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Hepatitis B and alcohol affect survival of hepatocellular carcinoma patients

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World Journal of Gastroenterology 2005年第23期11卷 3491-3497页

作者： Linda L.Wong Whitney M.Limm Naoky Tsai Richard Severino department of Surgery liver Center University of Hawaii

AIM: In the USA, Hawaii has the highest incidence of hepatocellular carcinoma (HCC) and a diverse *** is an ideal place to characterize HCC in the context of ethnicity/risk ***: A total of 262 cases of HCC (1992-2003) were retrospectively reviewed for demographics, ethnicity, birthplace, viral hepatitis, alcohol use, diabetes, smoking and risk factors for viral hepatitis such as intravenous drug abuse (IVDA), transfusions, tattoos and vertical transmission. Tumor stage, Child's class, Cancer of the liver Italian Program (CLIP) score, α-fetoprotein level, treatment and survival were ***: Gender, age, viral hepatitis, alcohol, IVDA, and diabetes differed significantly in Asians, non-Asians and Pacific Islanders. There were also specific differences within Asian subgroups. Alpha-fetoprotein, smoking, transfusions, stage and resectability did not differ between groups. Asians were more likely to have hepatitis B, while non-Asians were more likely to have hepatitis C. Factors that decreased survival included hepatitis B, alcohol, elevated alpha-fetoprotein, CLIP ＞2 and increased Child's class. When Asians were combined with Pacific Islanders, median survival (1.52 years vs 3.54 years), 1- and 3-year survival was significantly worse than those for non-Asians. After Cox regression analysis for hepatitis B and alcohol, there was no difference in survival by ***: Various ethnicities have different risk factors for HCC. Hepatitis B, alcohol, and α-fetoprotein are more important factors for survival than ethnicity.

关键词： Hepatocellular cancer Ethnicity Hepatitis B

Isolated arterioportal fistula presenting with variceal hemorrhage

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World Journal of Gastroenterology 2013年第17期19卷 2714-2717页

作者： Anupama Nookala Behnam Saberi Ramon Ter-Oganesyan Gary Kanel Phillip Duong Takeshi Saito Division of Gastroenterology and liver Diseases Department of Medicine University of Southern California Los Angeles department of Radiology University of Southern California department of pathology University of Southern California

We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.

关键词： Arterioportal fistula Presinusoidal portal hypertension Hepatic vein pressure gradient Hepatic artery embolization

Repurposing Pirfenidone for Nonalcoholic Steatohepatitis-related Cirrhosis:A Case Series

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Journal of Clinical and Translational Hepatology 2020年第1期8卷 100-105页

作者： Cyriac Abby Philips Guruprasad Padsalgi Rizwan Ahamed Rajaguru Paramaguru Sasidharan Rajesh Tom George Pushpa Mahadevan Philip Augustine The liver Unit and Monarch liver Lab Cochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia department of Gastroenterology Cochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia department of pathology Al Salam International HospitalBneid Al QarKuwaitIndia department of Diagnostic and Interventional Radiology Department of Gastroenterology and The Liver UnitCochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia department of Clinical pathology VPS Lakeshore HospitalKochiKeralaIndia

We repurposed the antifibrotic drug pirfenidone—which is approved for treatment of idiopathic lung fibrosis—in a series of patients with nonalcoholic steatohepatitis-related *** report demonstrates the observed improvements in necroinflammation and regression of cirrhosis with pirfeni-done use for 12-weeks,associated with classical hepatic repair complex features on follow-up liver *** novel work could help stimulate further randomized trials of pirfe-nidone in patients with nonalcoholic steatohepatitis-related liver fibrosis or cirrhosis,for whom no recommended drug treatments exists currently.

关键词： NASH Fibrosis Antifibrotic Hepatitis Pirfenidone

COVID-19 in liver Transplant Recipients-A Series with Successful Recovery

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Journal of Clinical and Translational Hepatology 2020年第4期8卷 467-473页

作者： Ashok Choudhury Golamari Srinivasa Reddy Shantan Venishetty Viniyendra Pamecha Saggere Muralikrishna Shasthry Arvind Tomar Lalita Gauri Mitra Venkata Siva Tez Prasad Rajendra Prasad Mathur Debajyoti Bhattacharya Shiv Kumar Sarin department of Hepatology and liver Transplant Institute of Liver and Biliary SciencesNew DelhiIndia department of HPB Surgery and liver Transplant Institute of Liver and Biliary SciencesNew DelhiIndia department of Pulmonary Medicine Institute of Liver and Biliary SciencesNew DelhiIndia department of Critical Care Medicine Institute of Liver and Biliary SciencesNew DelhiIndia department of Nephrology Institute of Liver and Biliary SciencesNew DelhiIndia

The severe acute respiratory syndrome corona virus-2 (referred to as SARS-CoV-2) pandemic had a great impact on public life in general as well as on populations with pre-existing disease and co-morbidities. liver transplant and immunosuppressant medication predisposes to more severe disease and is often associated with poor outcome. The clinical features, disease course, treatment and process of modulating the immunosuppression is challenging. Here, we describe the clinical presentation, treatment and outcomes in six liver transplant recipients. Out of those six patients, three had mild, one had moderate and one had severe COVID-19, and one was asymptomatic. The immunosup-pression minimization or withdrawal was done based upon the clinical severity. Consideration of tocilizumab and/or convalescent plasma as well as antivirals i.e. remdesvir done in severe cases. The routine practice of prophylactic anti-coagulation, consideration of repurposed drugs (i.e. teico-planin and doxycycline), and watchful monitoring of asymptomatic recipients helped to achieve an uneventful recovery.

关键词： liver transplant COVID-19 SARS-CoV-2 liver injury Remdesivir Convalescent plasma

Hepatocellular adenoma and focal nodular hyperplasia: a series of 24 patients with clinicopathological and radiological correlation

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Chinese Medical Journal 2000年第9期113卷 84-89页

作者：纪元朱雄增孙惠川谭云山马曾辰叶青海宿杰阿克苏汤钊猷 department of pathology Institute of Liver CancerZhongshan Hospital department of pathology Cancer HospitalShanghai MedicalUniversity

To investigate two rare benign lesions, hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH), and evaluate differential diagnosis Methods Twenty-four consecutive patients with presumed HCA and FNH were studied at the liver Cancer Institute from January 1996 to May 1999 Preoperative assessment included clinical evaluation, symptoms and laboratory tests New imaging techniques were prospectively appraised in addition to usual techniques All had hepatic resections and follow-up Histologic examination of surgical specimens was obtained in all cases Results In every instance, FNH was an incidental finding FNH consists of nodular aggregates of cytologically normal hepatocytes with foci of intranodular bile duct proliferation In this series, patients with HCA had larger tumors and more often were symptomatic but the occurrence was unrelated to oral contraceptive steroids (OCS) usage Intralesional hemorrhage or necrosis is common, and was seen in 75% of cases The best imaging procedure in the diagnosis of FNH was MRI Color Doppler US was a useful adjunct, but CT lacked specificity, making histological diagnosis mandatory All patients underwent tumor resected were tumor——free during the follow-up Conclusions FNH is a distinct histopathologic entity, and is distinguishable from HCA FNH is a hyperplastic response by the liver parenchyma to a pre-existing arterial malformation HCA is a liver neoplasia and has the potential of malignant transformation to HCC Based on these findings, we believe that if the clinical suspicion of HCA or FNH is strong, resection is usually the best approach if technically feasible and histologic diagnosis is mandatory

关键词： hepatocellular adenoma focal nodular hyperplasia clinicopathological radiological

Prognostic analysis of surgical treatment of peripheral cholangiocarcinoma: Two decades of experience at Chang Gung Memorial Hospital

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World Journal of Gastroenterology 2005年第12期11卷 1779-1784页

作者： Yi-Yin Jan Chun-Nan Yeh Ta-Sen Yeh Tse-Ching Chen department of Surgery department of pathology

AIM: To analyze the prognostic factors influencing the overall survival of peripheral cholangiocarcinoma (PCC) patients undergoing surgical treatment during 25 years at a single institution. METHODS: This study retrospectively reviewed prospectively collecting data about 373 patients with historically proven PCC who underwent surgical treatment between 1977 and 2001. RESULTS: Three hundred and seventy-three PCC patients (159 men and 214 women) underwent surgical treatment from 1977 to 2001. Among them, 187 PCC patients underwent hepatectomy and 135 had curative resection (curative resectability rate: 36.2%). The follow-up duration ranged from 1.05 to 167.6 mo (mean/median = 14.1/7.2 mo). Overall cumulative survival rates at 1, 3, and 5 years were 32.5%, 9.2%, and 4.1%, respectively. Univariate log-rank analysis identified the following as adverse influences on overall survival: presence of symptoms, absence of mucobilia, elevated CEA and CA 19-9 levels, non-papillary tumor type, receiving non-hepatectomy, advanced tumor staging, lack of post-operative chemotherapy, and radiotherapy. Meanwhile, multivariate Cox's proportional hazard analysis demonstrated that absence of mucobilia, non-papillary tumor type, advanced tumor staging, non-hepatectomy, and lack of post-operative chemotherapy were the five independent prognostic factors that adversely affected overall survival. CONCLUSION: Favorable overall survival of PCC patients undergoing surgical treatment depends on early tumor stage, presence of mucobilia, papillary tumor type, hepatic resection, and post-operative chemotherapy.

关键词： Prognostic factor Surgical treatment Peripheral cholangiocarcinoma

Safety and efficacy of Hansenula-derived PEGylated-interferon alpha-2a and ribavirin combination in chronic hepatitis C Egyptian children

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World Journal of Gastroenterology 2014年第16期20卷 4681-4691页

作者： Suzan El Naghi Tawhida Y Abdel-Ghaffar Hanaa El-Karaksy Elham F Abdel-Aty Mona S El-Raziky Aleef A Allam Heba Helmy Hanaa A El-Araby Behairy E Behairy Mohamed A El-Guindi Hatem El-Sebaie Aisha Y Abdel-Ghaffar Nermin A Ehsan Ahmed M El-Hennawy Mostafa M Sira Pediatric department National Hepatology and Tropical Medicine Research Institute11441 CairoEgypt Yassin Abdel Ghaffar Charity Center for liver Disease and Research 2851 CairoEgypt Pediatric department Ain Shams University11566 CairoEgypt department of Pediatrics Cairo University Pediatric Hospital11562 CairoEgypt Pediatric Hepatology department National Liver InstituteMenofiya UniversityShebin El-koom32511 MenofiyaEgypt Biochemistry department National Liver Institute32511 MenofiyaEgypt Clinical pathology department Ain Shams University11566 CairoEgypt pathology department National Liver InstituteMenofiya UniversityShebin El-koom32511 MenofiyaEgypt pathology department Cairo UniversityFaculty of MedicineKasr El-Aini11562 CairoEgypt

AIM: To investigate the safety and efficacy of a Hansenula-derived PEGylated (polyethylene glycol) interferon (IFN)-alpha-2a (Reiferon Retard) plus ribavirin customized regimen in treatment-naïve and previously treate... 详细信息

关键词： Children Chronic hepatitis C Hansenula polymorpha PEGylated interferon Response rate Ribavirin Treatment

Resistance to apoptosis should not be taken as a hallmark of cancer

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Chinese Journal of Cancer 2014年第2期33卷 47-50页

作者： Rui-An Wang Zeng-Shan Li Qing-Guo Yan Xiu-Wu Bian Yan-Qing Ding Xiang Du Bao-Cun Sun Yun-Tian Sun Xiang-Hong Zhang department of pathology The Fourth Military Medical University department of pathology The Third Military Medical University department of pathology Nanfang Medical University department of pathology Fudan University department of pathology Tianjin Medical University department of pathology Cancer Hospital of Chinese Academy for Medical Sciences department of pathology Hebei Medical University

In the research community, resistance to apoptosis is often considered a hallmark of cancer. However, pathologists who diagnose cancer via microscope often see the opposite. Indeed, increased apoptosis and mitosis are usually observed simultaneously in cancerous lesions. Studies have shown that increased apoptosis is associated with cancer aggressiveness and poor clinical outcome. Furthermore, overexpression of Bcl-2, an antiapoptotic protein, is linked with better survival of cancer patients. Conversely, Bax, CD95, Caspase-3, and other apoptosis-inducing proteins have been found to promote carcinogenesis. This notion of the role of apoptosis in cancer is not new; cancer cells were found to be short-lived 88 years ago. Given these observations, resistance to apoptosis should not be considered a hallmark of cancer.

关键词：癌症患者抗凋亡蛋白 Caspase-3 抗细胞凋亡 Bcl-2蛋白 Bax蛋白有丝分裂过度表达

Hepatic progenitor cells in human liver tumor development

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World Journal of Gastroenterology 2006年第39期12卷 6261-6265页

作者： Louis Libbrecht liver Research Unit of the Laboratory of Morphology and Molecular pathology University of Leuven Leuven Belgium

In recent years, the results of several studies suggest that human liver tumors can be derived from hepatic progenitor cells rather than from mature cell types. The available data indeed strongly suggest that most combined hepatocellular-cholangiocarcinomas arise from hepatic progenitor cells that retained their potential to differentiate into the hepatocytic and biliary lineages. Hepatic progenitor cells could also be the basis for some hepatocellular carcinomas and hepatocellular adenomas, although it is very difficult to determine the origin of an individual hepatocellular carcinoma. There is currently not enough data to make statements regarding a hepatic progenitor cell origin of cholangiocarcinoma. The presence of hepatic progenitor cell markers and the presence and extent of the cholangiocellular component are factors that are related to the prognosis of hepatocellular carcinomas and combined hepatocellular- cholangiocarcinomas, respectively.

关键词： Hepatic progenitor cell Hepatocellular carcinoma liver tumor