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Present and future possibilities for early diagnosis of hepatocellular carcinoma

World Journal of Gastroenterology 2010年第4期16卷 418-424页

作者： Piotr Stefaniuk Janusz Cianciara Alicja Wiercinska-Drapalo department of hepatology and acquired immuno-deficiencies Warsaw Medical University37Wolska StWarsaw 01-201Poland

Hepatocellular carcinoma(HCC) represents the fifth most common cancer in the world,and the third most frequent oncological cause of *** incidence of HCC is on the *** typically develops in patients with chronic liver diseases,and cirrhosis,usually with viral etiology,is the strongest predisposing *** HCC diagnosis is a multistage process including clinical,laboratory,imaging and pathological *** prognosis of HCC is mostly poor,because of detection at an advanced,non-resectable *** curative treatment(surgery) is limited and really possible only for cases with small HCC *** this reason,more effective surveillance strategies should be used to screen for early occurrence of HCC targeted to the population at *** far,the generally accepted serological marker is α-fetoprotein(AFP).Its diagnostic accuracy is unsatisfactory and questionable because of low sensitivity,therefore there is a strong demand by clinicians for new HCC-specific *** this review,we will focus on other biomarkers that seem to improve HCC diagnosis,such as AFP-L3,des-γ-carboxyprothrombin,α-l-fucosidase,,γ-glutamyl transferase,glypican-3,squamous cell carcinoma antigen,a new generation of immunoglobulin M-immunocomplexes,and very promising geneexpression profiling.

关键词： Hepatocellular carcinoma Chronic hepatitis Liver cirrhosis Cancer screening Surveillance Biological markers

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Aetiological factors of Budd-Chiari syndrome in Algeria

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World Journal of hepatology 2015年第6期7卷 903-909页

作者： Nawel Afredj Nawal Guessab Abdelbasset Nani Sid Ahmed Faraoun Ibtissem Ouled Cheikh Rafik Kerbouche Djouhar Hannoun Zine Charef Amir Hayet Ait Kaci Kamel Bentabak Aurélie Plessier Dominique-Charles Valla Valerie Cazals-Hatem Marie-Hélène Denninger Tadjeddine Boucekkine Nabil Debzi hepatology Unit Department of Medicine Mustapha Hospital Radiology Unit Centre Pierre and Marie Curie National Institute of Public Health (INSP) Pathology Unit CHU Mustapha Pathology Unit Centre Pierre and Marie Curie Surgery Unit Centre Pierre and Marie Curie hepatology Unit Beaujon Hospital Pathology Unit Beaujon Hospital immunohematology Laboratory Beaujon Hospital

syndrome （BCS） and identify the aetiologies of thisdisease in ***： Patients with BCS, hospitalised in our unitfrom January 2004 until June 2010 were included and theaetiological factors were assessed. Patients presentinga BCS in the setting of advanced-stage cirrhosis or aliver transplantation were excluded from the study. Thediagnosis was established when an obstruction of hepaticvenous outflow （thrombosis, stenosis or compression）was demonstrated. We diagnosed myeloproliferativedisease （MPD） by bone marrow biopsy and V617FJAK2 mutation. Anti-phospholipid syndrome （APLS） wasdetected by the presence of anticardiolipin antibodies,anti-β2 glycoprotein antibodies and Lupus *** also detected paroxysmal nocturnal haemoglobinuria（PNH） by flow cytometry. Celiac disease and Beh？etdisease were systematically investigated in our *** anticoagulant protein deficiencies were alsoassessed. We tested our patients for the G20210Amutation at Beaujon Hospital. Imaging procedures wereperformed to determine a local cause of BCS, such as ahydatid cyst or a liver ***： One hundred and fifteen patients wereincluded. Mean follow up： 32.12 mo. Mean age： 34.41years, M/F = 0.64. Chronic presentation was frequent：63.5%. The revealing symptoms for the BCS wereascites （74.8%） and abdominal pain （42.6%）. Themost common site of thrombosis was the hepatic veins（72.2%）. Involvement of the inferior vena cava alonewas observed in 3 patients. According to the radiologicalinvestigations, BCS was primary in 94.7% of the cases（n = 109） and secondary in 5.2% （n = 6）. An aetiologywas identified in 77.4% of the patients （n = 89）; itwas multifactorial in 27% （n = 31）. The predominantaetiology of BCS in our patients was a myeloproliferativedisease, observed in 34.6% of cases. APLS was foundin 21.7% and celiac disease in 11.4%. Other acquiredconditions were： PNH （n = 4）, systemic disease （n = 6）and inflammatory bowel disease （n = 5）. Anticoagulantprotein defici

关键词： Algeria Etiologie Celiac disease Budd-Chiari Thrombosis

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Intravenous immunoglobulins in liver transplant patients: Perspectives of clinical immune modulation

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World Journal of hepatology 2015年第11期7卷 1494-1508页

作者： Arno Kornberg department of Surgery Klinikum rechts der Isar Technical University

Shortage of appropriate donor grafts is the foremost current problem in organ transplantation. As a logical consequence, waiting times have extended and pretransplant mortality rates were significantly increasing. The implementation of a priority-based liver allocation system using the model of end-stage liverdisease(MELD) score helped to reduce waiting list mortality in liver transplantation(LT). However, due to an escalating organ scarcity, pre-LT MELD scores have significantly increased and liver recipients became more complex in recent years. This has finally led to posttransplant decreasing survival rates, attributed mainly to elevated rates of infectious and immunologic complications. To meet this challenging development, an increasing number of extended criteria donor grafts are currently accepted, which may, however, aggravate the patients' infectious and immunologic risk profiles. The administration of intravenous immunoglobulins(IVIg) is an established treatment in patients with immune deficiencies and other antibody-mediated diseases. In addition, IVIg was shown to be useful in treatment of several disorders caused by deterioration of the cellular immune system. It proved to be effective in preventing hyperacute rejection in highly sensitized kidney and heart transplants. In the liver transplant setting, the administration of specific Ig against hepatitis B virus is current standard in post-LT antiviral prophylaxis. The mechanisms of action of IVIg are complex and not fully understood. However, there is increasing experimental and clinical evidence that IVIg has an immuno-balancing impact by a combination of immuno-supporting and immuno-suppressive properties. It may be suggested that, especially in the context of a worsening organ shortage with all resulting clinical implications, liver transplant patients should benefit from immuno-regulatory capabilities of IVIg. In this review, perspectives of immune modulation by IVIg and impact on outcome in liver t

关键词： Intravenous immunoglobulins Immunemodulation Hyperimmunoglobulin Model of end-stageliver disease Liver transplantation

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