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Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic liver disease

World Journal of Gastroenterology 2009年第20期15卷 2506-2511页

作者： Valter Donadon Massimiliano Balbi Michela Ghersetti silvia grazioli Antonio Perciaccante Giovanni Della Valentina Rita Gardenal Maria Dal Mas Pietro Casarin Giorgio Zanette Cesare Miranda Department of Medicine Internal Medicine 3rd Pordenone Hospital Diabetes Clinic Pordenone Hospital Via Montereale 24 Pordenone 33170 Italy

AIM： To explore the association between hepatocellular carcinoma （HCC） and type 2 diabetes mellitus, describe the temporal relations between the onset of diabetes and the development of HCC and evaluate the possible effects of antidiabetic therapy on HCC risk,METHODS： We recruited 465 HCC patients, 618 with cirrhosis and 490 control subjects. We evaluated the odds ratio （OR） for HCC by univariate and multivariate analysis. Moreover, OR for HCC in diabetic subjects treated with insulin or sulphanylureas and with metformin were ***： The prevalence of diabetes mellitus was 31.2% in HCC, 233% in cirrhotic patients and 12.7% in the Control group. By univariate and multivariate analysis, the OR for HCC in diabetic patients were respectively 3.12 （CI 2.2-4.4, P 〈 0.001） and 2.2 （CI 1.2-4.4, P = 0.01）. In 84.9% of cases, type 2 diabetes mellitus was present before the diagnosis of HCC. Moreover, we report an OR for HCC of 2.99 （CI 1.34-6.65, P = 0.007） in diabetic patients treated with insulin or sulphanylureas, and an OR of 0.33 （CI 0.1-0.7, P = 0.006） in diabetic patients treated with ***： Our study confirms that type 2 diabetes mellitus is an independent risk factor for HCC and pre-exists in the majority of HCC patients. Moreover, in male patients with type 2 diabetes meUitus, our data shows a direct association of HCC with insulin and sulphanylureas treatment and an inverse relationship with metformin therapy.

关键词： Hepatocellular carcinoma Type 2 diabetes mellitus Insulin Sulphanylureas Metformin

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Recent advances in non-invasive magnetic resonance imaging assessment of hepatocellular carcinoma

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World Journal of Gastroenterology 2018年第23期24卷 2413-2426页

作者： Davide Ippolito Riccardo Inchingolo Luigi grazioli silvia Girolama Drago Michele Nardella Marco Gatti Riccardo Faletti School of Medicine University of Milano-Bicocca Department of Diagnostic Radiology HS Gerardo Monza Division of Interventional Radiology Department of RadiologyMadonna delle Grazie Hospital Department of Radiology University of Brescia "Spedali Civili" Department of Surgical Sciences Radiology UnitUniversity of Turin

Magnetic resonance(MR) imaging of the liver is an important tool for the detection and characterization of focal liver lesions and for assessment of diffuse liver disease,having several intrinsic characteristics,represented by high soft tissue contrast,avoidance of ionizing radiation or iodinated contrast media,and more recently,by application of several functional imaging techniques(i.e.,diffusion-weighted sequences,hepatobiliary contrast agents,perfusion imaging,magnetic resonance(MR)-elastography,and radiomics analysis). MR functional imaging techniques are extensively used both in routine practice and in the field of clinical and pre-clinical research because,through a qualitative rather than quantitative approach,they can offer valuable information about tumor tissue and tissue architecture,cellular biomarkers related to the hepatocellular functions,or tissue vascularization profiles related to tumor and tissue biology. This kind of approach offers in vivo physiological parameters,capable of evaluating physiological and pathological modifications of tissues,by the analysis of quantitative data that could be used in tumor detection,characterization,treatmentselection,and follow-up,in addition to those obtained from standard morphological imaging. In this review we provide an overview of recent advanced techniques in MR for the diagnosis and staging of hepatocellular carcinoma,and their role in the assessment of response treatment evaluation.

关键词： Liver Cirrhosis Hepatocellular carcinoma Magnetic resonance Transarterial chemoembolization Contrast media

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