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Typing of biliary tumor thrombus influences the prognoses of patients with hepatocellular carcinoma

Cancer Biology & Medicine 2021年第3期18卷 808-815页

作者： juxian sun Jiayi Wu Chang Liu Jie Shi Yonggang Wei Jianyin Zhou Zhibo Zhang Wan Yee Lau Maolin Yan Shuqun Cheng Department of Hepatic SurgeryⅥ The Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghai 200433China Shengli Clinical Medical College Fujian Medical UniversityFuzhou 350001China Department of Hepatobiliary Surgery Fujian Provincial HospitalFuzhou 350001China Department of Hepatobiliary Surgery West China HospitalSichuan UniversityChengdu 610041China Department of Hepatobiliary Surgery Zhongshan HospitalXiamen UniversityXiamen 361004China Department of Hepatobiliary Surgery The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350002China Faculty of Medicine The Chinese University of Hong KongHong Kong 999077China

Objective:To establish a new classification of biliary tumor thrombus(BTT).Methods:Overall survival of patients with BTT was first used to determine whether it correlated with current hepatocellular carcinoma staging *** and multivariate analyses were used to determine factors affecting the overall survival(OS)to form the basis of our new classification for ***:All 6 international staging systems showed overlapping survival *** followed by multivariate analyses showed that total bilirubin and intrahepatic/extrahepatic BTT were significant risk factors of *** on these data,a new BTT classification was defined as:TypeⅠ:intrahepatic BTT;and TypeⅡ:extrahepatic BTT involving a common bile duct or common hepatic ***Ⅰwas further subdivided into type Ia:BTT involving a second-order intrahepatic duct or above,and type Ib:BTT involving a first-order intrahepatic ***Ⅱwas further subdivided into typeⅡa and typeⅡb using a cut-off total bilirubin(TB)>300μmol/*** numbers(percentages)of patients with typesⅠandⅡBTT were 69(34.2%)and 133(65.8%),*** median OS of typeⅠpatients was significantly higher than that of typeⅡpatients(37.5 months vs.23.2 months;P=0.002).Using subgroup analyses,OS outcomes were significantly different between the subgroups of typeⅡb and type IIa,although there was no significant difference between the type Ia and type Ib subgroups(P=0.07).Conclusions:A new BTT classification was established to predict prognoses of HCC patients with BTT who underwent liver resection.

关键词： Hepatocellular carcinoma biliary tumor thrombus staging system surgery prognosis

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Combined FOLFOX4 with all-trans retinoic acid versus FOLFOX4 with placebo in treatment of advanced hepatocellular carcinoma with extrahepatic metastasis: a randomized, double-blind comparative study

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Signal Transduction and Targeted Therapy 2023年第10期8卷 5096-5105页

作者： juxian sun Feifei Mao Chang Liu Fan Zhang Dafeng Jiang Weixing Guo Lei Huo Liping Zhou Wan Yee Lau Jie Shi Shuqun Cheng Department of Hepatic Surgery VI Third Affliated Hospital of Naval Medical UniversityShanghaiChina Tongji University Cancer Center Shanghai Tenth People's HospitalSchool of MedicineTongji UniversityShanghaiChina Department of General Surgery Fujian Cancer HospitalFujan Medical UniversityFuzhouChina Department of Oncology Zhejiang Sian International HospitalJiaxingChina Department of Radiology Third Affliated Hospital of Naval Medical UniversityShanghaiChina Faculty of Medicine The Chinese University of Hong KongPrince of Wales HospitalShatinNew TerritoriesHong Kong SARChina

The majority of hepatocellular carcinoma(HCC)cases are diagnosed at an advanced ***,there are only a few therapeutic methods available for patients with advanced HCC and extrahepatic metastasis(EHM).Systemic chemotherapy,such as FOLFOX4(infusions of fluorouracil,leucovorin,and oxaliplatin),has been reported for treating advanced HCC with EHM,but its effectiveness is very poor.

关键词： FOLFOX4 metastasis chemotherapy

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Chinese expert consensus on clinical application of molecularly targeted drugs for hepatocellular carcinoma (2022 edition)

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中华医学杂志(英文版) 2024年第21期137卷 2630-2632页

作者： sun juxian Li Qiu Bai Xueli Cai Jianqiang Chen Yajin Chen Minshan Dai Chaoliu Fang Chihua Jia Weidong Li Xiangcheng Wen Tianfu Xia Jinglin Ying Mingang Zhang Zhiwei Zhang Xuewen Zeng Zhaochong Cheng Shuqun Department of Hepatic Surgery VI Eastern Hepatobiliary Surgery Hospital Naval Medical University Shanghai China Department of Medical Oncology Cancer Center West China Hospital Sichuan University Chengdu Sichuan China Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang China Department of Hepatobiliary Surgery Cancer Hospital Chinese Academy of Medical Sciences Beijing China Department of Hepatobiliopancreatic Surgery Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou Guangdong China Department of Hepatobiliary Surgery Sun Yat-sen University Cancer Center Guangzhou Guangdong China Department of Hepatobiliary and Spleenary Surgery The Affiliated Shengjing Hospital China Medical University Shenyang Liaoning China Department of Hepatobiliary Surgery Zhujiang Hospital First Military Medical University Guangzhou Guangdong China Department of General Surgery Anhui Key Laboratory of Hepatopancreatobiliary Surgery Anhui Provincial Hospital The First Affiliated Hospital of USTC University of Science and Technology of China Hefei Anhui China Hepatobiliary Center The First Affiliated Hospital of Nanjing Medical University Key Laboratory of Living Donor Liver Transplantation Nanjing Jiangsu China Department of Liver Surgery West China Hospital of Sichuan University Chengdu Sichuan China The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang China Liver Cancer Institute & Zhongshan Hospital Fudan University Shanghai China Department of Gastrointestinal Oncological Surgery Fujian Provincial Cancer Hospital Fujian Medical University Teaching Hospital Fuzhou Fujian China Department of Surgery Hepatic Surgery Center Institute of HBP Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China Department of Hepatobiliary and Pancreas Surgery The Second Hospital of Jilin University Changc

Primary liver cancer is one of the most common malignant tumors in China. In 2020, 410,038 new cases of liver cancer and 391,152 deaths due to liver cancer were reported in China, which places liver cancer as the second most common cancer-related cause of death in China; of these cancers, hepatocellular carcinoma(HCC) accounts for 85-90%. HCC poses a significant threat to the lives and health of Chinese people.

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A novel chemotherapy strategy for advanced hepatocellular carcinoma: a multicenter retrospective study

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Chinese Medical Journal 2022年第19期135卷 2338-2343页

作者： juxian sun Chang Liu Jie Shi Nanya Wang Dafeng Jiang Feifei Mao Jingwen Gu Liping Zhou Li Shen Wan Yee Lau Shuqun Cheng Department of Hepatic Surgery VI Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityShanghai 200433China Department of Integrative Oncology Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityShanghai 200433China Department of Outpatient Department Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityShanghai 200433China Department of Oncology First Hospital of Jlin UniversityChangchunJlin 1300China Department of Oncology Zhejiang Sian International Hospital JiaxingZhejang 314000China Tongji University Cancer Center Shanghai Tenth People's HospitaSchool of MedicineTongji UniversitShanghai 200040China Faculty of Medicine The Chinese University of Hong KongPrince of Wales HospitalShatinNew TerritoriesHong Kong SAR 999077China.

Background:Chemotherapy is a common treatment for advanced hepatocellular carcinoma,but the effect is not *** study aimed to retrospectively evaluate the effects of adding all-trans-retinoic acid(ATRA)to infusional fluorouracil,leucovorin,and oxaliplatin(FOLFOX4)for advanced hepatocellular carcinoma(HCC).Methods:We extracted the data of patients with advanced HCC who underwent systemic chemotherapy using FOLFOX4 or ATRA plus FOLFOX4 at the Eastern Hepatobiliary Surgery Hospital,First Hospital of Jilin University,and Zhejiang Sian International Hospital and retrospectively compared for overall *** Cox proportional hazards model was used to calculate the hazard ratios for overall survival and disease progression after controlling for age,sex,and disease ***:From July 2013 to July 2018,111 patients with HCC were included in this *** median survival duration was 14.8 months in the ATRA plus FOLFOX4 group and 8.2 months in the FOLFOX4 only group(P<0.001).The ATRA plus FOLFOX4 group had a significantly longer median time to progression compared with the FOLFOX4 group(3.6 monthsvs.1.8 months,P<0.001).Hazard ratios for overall survival and disease progression were 0.465(95%confidence interval:0.298–0.726;P=0.001)and 0.474(0.314–0.717;P<0.001)after adjusting for potential confounders,***:ATRA plus FOLFOX4 significantly improves the overall survival and time to disease progression in patients with advanced HCC.

关键词： Hepatocellular carcinoma ATRA plus FOLFOX4 Overall survival All-trans-retinoic acid Fluorouracil Leucovorin Oxaliplatin

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肝癌合并门静脉癌栓治疗的瓶颈与对策

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中华消化外科杂志 2018年第5期17卷 426-429页

作者：程树群孙居仙石洁海军军医大学东方肝胆外科医院肝外六科上海200438

肝癌发生发展过程中易侵犯门静脉形成门静脉癌栓．由于预后极差且缺乏有效的治疗手段．是影响肝癌整体疗效提高的瓶颈。近年来，随着新治疗理念和方法的开展，门静脉癌栓的疗效有所提高，但仍存在诸多难点和瓶颈。如何统一各项治疗的适... 详细信息

肝癌发生发展过程中易侵犯门静脉形成门静脉癌栓．由于预后极差且缺乏有效的治疗手段．是影响肝癌整体疗效提高的瓶颈。近年来，随着新治疗理念和方法的开展，门静脉癌栓的疗效有所提高，但仍存在诸多难点和瓶颈。如何统一各项治疗的适应证、如何创新诊断与治疗技术、如何进行多学科联合诊断与治疗和如何进行高质量循证医学研究等对提高肝癌合并门静脉癌栓患者疗效尤为重要。针对诸多瓶颈需要建立相应的策略，《肝细胞癌合并门静脉癌栓多学科诊治中国专家共识（2016版）》的发布为临床治疗和科研提供了有力的参考，研究者应开发新治疗手段、推广多学科综合治疗理念、开展高质量临床研究等以提高肝癌合并门静脉癌栓患者的整体疗效。

关键词：肝肿瘤门静脉癌栓分型多学科治疗

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原发性肝癌伴门静脉癌栓放射治疗的现状及展望

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中华肝胆外科杂志 2014年第6期20卷 476-480页

作者：张龙李楠石洁郭卫星薛捷孙居仙程树群第二军医大学东方肝胆外科医院肝外六科上海200438

原发性肝癌（HCC）伴门静脉癌栓（PVTT）不仅发病率非常高，而且预后很差。目前，单纯放射治疗或放射联合介入等治疗方式是值得重视的有效治疗方法。放射治疗根据治疗方式、途径的不同分为外放射和内放射治疗。本文就肝癌门静脉癌栓放... 详细信息

原发性肝癌（HCC）伴门静脉癌栓（PVTT）不仅发病率非常高，而且预后很差。目前，单纯放射治疗或放射联合介入等治疗方式是值得重视的有效治疗方法。放射治疗根据治疗方式、途径的不同分为外放射和内放射治疗。本文就肝癌门静脉癌栓放射治疗的现状及进展做一综述。

关键词：原发性肝癌门静脉癌栓放射治疗

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莒县宅基地土地登记发证工作探索

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山东国土资源 2011年第9期27卷 64-66页

作者：汪修勇李海玲孙金莒县国土资源局山东莒县276500

莒县积极探索农村宅基地登记发证工作方式,通过简化确权表格,做好变更、注销登记等工作,提高了工作效率和质量,进一步明晰了农村土地产权,维护了农民和农村集体经济组织的合法权益,促进了社会和谐和新农村建设的顺利开展。

关键词：宅基地农村登记发证探索莒县

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Multidisciplinary management of recurrent and metastatic hepatocellular carcinoma after resection: an international expert consensus

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Hepatobiliary Surgery and Nutrition 2018年第5期7卷 353-371页

作者： Tianfu Wen Chen Jin Antonio Facciorusso Matteo Donadon Ho-Seong Han Yilei Mao Chaoliu Dai Shuqun Cheng Bixiang Zhang Baogang Peng Shunda Du Changjun Jia Feng Xu Jie Shi juxian sun Peng Zhu Satoshi Nara JMichael Millis Qiu Li Weixia Chen Wusheng Lu Hong Tang Lvnan Yan Yong Zeng Bo Li Jiayin Yang Wentao Wang Hong Wu Mingqing Xu Zheyu Chen Changli Lu Chuan Li Wei Peng Xiaoyun Zhang Department of Liver Surgery and Liver Transplantation Center West China HospitalSichuan UniversityChengdu 610041China Department of Medical and Surgical Sciences University of FoggiaFoggiaItaly Department of Hepatobiliary&General Surgery Humanitas UniversityHumanitas Clinical and Research CenterMilanItaly Seoul National University Bundang Hospital Seoul National University College of MedicineSeoulKorea Department of Liver Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Hepatobiliary and Splenic Surgery Shengjing HospitalChina Medical UniversityShenyang 110000China Department of Hepatic Surgery VI Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityShanghai 200433China Hepatic Surgery Center Tongji HospitalHuazhong University of Science and TechnologyWuhan 430030China Department of Liver Surgery the First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Hepatobiliary and Pancreatic Surgery Division National Cancer Center HospitalTokyoJapan Department of Surgery University of ChicagoChicagoILUSA MDT of West China Hospital Department of Medical Oncology Cancer CenterState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu 610041China Department of Radiology West China HospitalSichuan UniversityChengdu 610041China Center of Infectious Diseases West China HospitalSichuan UniversityChengdu 610041China

Hepatocellular carcinoma (HCC) is the sixth-most common cancer and the third leading cause of cancer-related death in the world. However, 40–70% patients eventually suffer from postoperative recurrence within 5 years. HCC recurrence after surgery severely affects prognosis of the patients. Nevertheless, there is an opportunity to improve patients' prognosis if doctors and researchers can recognize the importance of a standardized perioperative management and study it in clinical and pre-clinical settings. Hence, based on our own experience and published studies from other researchers, we develop this consensus regarding multidisciplinary management of locally recurrent and metastatic hepatocellular carcinoma after resection. This consensus consists of the entire course of recurrent hepatocellular carcinoma (RHCC) management, including prediction of recurrence, prevention, diagnosis, treatment and surveillance of RHCC. Consensus recommendations are presented with grades of evidences (Ia, Ib, IIa, IIb, III and IV), and strength ofrecommendations (A, B, C, D and E). We also develop a decision-making path for RHCC treatment, which can intuitively demonstrate the management for RHCC. It is hoped that we may make some effort to standardize the management of RHCC and ultimately understand how to improve outcomes.

关键词： Recurrent hepatocellular carcinoma (RHCC) multidisciplinary management consensus

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三孢布拉氏霉菌番茄红素环化酶定点突变和定向进化研究

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浙江农业科学 2019年第12期60卷 2231-2237,2241页

作者：孙菊鲜康春婷远宜彤李钊葛欣辛琪河北大学生命科学学院

三孢布拉氏霉菌中carRA基因编码的CarRA为双功能酶,该酶的R结构域具有番茄红素环化酶的功能,是三孢布拉氏霉菌类胡萝卜素合成途径过程中的关键酶,其酶活性的高低即环化能力的强弱决定了番茄红素的积累水平。为深入研究三孢布拉氏霉菌番... 详细信息

三孢布拉氏霉菌中carRA基因编码的CarRA为双功能酶,该酶的R结构域具有番茄红素环化酶的功能,是三孢布拉氏霉菌类胡萝卜素合成途径过程中的关键酶,其酶活性的高低即环化能力的强弱决定了番茄红素的积累水平。为深入研究三孢布拉氏霉菌番茄红素环化酶的功能,以酿酒酵母菌株W303为出发菌株,首先构建了二甲基辛烯二甲基辛烯焦磷酸高效合成的酿酒酵母底盘菌株W303-thmgr-Bts 1,在该底盘菌株中表达三孢布拉氏霉菌的carB和carRA基因,完成类胡萝卜素代谢途径的构建。在此基础上对R结构域进行定点突变和随机突变,并成功构建了5个单一保守位点的突变酶和依赖于酵母同源重组的番茄红素环化酶随机突变体库。通过评估各突变株的菌落颜色和测定类胡萝卜素的产量来确定一系列位点的突变对R结构域催化番茄红素合成β-胡萝卜素能力的影响,最终筛选出了影响该蛋白活性的关键氨基酸位点,为三孢布拉氏霉菌番茄红素环化酶的催化机制研究与酶活性改良奠定了理论基础。

关键词：三孢布拉氏霉菌番茄红素环化酶定点突变随机突变

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肝癌合并门静脉癌栓术前放疗疗效评价

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中华肝脏外科手术学电子杂志 2019年第3期8卷 238-241页

作者：冯爽李铁华孙居仙徐胜李晶陆艳孟岩第二军医大学东方肝胆外科医院放射治疗科上海200438

目的探讨术前放疗对原发性肝癌(肝癌)伴门静脉癌栓的疗效及其应用价值。方法回顾性分析2014年1月至2017年12月东方肝胆外科医院收治的248例肝癌合并门静脉癌栓患者临床资料。其中男189例,女59例;年龄32～82岁,中位年龄53岁。患者均签署... 详细信息

目的探讨术前放疗对原发性肝癌(肝癌)伴门静脉癌栓的疗效及其应用价值。方法回顾性分析2014年1月至2017年12月东方肝胆外科医院收治的248例肝癌合并门静脉癌栓患者临床资料。其中男189例,女59例;年龄32～82岁,中位年龄53岁。患者均签署知情同意书,符合医学伦理学规定。根据治疗方法不同患者分为术前放疗+手术组(术前放疗组,102例)和单纯放疗组(146例)。观察放疗效果和不良反应。生存分析采用非参数法Wilcoxon检验。结果多数患者放疗期间有不同程度的消化道反应,表现为恶心、呕吐、纳差、腹胀等,未见上消化道出血及严重呕吐,均经对症治疗后缓解。患者均未发生严重的肝损害。通过术前18 Gy剂量放疗,最终41%(102/248)患者获得手术机会。放疗后肿瘤大面积坏死,门静脉癌栓局限、硬化、纤维化。术前放疗组1年生存率为49%,明显高于单纯放疗组的32%(Z=44.804,P<0.05)。结论术前放疗可使部分肝癌合并门静脉癌栓患者降期,获得手术切除机会,明显改善患者预后,延长总体生存时间。

关键词：癌,肝细胞放射疗法门静脉栓塞肿瘤细胞,循环

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