitoneum small bowel GIST small bowel neoplasm imatinib

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Superior antibody and membrane protein‑specific T‑cell responses to CoronaVac by intradermal versus intramuscular routes in adolescents

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World Journal of Pediatrics 2024年第4期20卷 353-370页

作者： Jaime S.Rosa Duque Samuel M.S.Cheng Carolyn A.Cohen Daniel Leung Xiwei wang Xiaofeng Mu Yuet Chung Tsun Ming lau Manni wang Wenyue Zhang Yanmei Zhang Howard H.W.Wong Leo C.H.Tsang Sara Chaothai Tsz Chun Kwan John K.C.Li karl C.K.Chan Leo L.H.Luk Jenson C.H.Ho Wing Yan Li Amos M.T.Lee Jennifer H.Y.Lam Sau Man Chan Wilfred H.S.Wong Issan Y.S.Tam Masashi Mori Sophie A.Valkenburg Malik Peiris Wenwei Tu Yu Lung lau Department of Paediatrics and Adolescent Medicine The University of Hong KongHong KongChina School of Public Health The University of Hong KongHong KongChina HKU‑Pasteur Research Pole School of Public HealthThe University of Hong KongHong KongChina Research Institute for Bioresources and Biotechnology Ishikawa Prefectural UniversityNonoichiJapan Department of Microbiology and Immunology Peter Doherty Institute for Infectionand ImmunityUniversity of MelbourneMelbourneVICAustralia Center for Immunology and Infection C2i Hong KongChina

Background Optimising the immunogenicity of COVID-19 vaccines to improve their protection against disease is *** dosing by intradermal(ID)administration has been shown to be equally immunogenic as intramuscular(IM)administration for several vaccines,but the immunogenicity of ID inactivated whole severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)at the full dose is *** study(NCT04800133)investigated the superiority of antibody and T-cell responses of full-dose CoronaVac by ID over IM administration in *** Participants aged 11–17 years received two doses of IM or ID vaccine,followed by the 3rd dose 13–42 days *** and cellular immunogenicity outcomes were measured post-dose 2(IM-CC versus ID-CC)and post-dose 3(IMCCC versus ID-CCC).Doses 2 and 3 were administered to 173 and 104 adolescents,*** Spike protein(S)immunoglobulin G(IgG),S-receptor-binding domain(RBD)IgG,S IgG Fcγreceptor IIIa(FcγRIIIa)-binding,SNM[sum of individual(S),nucleocapsid protein(N),and membrane protein(M)peptide pool]-specific interleukin-2(IL-2)+CD4^(+),SNM-specific IL-2^(+)CD8^(+),S-specific IL-2^(+)CD8^(+),N-specific IL-2^(+)CD4^(+),N-specific IL-2^(+)CD8^(+)and M-specific IL-2^(+)CD4^(+)responses fulfilled the superior and non-inferior criteria for ID-CC compared to IM-CC,whereas IgG avidity was *** ID-CCC,S-RBD IgG,surrogate virus neutralisation test,90%plaque reduction neutralisation titre(PRNT90),PRNT50,S IgG avidity,S IgG FcγRIIIa-binding,M-specific IL-2^(+)CD4^(+),interferon-γ+CD8^(+)and IL-2^(+)CD8^(+)responses were superior and non-inferior to *** estimated vaccine efficacies were 49%,52%,66%and 79%for IM-CC,ID-CC,IM-CCC and ID-CCC,*** ID groups reported more local,mild adverse *** This is the first study to demonstrate superior antibody and M-specific T-cell responses by ID inactivated SARSCoV-2 vaccination and serves as the basis for future research to improve the

关键词： CoronaVac Coronavirus disease 2019 Immunity Intradermal Vaccine

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Reply to the commentary on “The efficiency of pathological response after preoperative transcatheter arterial chemoembolization for microvascular invasion and early tumor recurrence in hepatocellular carcinoma”

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Hepatobiliary Surgery and Nutrition 2023年第1期12卷 144-147页

作者： Yun Yang Weiping Zhou wan Yee lau Eastern Hepatobiliary Surgery Hospital ShanghaiChina Faculty of Medicine The Chinese University of Hong KongHong KongChina

We thank He et *** their interest in our recent article(1)and for their thoughtful *** first question raised by He et *** on the total number of patients in the PSM cohort in Table 1,which they considered *** this study,we first analyzed the incidences of MVI in the groups of patients with or without preoperative *** PSM,there were 737 patients who received preoperative TACE,and 1,233 patients who did not receive preoperative TACE.

关键词： preoperative invasion

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Impact of pathological response after preoperative transcatheter arterial chemoembolization(TACE)on incidences of microvascular invasion and early tumor recurrence in hepatocellular carcinoma:a multicenter propensity score matching analysis

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Hepatobiliary Surgery and Nutrition 2022年第3期11卷 386-399页

作者： Yun Yang Zheng Dang Peng Lu Youwen Qian Kongying lin Zeya Pan wan Yee lau Weiping Zhou The Third Department of Hepatic Surgery Eastern Hepatobiliary Surgery HospitalShanghaiChina Department of Hepatobiliary Surgery 940 Hospital of PLA Joint Logistic Support ForceLanzhouChina Department of Hepatobiliary Surgery Hainan Hospital of Chinese PLA General HospitalSanyaChina Department of Pathology Eastern Hepatobiliary Surgery HospitalShanghaiChina Department of Hepatopancreatobiliary Surgery Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina Faculty of Medicine the Chinese University of Hong KongHong KongChina Key Laboratory of Signaling Regulation and Targeting Therapy of Liver Cancer(SMMU) Ministry of EducationShanghaiChina Shanghai Key Laboratory of Hepatobiliary Tumor Biology(EHBH) ShanghaiChina

Background:To study the influence of pathological responses(PR)after transcatheter arterial chemoembolization(TACE)on incidences of microvascular invasion(MVI)and early recurrence in hepatocellular carcinoma(HCC)***:Between 2013 to 2015,consecutive HCC patients who underwent liver resection with“curative”intent at three hospitals were enrolled in this *** with different areas of PR after preoperative TACE were compared with those without preoperative TACE on the incidences of MVI,early recurrence rates and patterns of recurrence before and after propensity score matching(PSM).Results:Of 1,970 patients,737 patients who received preoperative TACE were divided into three groups according to the areas of PR:≥90%(n=226),60-90%(n=447),and<60%(n=64).PR≥90%was an independent protective factor of incidences of MVI[odds ratio(OR),0.144;95%confidence interval(CI),0.082-0.245,P<0.001)and early recurrence(HR,0.742;95%CI,0.561-0.963,P=0.032);while PR<60%was an independent risk factor of incidences of MVI(OR,6.076;95%CI,3.004-11.728,P<0.001)and early recurrence(HR,1.428;95%CI,1.095-1.929;P=0.009).Furthermore,patients with PR<60%were significantly more likely to develop multiple intrahepatic recurrences involving multiple hepatic segments when compared with patients without preoperative ***:This study indicated the area of PR after TACE was closely associated with the incidences of MVI and early tumor *** with PR<60%were at significantly higher risks of having more MVI,early and multiple tumor recurrences.

关键词： Hepatocellular carcinoma(HCC) transcatheter arterial chemoembolization(TACE) pathological response microvascular invasion(MVI) early recurrence

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Novel liver vein deprivation technique that promotes increased residual liver volume(with video):A case report

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World Journal of Clinical Cases 2022年第31期10卷 11579-11584页

作者： Gang Wu Ji-Peng Jiang Dong-hui Cheng Chong Yang Dong-Xu Liao Yu-Bo Liao wan-Yee lau Yu Zhang Department of Hepatobiliary Surgery Sichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaChengdu 610072Sichuan ProvinceChina Organ Transplantation Center Sichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaChengdu 610072Sichuan ProvinceChina Faculty of Medicine The Chinese University of Hong KongPrince of Wales HospitalHongkong 999077China

BACKGROUND Inadequate volume of future liver remnant(FLR)is a major challenge for hepatobiliary surgeons treating large or multiple liver *** an alternative to associating liver partition and portal vein ligation(ALPPS)for staged hepatectomy and liver venous deprivation(LVD)using stage 1 interventional radiology for vascular embolization combined with stage 2 open liver resection have been *** SUMMARY A novel modified LVD technique was performed in a patient with pancreatic neuroendocrine tumor with liver metastases by using stage 1 laparoscopic ligation of the right hepatic vein,right posterior portal vein,and short hepatic veins combined with local excision of three liver metastases in the left *** operation was followed three days later by interventional radiology to embolize an anomalous right anterior portal vein to complete LVD.A stage 2 laparoscopic right hemihepatectomy and pancreaticosplenectomy were then carried *** The minimally invasive technique promoted a rapid increase,comparable to ALPPS,in volume of the FLR after the stage 1 operation to allow the laparoscopic stage 2 resection to be performed.

关键词： Laparoscopic Liver venous deprivation Future liver remnant Case report

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Multiple hepatocellular carcinomas: liver resection or transcatheter arterial chemoembolization?

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Hepatobiliary Surgery and Nutrition 2019年第5期8卷 519-521页

作者： Yin Lei lau wan Yee Wei-Ping Zhou The Third Department of Hepatic Surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghai 200438China Faculty of Medicine The Chinese University of Hong KongPrince of Wales HospitalShatinHong KongChina

The article by Fukami et *** in the Annals ofSurgery is a detailed study using a very large samplesize to discuss on the treatment strategies for multiplehepatocellular carcinoma(HCC)(1).Although thisis a retrospectiv... 详细信息

关键词： Surgery arterial liver

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Optimal central venous pressure during partial hepatectomy for hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2013年第5期12卷 520-524页

作者： Cheng-Xin lin Ya Guo wan Yee lau Guang-Ying Zhang Yi-Ting Huang Wen-Zheng He Eric CH Lai Department of Anesthesiology First Affiliated Hospital of Guangxi Medical University Department of Hepatic and Biliary Surgery First Affiliated Hospital of Guangxi Medical University Faculty of Medicine The Chinese University of Hong Kong

BACKGROUND:Low central venous pressure(CVP) affects hemodynamic stability and tissue *** prospective study aimed to evaluate the optimal CVP during partial hepatectomy for hepatocellular carcinoma(HCC).METHODS:Ninety-seven patients who underwent partial hepatectomy for HCC had their CVP controlled at a level of 0 to 5 mmHg during hepatic parenchymal *** systolic blood pressure(SBP) was maintained,if possible,at 90 mmHg or *** B surface antigen was positive in 90 patients(92.8%) and cirrhosis in 84 patients(86.6%).Pringle maneuver was used routinely in these patients with clamp/unclamp cycles of 15/5 *** average clamp time was 21.4±8.0 *** patients were divided into 5 groups based on the CVP:group A:0-1 mmHg;B:1.1-2 mmHg;C:2.1-3 mmHg;D:3.1-4 mmHg and E:4.1-5 *** blood loss per transection area during hepatic parenchymal transection and the arterial blood gas before and after liver transection were ***:With active fluid load,a constant SBP ≥90 mmHg which was considered as optimal was maintained in 18.6% in group A(95% CI:10.8%-26.3%);39.2% in group B(95% CI:29.5%-48.9%);72.2% in group C(95% CI:63.2%-81.1%);89.7% in group D(95% CI:83.6%-95.7%);and 100% in group E(95% CI:100%-100%).The blood loss per transection area during hepatic parenchymal transection decreased with a decrease in *** to groups D and E,blood loss in groups A,B and C was significantly less(analysis of variance test,Pline,the blood oxygenation decreased significantly when the CVP was *** excess and HCO 3-in groups A and B were significantly decreased compared with those in groups C,D and E(P<0.05).CONCLUSION:In consideration of blood loss,SBP,base excess and HCO 3-,a CVP of 2.1-3 mmHg was optimal in patients undergoing partial hepatectomy for HCC.

关键词： central venous pressure hepatectomy blood loss

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