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Branched-chain amino acids to tyrosine ratio value as a potential prognostic factor for hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第17期18卷 2005-2008页

作者： toru ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini Hospital280-7 TerajiNiigata 950-1104Japan

The prognosis of hepatocellular carcinoma(HCC) depends on tumor extension as well as hepatic function.Hepatic functional reserve is recognized as a factor affecting survival in the treatment of HCC;the ChildPugh classif ication system is the most extensively used method for assessing hepatic functional reserve in patients with chronic liver disease,using serum albumin level to achieve accurate assessment of the status of protein metabolism.However,insuff icient attention has been given to the status of amino acid(AA) metabolism in chronic liver disease and HCC.Fischer's ratio is the molar ratio of branched-chain AAs(BCAAs:leucine,valine,isoleucine) to aromatic AAs(phenylalanine,tyrosine) and is important for assessing liver metabolism,hepatic functional reserve and the severity of liver dysfunction.Although this ratio is diff icult to determine in clinical situations,BCAAs/tyrosine molar concentration ratio(BTR) has been proposed as a simpler substitute.BTR correlates with various liver function examinations,including markers of hepatic f ibrosis,hepatic blood flow and hepatocyte function,and can thus be considered as reflecting the degree of hepatic impairment.This manuscript examines the literature to clarify whether BTR can serve as a prognostic factor for treatment of HCC.

关键词：支链氨基酸酪氨酸肝癌预后肝功能损害蛋白质代谢比值功能评估

Early administration of branched-chain amino acid granules

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World Journal of Gastroenterology 2012年第33期18卷 4486-4490页

作者： toru ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini Hospital Niigata 950-1104 Japan

The effect of malnutrition on survival in patients with decompensated liver cirrhosis has not been well defined. Nutritional intervention with branched-chain amino acid (BCAA) can increase serum albumin concentration in patients with decompensated cirrhosis but its effects on survival are unclear. The BCAA to tyrosine ratio (BTR) is a surrogate marker (the normal range of BTR is between 4.41 and 10.05, and a Fischer's ratio of 1.8 corresponds to a BTR of 3.5) in patients with decompensated liver cirrhosis, and BCAA inhibits hepatic carcinogenesis in patients with compensated cirrhosis. This review discusses data regarding the effect of early administration of BCAA granules based on the ratio of BCAA to BTR on prognosis in patients with cirrhosis.

关键词：支链氨基酸早期管理颗粒肝硬化血清白蛋白 BTR 营养不良营养干预

Can zinc enhance response interferon therapy for patients with HCV-related liver disease?

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World Journal of Gastroenterology 2012年第25期18卷 3196-3200页

作者： toru ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini HospitalNiigata 950-1104Japan

Patients with liver disease may be at risk of zinc depletion.Zinc supplementation has been shown to contribute to inhibition of liver fibrosis and improvement in hepatic encephalopathy.However,little is known about the anti-inflammatory effect of zinc on hepatitis C virus(HCV)-related chronic liver disease.The standard of care for chronic HCV has improved markedly since the approval of interferon(IFN) therapy more than a decade ago.Over the past 20 years,IFN therapy has improved to more effectively eliminate the virus,progressing from single IFN therapy to combination therapy with ribavirin(RBV) and finally to pegylated IFN(PEG-IFN) therapy.However,even combined therapy with PEG-IFN and RBV for 48 wk is unable to eliminate the virus in some 40% of hepatitis C cases,particularly those with genotype 1b and high viral load.Treatment options for patients who have relapsed or are refractory to treatment with PEG-IFN and RBV therefore need to be critically assessed.This paper overviews the relationship between chronic liver disease and zinc metabolism.

关键词：联合治疗肝脏疾病干扰素 HCV 补锌患者丙型肝炎病毒利巴韦林

Risk management of hepatocellular carcinoma occurrence after hepatitis Cvirus eradication-from IFN based era to IFN-free DAA era

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Hepatobiliary Surgery and Nutrition 2020年第2期9卷 227-229页

作者： toru ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata HospitalNiigataJapan

Chronic hepatitis C virus(HCV)infection is a public health issue which effects people throughout the world,with more than 71 million people effected,and 400,000 deaths annually(1).HCV,which is when active carriage of HCV RNA is in the blood,is the leading cause of cirrhosis,liver failure,and hepatocellular carcinoma(HCC)(2).Among HCV infected cirrhotic patients,the incidence rate of HCC steadily increases with increased degree of fibrosis,with annual reported incidence of 1.4%to 7%respectively(3).The eradication of the virus and therefore prevention of HCC development and liver related death is the ultimate treatment objective for chronic HCV.In 1991,the first treatment approved by the Food&Drug Administration(FDA)to treat chronic hepatitis C(CHC)was IFNα-2b monotherapy(4),which allowed 15-20%of sustained virological response(SVR)and also induced major side effects such as asthenia,neutropenia,myalgia and influenzalike syndromes(5).

关键词： hepatocellular prevention sustained

Prevention of post-embolization syndrome after transarterial chemoembolization for hepatocellular carcinoma—is prophylactic dexamethasone useful, or not?

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Hepatobiliary Surgery and Nutrition 2018年第3期7卷 214-216页

作者： toru ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini HospitalNiigataJapan

Hepatocellular carcinoma (HCC) is the most common cause of death from cancer worldwide (1). In some treatment strategy, transarterial chemoembolization (TACE) was established for the treatment of HCC when surgical resection or other local treatment is not indicated and the recommended first line-therapy for patients in intermediate stage (2). Although a relatively safe procedure, TACE is often associated with post-embolization syndrome (PES) such as a clinical syndrome mediated by an inflammatory response associated with the embolization itself and/or chemotherapeutic agent delivered (3,4).

关键词： arterial death treatment

Secondary prevention of recurrence by interferon therapy after ablation therapy for hepatocellular carcinoma in chronic hepatitis C patients

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World Journal of Gastroenterology 2008年第40期14卷 6140-6144页

作者： toru ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Second Hospital

Chronic hepatitis C is a leading cause of hepatocellular carcinoma (HCC) worldwide.Interferon (IFN) ther-apy decreases the incidence of HCC in patients with chronic hepatitis C.Prevention of chronic-hepatitis-C-related HCC is one of the most important issues in current hepatology.We have previously reported that male gender and high titer of hepatitis C virus (HCV) RNA are predictive factors for the development of HCC in HCV-related cirrhosis.Clinical efforts at eradicat-ing or reducing the viral load may reduce the risk for HCC.Furthermore,because HCC often recurs after ablation therapy,we performed a trial of IFN in pa-tients with chronic liver disease caused by HCV to see whether IFN therapy decreases recurrence after abla-tion therapy of HCV-related HCC.By using IFN therapy as a secondary prevention,patients with HCC who had received complete tumor ablation showed better sur-vival,primarily as a result of the preservation of liver function and also probably prevention of recurrence.Postoperative IFN therapy appears to decrease recur-rence after ablation therapy such as radiofrequency ablation (RFA) therapy of HCV-related HCC.We believe that there is a survival benefit in secondary prevention using IFN therapy.However,a controlled study is es-sential to obtain conclusive evidence of the efficacy of this strategy.

关键词：肝细胞癌射频消融干扰素治疗效果

Chemotherapy with enteric-coated tegafur/uracil for advanced hepatocellular carcinoma

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World Journal of Gastroenterology 2008年第18期14卷 2797-2801页

作者： toru ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Second Hospital Teraji 280-7 Niigata 950-1104 Japan

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, including Japan. Although the development of imaging modalities has made the early diagnosis of HCC possible, surgically resectable cases are relatively uncommon because of hepatic function reserve and/or an advanced stage at presentation. Several modalities, such as transcatheter arterial chemoembolization, percutaneous ethanol injection, microwave coagulation therapy and radiofrequency ablation are reportedly useful in treating patients with non-resectable disease. However, unfortunately, many HCC patients have tumor recurrence. The overall prognosis of patients with HCC is very poor, and treatment of the advanced form is still problematic. In this article, we review the clinical efficacy and toxicity of enteric-coated tegafur/uracil in the treatment of patients with advanced non-resectable HCC.

关键词：肝细胞癌肿瘤休眠皮炎菌尿嘧啶化学疗法

Is it relevant that intra-arterial chemotherapy may be effective for advanced pancreatic cancer?

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World Journal of Gastroenterology 2007年第32期13卷 4306-4309页

作者： toru ishikawa Departments of Gastroenterology and Hepatology Saiseikai Niigata Second HospitalNiigataJapan

Unresectable pancreatic cancers have an extremely dismal prognosis and chemoresistant nature. The treatment of pancreatic cancer is still problematic. Gemcitabine is a promising new agent that has been studied recently for palliation of advanced pancreatic cancer. However,the response rates have been highly variable,and are often irreproducible. To improve this low response rate,various treatments are needed because no standard treatment exists. Intra-arterial chemotherapy is considered to take advantage of the first pass effect of the drug,generating higher local drug concentrations in tumor cells with lower toxicity. Regional intra-arterial chemotherapy may provide high levels of cytostatic concentrations within the tumor and,simultaneously,a low rate of systemic side effects compared with systemic administration of anti-neoplastic drugs. Intra-arterial chemotherapy has been introduced as an alternative treatment for advanced pancreatic cancer. Further clinical trials of this method should be subjected to a prospective randomized controlled study for advanced pancreatic cancer.

关键词：胰腺癌动脉化疗治疗法全身化学治疗法肿瘤细胞

Anti-viral therapy to reduce recurrence and improve survival in hepatitis B virus-related hepatocellular carcinoma

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World Journal of Gastroenterology 2013年第47期19卷 8861-8866页

作者： toru ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini HospitalNiigata 950-1104Japan

Hepatocellular carcinoma(HCC)is the most common malignancy and the third leading cause of cancer death worldwide.Chronic infection with hepatitis B virus(HBV)and hepatitis C virus accounts for approximately75%-80%of HCC cases worldwide.In particular,chronic HBV infection is a predominant risk factor for HCC in Asia and Africa.Hepatic resection and radiofrequency ablation are increasingly used for the curative treatment of HCC,and good local control can be achieved.However,the high rate of recurrence is a major obstacle to improving prognosis.A high viral load of HBV DNA is the most important correctable risk factor for recurrence.Furthermore,interferon and/or nucleotide analogues may decrease HBV DNA.Therefore,these drugs may decrease recurrence.In this article,treatment strategies for HBV-related HCC are described in order to reduce recurrence and improve survival.

关键词： Hepatocellular carcinoma Hepatitis B virus Recurrence Nucleotide analogues Interferon