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Precautions in caudate lobe resection: Report of 11 cases

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World Journal of Gastroenterology 2008年第17期14卷 2767-2770页

作者： Zeng-Qing Wen Yi-Qun Yan Jia-Mei Yang Meng-Chao Wu First department of Hepatic Surgery Eastern HepatobiliarySurgery Hospital Second Military Medical University Shanghai200438 China

AIM： To find the precautions against the safety in caudate lobe resection. METHODS： The clinical data obtained from 11 cases of primary liver cancer in caudate lobe who received hepatectomy successfully were retrospectively analyzed. Four safe procedures were used in resection of primary liver cancer in caudate lobe：（1） selection of appropriate skin incision to obtain excellent exposure of operative field; （2） adequate mobilization of the liver to allow the liver to be displaced upwards to the left or to the right; （3） preparatory placement of tapes for total hepatic vascular exclusion, so that this procedure could be used to control the fatal bleeding of the liver when necessary; （4） selection of the ideal route for hepatectomy based on the condition of the tumor and the combined removal of multiple lobes if necessary. Among the 11 cases, simple occlusion of vessels of porta hepatis was used in caudate Iobectomy for 6 cases, while in the other cases, the vessels were intermittently occluded several times or total hepatic vascular isolation was used in the caudate Iobectomy. Combined partial right hepatectomy was done for 3 cases, combined left lateral Iobectomy for 2 cases and caudate Iobectomy alone for 6 cases. RESULTS： Operation was successful for all the 11 cases. Intermittent inflow occlusion was performed for all patients for 15 min at 5-min intervals. Blockade was performed twice in 3 patients and total hepatic vascular exclusion was performed in one of the three patients. Blockade was performed three times in one patient, including a total hepatic vascular exclusion. Total hepatic vascular exclusion was performed only in one patient. The mean blood loss was 300 mL. Ascites and pleural effusion occurred in 4 patients, jaundice in 1 patient. Six patients died of tumor recurrence in 6, 11, 12, 13, 15, 19 mo after operation, respectively. The other 5 patients have survived more than 16 mo since the operation. CONCLUSION： Caudate Iobectomy for liver cance

关键词： Caudate lobe Primary liver cancer Hepatectomy Porta hepatis Vascular exclusion

Effect of resveratrol on pancreatic oxygen free radicals in rats with severe acute pancreatitis

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World Journal of Gastroenterology 2006年第1期12卷 137-140页

作者： Zhen-Dong Li Qing-Yong Ma Chang-An Wang department of hepatobiliarysurgery First Hospital of Xi'an Jiaotong University Xi'an710061 Shaanxi Province China department of Pathology Xi'an MunicipalCenter Hospital Xi'an 710068 Shaanxi Province China

AIM： To investigate the therapeutic effects of resveratrol （RESV） as a free radical scavenger on experimental severe acute pancreatitis （SAP）. METHODS： Seventy-two male Sprague-Dawley rats were divided randomly into sham operation group, SAP group, and resveratrol-treated group. Pancreatitis was induced by intraductal administration of 0.1 mL/kg 4% sodium taurocholate. RESV was given intravenously at a dose of 20 mg/kg body weight. All animals were killed at 3, 6, 12 h after induction of the model. Serum amylase, pancreatic superoxide dismutase （SOD）, malondialdehyde （MDA）, and myeloperoxidase （MPO） were determined. Pathologic changes of the pancreas were observed under optical microscope. RESULTS： The serum amylase, pancreatic MPO and the score of pathologic damage increased after the induction of pancreatitis, early （3, 6 h） SAP samples were characterized by decreased pancreatic SOD and increased pancreatic MDA. Resveratrol exhibited a protective effect against lipid peroxidation in cell membrane caused by oxygen free radicals in the early stage of SAP. This attenuation of the redox state impairment reduced cellular oxidative damage, as reflected by lower serum amylase, less severe pancreatic lesions, normal pancreatic MDA levels, as well as diminished neutrophil infiltration in pancreas. CONCLUSION： RESV may exert its therapeutic effect on SAP by lowering pancreatic oxidative free radicals and reducing pancreatic tissue infiltration of neutrophils.

关键词： Severe acute pancreatitis Resveratrol Oxygen free radical Neutrophil

P16 gene hypermethylation and hepatocellular carcinoma:A systematic review and meta-analysis

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World Journal of Gastroenterology 2011年第25期17卷 3043-3048页

作者： Jia-Jie Zang Feng Xie Jin-Fang Xu Ying-Yi Qin Rong-Xi Shen Jia-Mei Yang Jia He department of Health Statistics Second Military Medical Univer-sity Shanghai 200433 China department of Special Treatment and Liver Transplantation Eastern HepatobiliarySurgery Hospital Second Military Medical University Shanghai200438 China

AIM:To quantitatively investigate the effect of p16 hypermethylation on hepatocellular carcinoma (HCC) and hepatocirrhosis using a meta-analysis of available casecontrol ***:Previous studies have primarily evaluated the incidence of p16 hypermethylation in HCC and corresponding control groups,and compared the incidence of p16 hypermethylation in tumor tissues,pericancer liver tissues,normal liver tissues and non-tumor liver tissues with that in other *** regarding publication information,study characteristics,and incidence of p16 hypermethylation in both groups were collected from these studies and ***:Fifteen studies,including 744 cases of HCC and 645 non-tumor cases,were identified for *** significant odds ratios (ORs) of p16 hypermethylation were obtained from tumor tissues and non-tumorous liver tissues of HCC patients (OR 7.04,95% CI:3.87%-12.78%,P < 0.0001),tumor tissues of HCC patients and healthy liver tissues of patients with other diseases (OR 12.17,95% CI:6.64%-22.31%,P < 0.0001),tumor tissues of HCC patients and liver tissues of patients with non-tumorous liver diseases (OR 6.82,95% CI:4.31%-10.79%,P < 0.0001),and cirrhotic liver tissues and non-cirrhotic liver tissues (OR 4.96,95% CI:1.45%-16.96%,P=0.01).The pooled analysis showed significantly increased ORs of p16 hypermethylation (OR 6.98,95% CI:4.64%-10.49%,P < 0.001) from HCC tissues and cirrhotic ***:P16 hypermethylation induces the inactivation of p16 gene,plays an important role in hepatocarcinogenesis,and is associated with an increased risk of HCC and liver cirrhosis.

关键词： P16 hypermethylation Hepatocellular carci-noma Liver cirrhosis Meta-analysis Odds ratio

Rab23 is a potential biological target for treating hepatocellular carcinoma

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World Journal of Gastroenterology 2007年第7期13卷 1010-1017页

作者： Yun-Jian Liu Qian wang Wen Li Xiao-Hui Huang Shu-Hong Huang Lian-Zhou Chen Ling Xue Hong-Wei Zhang department of hepatobiliarysurgery First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou 510080 Guangdong Province China Depatment of Pathology First Affiliated Hospitalof Sun Yat-Sen University Guangzhou 510080 GuangdongProvince China Institute of DevelopmentalBiology School of Life Sciences Shandong University Jinan250100 Shandong Province China

AIM： To elucidate the role of Rab23 in hepatocellular carcinoma （HCC） by assessing the expression of Rab23 in HCC tissue and in HCC cell lines. METHODS： Primary tumors （n = 100） were stained with Rab23 antibodies using immunohistochemistry and in situ hybridization in tissue microarrays. Relationships between gene expression and pathology parameters were analysed. The biological significance of Rab23 in Hep-3B cells was examined by knocking down Rab23 gene expression. We designed a pair of doublestranded RNAs against human rab23 and transfected siRNA into Hep-3B cells. Rab23 expression in these cells was examined using RT-PCR and Western blots. We investigated cell growth by MTT assays and fluorescenceactivated cell sorting. RESULTS： High cytoplasmic and nuclear expression of Rab23 was found in 38 of 71 （53.5%） and in 49 of 68 HCC patients （72%） respectively, which correlated with tumor size. HCC cell lines expressed Rab23. In Hep3B cells, siRNA for Rab23 decreased Rab23 mRNA by 4.5-fold and protein expression by 2-fold. Survival rates at 24 and 48 h for Hep-3B cells tTansfected with siRNA were lower and about 30% Hep-3B cells were apoptotic. Knocking down rab23 suppressed Hep3B cell growth, suggesting that rab23 could play an important role in Hep3B cell growth. CONCLUSION： Rab23 is overexpressed and/or activatedin HCC. Rab23 may be both a HCC predictor and a target for treating HCC.

关键词： Rab23 Sonic hedgehog Hepatocellularcarcinoma Tissue microarray siRNA

Preoperative evaluation with T-staging system for hilar cholangiocarcinoma

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World Journal of Gastroenterology 2007年第43期13卷 5754-5759页

作者： Ru-Fu Chen Zhi-Hua Li Jia-Jia Zhou Jie Wang Ji-Sheng Chen Qing Lin Qi-Bing Tang Ning-Fu Peng Zhi-Peng Jiang Quan-Bo Zhou department of hepatobiliarysurgery the Affiliated Second Hospital Sun Yat-sen University107 Yan-Jiang Xi Road GuangZhou 510120 GuangdongProvince China department of Oncology the Affiliated SecondHospital Sun Yat-sen University 107 Yan-Jiang Xi RoadGuangZhou 510120 Guangdong Province China department of Emergency the AffiliatedSecond Hospital Sun Yat-sen University 107 Yan-Jiang Xi RoadGuangZhou 510120 Guangdong Province China

AIM： To investigate the clinical value of T-staging system in the preoperative assessment of hilar cholangiocarcinoma. METHODS： From March 1993 to January 2006, 85 patients who had cholangiocarcinoma diagnosed by operative tissue-biopsy were placed into one of three stages based on the new T-staging system, and it was evaluated the resectability and survival correlated with T-staging. RESULTS： The likelihood of resection and achieving tumor-free margin decreased progressively with increasing T stage （P 〈 0.05）. The cumulative 1-year survival rates of T1, T2 and T3 patients were 71.8%, 50.8% and 12.9% respectively, and the cumulative 3-year survival rate was 34.4%, 18.2% and 0% respectively; the survival of different stage patients differed markedly （P 〈 0.001）. Median survival in the hepatic resection group was greater than in the group that did not undergo hepatic resection （28 mo vs 18 mo; P 〈 0.05）. The overall accuracy for combined MRCP and color Doppler Ultrasonagraphy detecting disease was higher than that of combined using CT and color Doppler Ultrasonagraphy （91.4% vs 68%; P 〈 0.05 ）. And it was also higher in detecting port vein involvement （90% vs 54.5%; P 〈 0.05）.CONCLUSION： The proposed staging system for hilar cholangiocarcinoma can accurately predict resectability, the likelihood of metastatic disease, and survival. A concomitant partial hepatectomy would help to attain curative resection and the possibility of longterm survival. MRCP/MRA coupled with color Doppler UItrasonagraphy was necessary for preoperative evaluation of hilar cholangiocarcinoma.（OR = 2.46, 95% CI = 0.98-6.14）, and a significantly elevated risk of developing esophageal cancer among alcohol drinkers among alcohol drinkers （OR = 9.86, 95% CI = 3.10-31.38）. CONCLUSION： ADH2 and ALDH2 genotypes areassociated with esophageal cancer risk. ADH2＊1 allele and ALDH2＊2 allele carriers have a much higher risk of developing esophageal cancer, especially among alcohol drinkers.

关键词： Hilar cholangiocarcinoma Preoperativestaging Survival rate Surgical treatment

Surgical procedure and prognosis of hilar cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2004年第3期3卷 453-457页

作者： Bin Yi, Bai-He Zhang, Yong-Jie Zhang, Xiao-Qing Jiang, Bao-Hua Zhang,Wen-Long Yu, Qing-Bao Chen and Meng-Chao Wu department of Biliary Surgery, Eastern hepatobiliarysurgery Hospital, Shanghai 200438 , China department of Biliary Surgery Eastern Hepatobiliary Surgery Hospital Shanghai 200438 China. billyyi@***

BACKGROUND: Hilar cholangiocarcinoma has a low radi-cal resection rate and a poor long-term survival rate. In re-cent years, its prognosis has been improved with advance-ment of preoperative diagnostic techniques and surgicaltechniques. The aim of this study was to evaluate the prog-nostic factors of hilar cholangiocarcinoma and the relationsof surgical procedure to the prognosis of the ***: A retrospective cohort study was done in 198patients with hilar cholangiocarcinoma (117 men and 81women, aged from 27 to 81 years) , who had been admit-ted to this hospital from December 1997 to December *** symptoms were jaundice (94.5%), pruritus (56.6%)and abdominal pain (33.8%). Bismuth-Corlette classifica-tion showed type in 14 patients, type in 19, type in12, type in 15, type in 112, and unclassifiable typein 26. 144 patients underwent laparotomy and others re-ceived bile drainage endoscopically (including endoscopicretrograde biliary drainage (ERBD) or endoscopic metalbiliary endoprosthesis (EMBE) in 21 patients, endoscopicnose-biliary drainage (ENBD) in 31 or percutaneous trans-hepatic cholangiodrainage in 2. 120 patients (83.3%) re-ceived tumor resection including radical resection in 59 pa-tients (41.0%). Twenty-three patients underwent paunchedbiliary exploration and ***: Cox' s regression model analysis showed thatoccupation, preoperative total serum bilirubin level, opera-tive procedure and postoperative adjuvant radiation weresignificantly related to postoperative survival rate in con-trast to gender, age, choledocholithiasis, hepatitis, preope-rative serum CA19-9 level, Bismuth-Corlette type, his-topathologic grading and postoperative chemotherapy. Thesurvival of patients in groups of biliary drainage, palliativeresection and radical resection differed statistically and pro-longed in a descending order. No statistical difference wasfound between ERBD or EMBE group and palliative resec-tion group. So was between ERBD or EMBE group

关键词： cholangiocarcinoma/surgery prognosis cholangiopancreatography endoscopic retrograde