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Metformin does not improve survival in patients with hepatocellular carcinoma

World Journal of Gastroenterology 2014年第42期20卷 15750-15755页

作者： Mamatha Bhat Roongruedee Chaiteerakij William S harmsen Cathy D Schleck Ju Dong Yang nasra h giama Terry M Therneau Gregory J Gores Lewis R Roberts Division of Gastroenterology and hepatology Mayo Clinic College of Medicine Division of Gastroenterology McGill University Health Centre Department of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Thai Red Cross Society Division of Biomedical Statistics and Informatics Mayo Clinic College of Medicine

AIM: To assess whether metformin, which has a chemopreventive effect in chronic liver disease, has any chemotherapeutic effect in hepatocellular carcinoma.

关键词： hepatocellular carcinoma Metformin Diabetes Survival Liver disease Lactic acidosis

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Model combining pre-transplant tumor biomarkers and tumor size shows more utility in predicting hepatocellular carcinoma recurrence and survival than the BALAD models

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World Journal of Gastroenterology 2018年第12期24卷 1321-1331页

作者： Nicha Wongjarupong Gabriela M Negron-Ocasio Roongruedee Chaiteerakij Benyam D Addissie Essa A Mohamed Kristin C Mara William S harmsen J Paul Theobald Brian E Peters Joseph G Balsanek Melissa M Ward nasra h giama Sudhakar K Venkatesh Denise M harnois Michael R Charlton hiroyuki Yamada Alicia Algeciras-Schimnich Melissa R Snyder Terry M Therneau Lewis R Roberts Division of Gastroenterology and hepatology Mayo ClinicRochesterMN 55905United States University of Puerto Rico Medical Sciences Campus San Juan 00921Puerto Rico Department of Medicine Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkok 10400Thailand Division of Biomedical Statistics and Informatics Mayo ClinicRochesterMN 55905United States Division of Laboratory Medicine Department of Laboratory Medicine and PathologyMayo Clinic College of MedicineRochesterMN 55905United States Department of Radiology Mayo Clinic College of MedicineRochesterMN 55905United States Department of Transplantation Mayo Clinic FloridaJacksonvilleFL 32224United States Wako Life Sciences IncorporatedMountain ViewCA 94043United States

AIM To assess the performance of BALAD, BALAD-2 and their component biomarkers in predicting outcome of hepatocellular carcinoma(hCC) patients after liver *** BALAD score and BALAD-2 class are derived from bilirubin, albumin, alpha-fetoprotein(AFP), Lens culinaris agglutinin-reactive AFP(AFP-L3), and des-gammacarboxyprothrombin(DCP). Pre-transplant AFP, AFP-L3 and DCP were measured in 113 patients transplanted for hCC from 2000 to 2008. hazard ratios(hR) for recurrence and death were calculated. Univariate and multivariate regression analyses were conducted. C-statistics were used to compare biomarker-based to predictive models. RESULTS During a median follow-up of 12.2 years, 38 patients recurred and 87 died. The hRs for recurrence in patients with elevated AFP, AFP-L3, and DCP defined by BALAD cut-off values were 2.42(1.18-5.00), 1.86(0.98-3.52), and 2.83(1.42-5.61), respectively. For BALAD, the hRs for recurrence and death per unit increased score were 1.48(1.15-1.91) and 1.59(1.28-1.97). For BALAD-2, the hRs for recurrence and death per unit increased class were 1.45(1.06-1.98) and 1.38(1.09-1.76). For recurrence prediction, the combination of three biomarkers had the highest c-statistic of 0.66 vs. 0.64, 0.61, 0.53, and 0.53 for BALAD, BALAD-2, Milan, and UCSF, respectively. Similarly, for death prediction, the combination of three biomarkers had the highest c-statistic of 0.66 vs 0.65,0.61, 0.52, and 0.50 for BALAD, BALAD-2, Milan, and UCSF. A new model combining biomarkers with tumor size at the time of transplant(S-LAD) demonstrated the highest predictive capability with c-statistics of 0.71 and 0.69 for recurrence and death. CONCLUSION BALAD and BALAD-2 are valid in transplant hCC patients, but less predictive than the three biomarkers in combination or the three biomarkers in combination with maximal tumor diameter(S-LAD).

关键词： alpha-fetoprotein AFP-L3 des-gammacarboxyprothrombin BALAD BALAD-2 hepatocellular carcinoma Liver transplant Recurrence Outcome

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high prevalence of chronic viral hepatitis B and C in Minnesota Somalis contributes to rising hepatocellular carcinoma incidence

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World Journal of Gastroenterology 2022年第35期28卷 5217-5229页

作者： Essa A Mohamed nasra h giama Abubaker O Abdalla hassan M Shaleh Abdul M Oseini hamdi A Ali Fowsiyo Ahmed Wesam Taha hager Ahmed Mohammed Jessica Cvinar Ibrahim A Waaeys hawa Ali Loretta K Allotey Abdiwahab O Ali Safra A Mohamed William S harmsen Eimad M Ahmmad Numra A Bajwa Mohamud D Afgarshe Abdirashid M Shire Joyce E Balls-Berry Lewis R Roberts Division of Gastroenterology and hepatology Mayo ClinicRochesterMN 55905United States Center for Clinical and Translational Science Mayo ClinicRochesterMN 55905United States School of Nursing University of MinnesotaMinneapolisMN 55455United States Division of Digestive Diseases Emory School of MedicineAtlantaGA 30322United States Department of Laboratory Medicine and Pathology Mayo ClinicRochesterMN 55905United States Department of Internal Medicine NewYork-Presbyterian QueensFlushingNY 11355United States Department of Pediatrics University of Nevada Las VegasLas VegasNV 89154United States Department of Quantitative health Sciences Mayo ClinicRochesterMN 55905United States Department of Medicine Gargar Urgent Care and ClinicMinneapolisMN 55406United States Office of the Director Shire ScientificMinneapolisMN 55405United States Department of Neurology Washington University School of Medicine in St LouisSt LouisMO 63130United States Knight Alzheimer Disease Research Center Washington University School of MedicineSt LouisMO 63130United States

BACKGROUND Chronic hepatitis B virus(hBV)and hepatitis C virus(hCV)infections are known risk factors for liver disease,cirrhosis and hepatocellular carcinoma(hCC).There is substantial global variation in hBV and hCV prevalence resulting in variations in cirrhosis and *** previously reported high prevalence of hBV and hCV infections in Somali immigrants seen at an academic medical center in *** To determine the prevalence of chronic viral hepatitis in Somali immigrants in Minnesota through a community-based screening *** We conducted a prospective community-based participatory research study in the Somali community in Minnesota in partnership with community advisory boards,community clinics and local mosques between November 2010 and December 2015(data was analyzed in 2020).Serum was tested for hepatitis B surface antigen,hepatitis B core antibody,hepatitis B surface antibody and anti-hCV *** Of 779 participants,15.4%tested positive for chronic hBV infection,50.2%for prior exposure to hBV and 7.6%for chronic hCV *** age-adjusted frequencies in males and females for chronic hBV were 12.5%and 11.6%;for prior exposure to hBV were 44.8%and 41.3%;and for chronic hCV were 6.7%and 5.7%,*** participants developed incident hCC during follow *** Chronic hBV and hCV are major risk factors for liver disease and hCC among Somali immigrants,with prevalence of both infections substantially higher than in the general United States ***-based screening is essential for identifying and providing health education and linkage to care for diagnosed patients.

关键词： Viral hepatitis Liver disease Community engagement African Immigrant health

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