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Clinical application of hepatic venous occlusion for hepatectomy

Chinese Medical Journal 2008年第9期121卷 806-810页

作者： PAN Ze-ya YANG Yuan ZHOU Wei-ping LI Ai-jun FU Si-yuan WU Meng-chao The Third Department of Hepatic Surgery Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China

Background Most liver resections require clamping of the hepatic pedicle （Pringle maneuver） to avoid excessive blood loss. But Pringle maneuver can not control backflow bleeding of hepatic vein. Resection of liver tumors involving hepatic veins may cause massive hemorrhage or air embolism from the injuries of the hepatic veins. Although total hepatic vascular exclusion can prevent bleeding of the hepatic veins effectively, it also may result in systemic hemodynamic disturbance because of the inferior vena cava being clamped. Hepatic venous occlusion, a new technique, can control the inflow and outflow of the liver without clamping the vena cava. Methods A total of 71 cases of liver tumors underwent resection with occlusion of more than one of the main hepatic veins. All tumors involved the second porta hepatis and at least one main hepatic vein. Ligation or occlusion with serreflnes, tourniquets and auricular clamps were used in hepatic venous occlusion. Results Of the 71 patients, ligation of the hepatic veins was used in 28 cases, occlusion with a tourniquet in 26, and occlusion with a serrefine in 17. Right hepatic veins were occluded in 38 cases, both right and middle hepatic veins in 2, the common trunk of the left and middle hepatic veins in 24, branches of the left and middle hepatic veins in 2, and all three hepatic veins in 5. Thirty-five cases underwent hemihepatic vascular occlusion, 4 alternate hemihepatic vascular occlusion, 23 portal triad clamping plus selective hepatic vein occlusion, and 9 portal triad clamping plus total hepatic vein occlusion. The third porta hepatis was isolated in 26 cases. The amount of intraoperative blood loss averaged （540±2.83）（range 100 to 1000） ml in the group of total hemihepatic vascular occlusion and in the group of alternate hemihepatic vascular occlusion, （620±317）（range 200-6000） ml in the group of portal triad clamping plus selective or total hepatic vein occlusion. All tumors were completely removed. Conclusions

关键词： liver neoplasms hepatic veins hepatectomy hemorrhage

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Aflatoxin sufferer and p53 gene mutation in hepatocellular carcinoma

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World Journal of Gastroenterology 1998年第1期4卷 33-34页

作者： DENG Zhuo-Lin MA Yun 不详

Ａｆｌａｔｏｘｉｎｓｕｆｅｒｅｒａｎｄｐ５３ｇｅｎｅｍｕｔａｔｉｏｎｉｎｈｅｐａｔｏｃｅｌｕｌａｒｃａｒｃｉｎｏｍａＤＥＮＧＺｈｕｏＬｉｎａｎｄＭＡＹｕｎＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＡｆｌａｔｏｘｉｎＢ１；ｇｅ... 详细信息

Ａｆｌａｔｏｘｉｎｓｕｆｅｒｅｒａｎｄｐ５３ｇｅｎｅｍｕｔａｔｉｏｎｉｎｈｅｐａｔｏｃｅｌｕｌａｒｃａｒｃｉｎｏｍａＤＥＮＧＺｈｕｏＬｉｎａｎｄＭＡＹｕｎＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＡｆｌａｔｏｘｉｎＢ１；ｇｅｎｅｓ，ｐ５３；ｍｕｔａｔｉｏｎ；...

关键词： Aflatoxin B1 genes,p53 mutation carcinoma,hepatocellular liver neoplasms

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Reversing effect of Tanshinone on malignant phenotypes of human hepatocarcinoma cell line

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World Journal of Gastroenterology 1998年第4期4卷 45-47页

作者： YUAN Shu-Lan HUANG Ren-Min WANG Xiu-Jie SONG Yi HUANG Guang-Qi Institute of Cancer Research West China University of Medical Sciences Chengdu 610041Sichuan Province China

AIM To study the reversing effect of Chinese drug tanshinone on malignant phenotype of cancer *** Human hepatocarcinoma cell line (SMMC-7721) was treated in vitro with 0.5mg/L tanshinone for 4 days, and variation in cell differentiation was *** The morphology of cancer cells was tended toward well differentiation and cell growth was markedly inhibited. BrdU uptake assay and immunohistochemical stain of PCNA showed that the BrdU labeling rate and PCNA positive rate were lower than the controls, but no difference was found statistically as compared with all transretinoic acid. Flow cytometric assay demonstrated that S phase cells decreased and G0/G1 phase cells increased. Expression of c-myc oncogene protein decreased but the c-fos oncogene protein markedly *** Tanshinone could reverse the inducing differentiation in human hepatocarcinoma cells (SMMC-7721). It may become a new prospective inducer of cell differentiation to treat cancers.

关键词： tanshinone liver neoplasms carcinoma,hepatocellular tumor cell,cultured cell line immunohistochemistry proliferation cell nuclear antigen flow cytometry

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Efficacy of texture analysis of pre-operative magnetic resonance imaging in predicting microvascular invasion in hepatocellular carcinoma

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World Journal of Clinical Oncology 2022年第11期13卷 918-928页

作者： Jordan Zheng Ting Sim Terrence Chi Hong Hui Tong Kuan Chuah Hsien Min Low Cher Heng Tan Vishal GShelat Department of Diagnostic Radiology Tan Tock Seng HospitalSingapore 308433Singapore School of Engineering Ngee Ann PolytechnicSingapore 599489Singapore Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Presence of microvascular invasion(MVI)indicates poorer prognosis postcurative resection of hepatocellular carcinoma(HCC),with an increased chance of tumour *** present standards,MVI can only be diagnosed postoperatively on *** analysis potentially allows identification of patients who are considered‘high risk’through analysis of pre-operative magnetic resonance imaging(MRI)*** will allow for better patient selection,improved individualised therapy(such as extended surgical margins or adjuvant therapy)and pre-operative *** This study aims to evaluate the accuracy of texture analysis on pre-operative MRI in predicting MVI in *** Retrospective review of patients with new cases of HCC who underwent hepatectomy between 2007 and 2015 was *** criteria:No preoperative MRI,significant movement artefacts,loss-to-follow-up,ruptured HCCs,previous hepatectomy and adjuvant *** patients were divided into MVI(n=15)and non-MVI(n=35)groups based on tumour *** images of the tumour on post-contrast-enhanced T1-weighted MRI were *** qualitative(performed by radiologists)and quantitative data(performed by software)were *** texture parameters were extracted based on the largest cross-sectional area of each tumor and analysed using MaZda *** separate methods were *** 1,2 and 3 exclusively made use of features derived from arterial,portovenous and equilibrium phases *** 4 and 5 made use of the comparatively significant features to attain optimal *** Method 5 achieved the highest accuracy of 87.8%with sensitivity of 73%and specificity of 94%.CONCLUSION Texture analysis of tumours on pre-operative MRI can predict presence of MVI in HCC with accuracies of up to 87.8%and can potentially impact clinical management.

关键词： Carcinoma Hepatocellular Magnetic resonance imaging liver neoplasms Retrospective studies Margins of excision

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Associations between serum uric acid and hepatobiliary-pancreatic cancer:A cohort study

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World Journal of Gastroenterology 2020年第44期26卷 7061-7075页

作者： Chong-Fei Huang Jun-Jun Huang Ning-Ning Mi Yan-Yan Lin Qiang-Sheng He Ya-Wen Lu Ping Yue Bing Bai Jin-Duo Zhang Chao Zhang Teng Cai Wen-Kang Fu Long Gao Xun Li Jin-Qiu Yuan Wen-Bo Meng The First Clinical Medical School Lanzhou UniversityLanzhou 730000Gansu ProvinceChina Special Minimally Invasive Surgery Department The First Hospital of Lanzhou UniversityLanzhou 730000Gansu ProvinceChina Institute of Genetics School of Basic Medical SciencesLanzhou UniversityLanzhou 730000Gansu ProvinceChina Gansu Province Institute of Hepatopancreatobiliary Lanzhou 730000Gansu ProvinceChina Gansu Province Key Laboratory Biotherapy and Regenerative Medicine Lanzhou 730000Gansu ProvinceChina Scientific Research and Planning Department The First Hospital of Lanzhou UniversityLanzhou 730000Gansu ProvinceChina Clinical Research Center and Scientific Research Center The Seventh Affiliated HospitalSun Yat-sen UniversityShenzhen 518107Guangdong ProvinceChina The Fifth Department of General Surgery The First Hospital of Lanzhou UniversityLanzhou 730000Gansu ProvinceChina

BACKGROUND Uric acid is the end product of purine *** studies have found that serum uric acid(SUA)levels are associated with the total cancer ***,due to the dual effect of uric acid on cancer,the relationship between the SUA levels and most specific-site cancer remains *** To investigate the associations between the SUA levels and incidence of hepatobiliary-pancreatic *** In this prospective cohort study,444462 participants free of cancer from the UK Biobank were *** SUA levels were measured at baseline,and the incidence of hepatobiliary-pancreatic cancer was determined by contacting the cancer *** hazard ratios(HRs)and 95%confidence intervals(CIs)between the SUA levels and hepatobiliary-pancreatic cancer were investigated using multiple adjusted Cox regression models adjusted for potential *** In total,920 participants developed liver,gallbladder,biliary tract or pancreatic cancer during a median of 6.6 yrs of *** found that the HR of pancreatic cancer in the highest SUA group was 1.77(95%CI:1.29-2.42)compared with that in the lowest *** stratifying by gender,we further found that SUA was associated with an increased risk of pancreatic cancer only among the females(highest quartile vs lowest quartile HR 2.04,95%CI:1.35-3.08).Among the males,the SUA levels were positively associated with the gallbladder cancer risk(highest quartile vs lowest quartile HR 3.09,95%CI:1.28-7.46),but a U-shaped association with the liver cancer risk was observed(P-nonlinear=0.03).CONCLUSION SUA is likely to have gender-specific effects on hepatobiliary-pancreatic *** SUA levels are a risk factor for pancreatic cancer in females and gallbladder cancer in males.A U-shaped association with the liver cancer risk was identified.

关键词： Uric acid liver neoplasms Pancreatic neoplasms Gallbladder neoplasms Biliary tract neoplasms Cohort studies

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Primary hepatic myelolipoma: A case report and review of the literature

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World Journal of Clinical Cases 2020年第19期8卷 4615-4623页

作者： Ke-Yu Li Ai-Lin Wei Ang Li Department of Hepato-Bilio-Pancreatic Surgery West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Primary hepatic myelolipoma is a rare hepatic mesenchymal tumor mixed by adipose tissue and bone marrow,and there is a lack of general guidelines related to its epidemiology and clinical *** SUMMARY A 26-year-old woman was admitted to our department complaining of a newly found tumor on her left lobe of the *** tumor was painless and not associated with any systemic or localized compressive *** tests disclosed a slight increase of gamma-glutamyl transpeptidase(70.0 U/L)and total bilirubin(19.2 pmol/L).Ultrasonography showed a mass about 5.0 cm x 5.0 cm in size that was located in the left lobe of the liver and displayed hyperechoic and well-encapsulated *** resection was applied,and the following histopathological examination observed a variable proportion of myeloid tissues scattering throughout mature fibrotic adipose tissues,in which myeloid,erythroid,and megakaryocytic cells can be found in magnified *** follow-up did not show any changes 6 mo after *** This case highlights an extremely rare hepatic mesenchymal tumor,the primary hepatic myelolipoma,and discloses the common characteristics behind this disease and gives clinical recommendations.

关键词： Hepatic myelolipoma liver neoplasms Myelolipoma Tumor liver Extraadrenal myelolipoma Case report

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Contrast-enhanced ultrasound in association with serum biomarkers for differentiating combined hepatocellular-cholangiocarcinoma from hepatocellular carcinoma and intrahepatic cholangiocarcinoma

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World Journal of Gastroenterology 2020年第46期26卷 7325-7337页

作者： Jie Yang Ya-han Zhang Jia-Wu Li Ying-Yu Shi Jia-Yan Huang Yan Luo Ji-Bin Liu Qiang Lu Department of Medical Ultrasound West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Pathology West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Radiology Thomas Jefferson UniversityPhiladelphiaPA 19107United States

BACKGROUND Combined hepatocellular-cholangiocarcinoma(CHC)is a rare type of primary liver *** to its complex histopathological characteristics,the imaging features of CHC can overlap with those of hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC).AIM To investigate the possibility and efficacy of differentiating CHC from HCC and ICC by using contrast-enhanced ultrasound(CEUS)liver Imaging Reporting and Data System(LI-RADS)and tumor *** Between January 2016 and December 2019,patients with histologically confirmed CHC,ICC and HCC with chronic liver disease were *** diagnostic formula for CHC was as follows:(1)LR-5 or LR-M with elevated alphafetoprotein(AFP)and carbohydrate antigen 19-9(CA19-9);(2)LR-M with elevated AFP and normal CA19-9;or(3)LR-5 with elevated CA19-9 and normal *** sensitivity,specificity,accuracy and area under the receiver operating characteristic curve were calculated to determine the diagnostic value of the *** After propensity score matching,134 patients(mean age of 51.4±9.4 years,108 men)were enrolled,including 35 CHC,29 ICC and 70 HCC *** on CEUS LI-RADS classification,74.3%(26/35)and 25.7%(9/35)of CHC lesions were assessed as LR-M and LR-5,*** rates of elevated AFP and CA19-9 in CHC patients were 51.4%and 11.4%,respectively,and simultaneous elevations of AFP and CA19-9 were found in 8.6%(3/35)of CHC *** sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under the receiver operating characteristic curve of the aforementioned diagnostic criteria for discriminating CHC from HCC and ICC were 40.0%,89.9%,58.3%,80.9%,76.9%and 0.649,*** considering the reported prevalence of CHC(0.4%-14.2%),the positive predictive value and NPV were revised to 1.6%-39.6%and 90.1%-99.7%,*** CHCs are more likely to be classified as LR-M than LR-5 by CEUS *** combination of the CEUS LI-R

关键词： Combined hepatocellular-cholangiocarcinoma Contrast-enhanced ultrasound liver imaging reporting and data system Sensitivity Diagnosis liver neoplasms

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Hepatocellular carcinoma surveillance and quantile regression for determinants of underutilisation in at-risk Australian patients

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World Journal of Gastrointestinal Oncology 2021年第12期13卷 2149-2160页

作者： Elizabeth SL Low Ross Apostolov Darren Wong Sandra Lin Numan Kutaiba Josephine A Grace Marie Sinclair Department of Gastroenterology and liver Transplant Unit Austin HealthHeidelberg 3084VictoriaAustralia Department of Medicine University of MelbourneMelbourne 3000VictoriaAustralia Department of Radiology Monash HealthClayton 3168VictoriaAustralia Department of Radiology Austin HealthHeidelberg 3084VictoriaAustralia

BACKGROUND While clinical guidelines recommend hepatocellular carcinoma(HCC)surveillance for at-risk individuals,reported surveillance rates in the United States and Europe remain disappointingly *** To quantify HCC surveillance in an Australian cohort,and assess for factors associated with surveillance *** All patients undergoing HCC surveillance liver ultrasounds between January 1,2018 to June 30,2018 at a tertiary hospital in Melbourne,Australia,were followed until July 31,2020,or when surveillance was no longer *** primary outcome was the percentage of time up-to-date with HCC surveillance(PTUDS).Quantile regression was performed to determine the impact of factors associated with HCC surveillance *** Among 775 at-risk patients followed up for a median of 27.5 months,the median PTUDS was 84.2%(IQR:66.3%-96.3%).85.0%of patients were followed up by specialist *** those receiving specialist care,quantile regression demonstrated differential associations at various quantile levels of PTUDS for several *** age at the 25th quantile(estimate 0.002 per percent,P=0.03),and cirrhotic status at the 75th quantile(estimate 0.021,P=0.017),were significantly associated with greater percentage of time *** ethnicity(estimate-0.089,P=0.048)and a culturally and linguistically diverse(CALD)background(estimate-0.063,P=0.01)were significantly associated with lower PTUDS at the 50th quantile,and again for CALD at the 75th quantile(estimate-0.026,P=0.045).CONCLUSION While median PTUDS in this Australian cohort study was 84.2%,awareness of the impact of specific factors across PTUDS quantiles can aid targeted interventions towards improved HCC surveillance.

关键词： liver cirrhosis Hepatitis,viral,human Carcinoma,hepatocellular liver neoplasms Early detection of cancer Population surveillance

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Clinicopathological analysis of 14 patients with combined hepatocellular carcinoma and cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2011年第6期10卷 620-625页

作者： Xian-Huan Yu,Lei-Bo Xu,Hong Zeng,Rui Zhang,Jie Wang and Chao LiuAuthor Affiliations:Department of Hepato-Pancreato-Biliary Surgery and Department of Pathology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,China Department of Hepato-Pancreato-Biliary Surgery Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou 510120 China Department of Pathology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou 510120 China

BACKGROUND:Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an uncommon subtype of primary hepatic carcinoma,and its prognosis is *** study was undertaken to investigate the prognosis and the clinicopathological characteristics of cHCC-CC,including their possible cellular ***:Among 852 patients with a primary hepatic carcinoma who underwent hepatectomy from January 1998 to April 2008 at our hospital,cHCC-CC was identified in 14 patients The clinicopathological characteristics of the 14 patients were analyzed *** expression of the liver stem cell markers (c-kit,CD90,CD133 and CK19) in the tumor tissue was detected by immunohistochemistry,and the Kaplan-Meier method was used to evaluate ***:Among the 14 patients,9 presented with abdominal pain,3 with anorexia and debilitation,and the remaining two patients were *** mean age was 53.6±3.0 (range 38-74) *** the included patients,11 had an elevated serum alpha-fetoprotein level,13 were infected with hepatitis B virus,9 had vascular invasion and 1 had lymph node metastasis The average diameter of the tumors was 9.9±1.1 (range 5.0-16.0) *** median overall survival time was 7.9±1.0 months In addition,the presence of the liver stem cell markers,c-kit CD90,CD133 and CK19 was 71.4%,85.7%,92.9% and 78.6% *** four markers were simultaneously expressed in eight ***:cHCC-CC has aggressive characteristics and the prognosis is extremely *** high expression of liver stem cell markers in the tumor tissue suggests that these tumors may derive from liver stem cells.

关键词： liver neoplasms hepatocellular carcinoma cholangiocarcinoma prognosis stem cells

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The Effect of Targeted Magnetic Nanopaticles on Hepatoma and the Expression of bcl-2/bax Protein

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2008年第4期28卷 443-446页

作者：王剑明肖宝来郑建伟邹声泉 Department of General Surgery Tongji Hospital Tongji Medical College of Huazhong University of Science and Technology

The effect of targeted magnetic nanoparticles on hepatoma and the underlying mechanism were examined. Nude mice transplanted with a human hepatoma cell line （HepG2 cells） were randomized into 5 groups, including：（1） group A, receiving normal saline, （2） group B, receiving 5-fluorouracil （5-Fu）, （3） group C, receiving magnetic nanoparticles containing 5-Fu, （4） group D, consisting of treatment with magnetic nanoparticles containing 5-Fu and inside magnetic field and （5） group E, receiving pure magnetic nanoparticles and inside magnetic field. Morphological features of transplanted tumors in mice in each group were observed under transmission electron microscope （TEM）. The expression of bcl-2/bax protein was immunohistochemically detected by SABC method. The results showed that a large number of apoptotic tumor cells were found in group B and group D under TEM. The expression of bcl-2 protein was significantly decreased and the expression of bax protein increased significantly in both group B and D as compared with those in group A, C and E （P〈0.01 for all）. The decrease in bcl-2 and the increase in bax were more in group D as compared with group B （P〈0.01）. It is concluded that the targeted magnetic nanoparticles containing 5-Fu can improve the chemotherapeutic effect of 5-Fu by decreasing bcl-2 expression, increasing bax expres- sion and inducing apoptosis of the liver cancer cells.

关键词： liver neoplasms cell line bcl-2 bax magnetic nanoparticles, 5-Fu

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