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Drug-eluting bead transarterial chemoembolization as neoadjuvant therapy pre-liver transplantation for advanced-stage hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2476-2486页

作者： Zhao-Dan Ye Li Zhuang Meng-Chen Song Zhe Yang Wu Zhang Jing-Feng Zhang Guo-Hong Cao department of Radiology Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical CollegeHangzhou 310022Zhejiang ProvinceChina department of hepatobiliary and pancreatic surgery Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical CollegeHangzhou 310022Zhejiang ProvinceChina Diagnostic and Therapeutic Center for Difficult Diseases Hwa Mei HospitalUniversity of Chinese Academy of SciencesNingbo 315010Zhejiang ProvinceChina

BACKGROUND The objectives of this study were to assess the safety and efficacy of drug-eluting bead transarterial chemoembolization(DEB-TACE)as neoadjuvant therapy before liver transplantation(LT)for advanced-stage hepatocellular carcinoma(HCC)and to analyze the prognostic *** To determine whether DEB-TACE before LT is superior to LT for advanced-stage *** A total of 99 individuals diagnosed with advanced HCC were studied *** participants were categorized into the following two groups based on whether they had received DEB-TACE before LT:DEB-TACE group(n=45)and control group(n=54).The participants were further divided into two subgroups based on the presence or absence of segmental portal vein tumor thrombus(PVTT).The DEB-TACE group consisted of two subgroups:Group A(n=31)without PVTT and group B(n=14)with *** control group also had two subgroups:Group C(n=37)without PVTT and group D(n=17)with *** on patient demographics,disease characteristics,therapy response,and adverse events(AEs)were *** overall survival(OS)and recurrence-free survival(RFS)rates were assessed using Kaplan-Meier *** and multivariate Cox regression analyses were conducted to determine the parameters that were independently related to OS and *** The DEB-TACE group exhibited an overall response rate of 86.6%.Following therapy,there was a significant decrease in the median alpha-fetoprotein(AFP)level(275.1 ng/mL vs 41.7 ng/mL,P<0.001).The main AE was post-embolization *** 2-year rates of RFS and OS were significantly higher in the DEB-TACE group than in the control group(68.9%vs 38.9%,P=0.003;86.7%vs 63.0%,P=0.008).Within the subgroups,group A had higher 2-year rates of RFS and OS compared to group C(71.0%vs 45.9%,P=0.038;83.8%vs 62.2%,P=0.047).The 2-year RFS rate of group B was markedly superior to that of group D(64.3%vs 23.5%,P=0.002).Results from multivariate analyses showed that pre-LT DEB-TACE[hazard ratio(HR)=

关键词： Hepatocellular carcinoma liver transplantation Portal vein tumor thrombus Drug-eluting bead transarterial chemoembolization Neoadjuvant treatment

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Acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases

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hepatobiliary & pancreatic Diseases International 2016年第1期15卷 93-98页

作者： Wong Hoi She Albert CY Chan Tan To Cheung Kenneth SH Chok See Ching Chan Ronnie TP Poon Chung Mau Lo Division of hepatobiliary & pancreatic surgery and liver transplantation Department of SurgeryThe University of Hong Kong

BACKGROUND： Acute pancreatitis is a relatively rare but po- tentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma. METHODS： A total of 1632 patients with hepatocellular car- cinoma who had undergone transarterial chemoembolization from ]anuary 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential com- plications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications. RESULTS： Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these pa- tients was 61 years. Most （79.6%） of the patients suffered from HBV-related hepatoceUular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin elut- ing bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven （0.4%） patients suffered from acute pancre- atitis post-chemoembolization. Six patients had chemoembo- lization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxornbicin eluting bead had a higher risk of acute pancreatitis [6/145 （4.1%） vs 1/1487 （0.1%）, P〈0.0001]. Two patients had anatomical arterial variations. Four patients developed acute pancreatitis- related complications including necrotizing pancreatitis （n=3） and pseudocyst formation （n=1）. All of the 4 patients resolved after the use of antibiotics and other conservative treatment. Three patients had further transarterial chemoembolization without any complication. CONCLUSIONS： Acute pancreatitis after transarterial chemo- embolization could result in serious complications, especially after treatment wit

关键词： transarterial chemoembolization acute pancreatitis hepatocellular carcinoma

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Biliary tract viability assessment and sequential hypothermic-normothermic perfusion in liver transplantation

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hepatobiliary surgery and Nutrition 2024年第3期13卷 505-508页

作者： Heithem Jeddou Stylianos Tzedakis Karim Boudjema department of hepatobiliary and Digestive surgery University HospitalRennes 1 UniversityRennesFrance Inserm EHESPIrset(Institut de recherche en santéenvironnement et travail)-UMR_S 1085Rennes 1 UniversityRennesFrance department of Digestive PancreaticHepato-biliary and Endocrine SurgeryCochin HospitalAssistance Publique-Hopitaux de Paris(AP-HP)ParisFrance UniversitéParis Cité ParisFrance

We read with great interest the study of Mergental et al.(1)reporting the 5-year outcomes of the VITTAL trial(2,3).VITTAL was a prospective,non-randomized,single-arm trial that tested end-ischemic oxygenated normothermic machine perfusion(NMP)with a“back-to-base”strategy to evaluate,and potentially transplant,liver grafts declined by all liver transplantation(LT)centers in the United *** a liver to be considered viable,it had to metabolize perfusate lactate to a concentration of≤2.5 mmol/L within four hours from the start of perfusion,and meet at least two of the following criteria:bile production without a defined quantity;maintenance of perfusate pH above 7.3;glucose consumption in the perfusate;maintenance of stable arterial and portal flow above 150 and 500 mL/min,respectively;maintenance of graft suppleness and homogeneous perfusion(4).Thirty-one discarded human donor livers underwent viability testing by using end-ischemic NMP,of which 22(71%)livers were subsequently *** primary outcome of the trial was graft survival rate at 90 days and it was 100%.

关键词： Biliary tract viability assessment normothermic perfusion hypothermic perfusion liver transplantation(LT)

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Unveiling hidden outcomes in malignant gastric outlet obstruction research–insights from a"Pancreas 2000"review

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World Journal of Gastrointestinal Endoscopy 2024年第8期16卷 451-461页

作者： Filipe Vilas-Boas Giacomo Emanuele Maria Rizzo Charles De Ponthaud Stuart Robinson Sebastien Gaujoux Gabriele Capurso Giuseppe Vanella Bahadır Bozkırlı department of Gastroenterology São João University HospitalPorto 4200Portugal Endoscopy Service Department of Diagnostic and Therapeutic ServicesScientific Institute for ResearchHospitalization and Healthcare-The Mediterranean Institute for Transplantation and Highly Specialized TherapiesPalermo 90127SiciliaItaly department of Digestive Hepato-Biliary and Pancreatic Surgery and Liver TransplantationAP-HP Pitié-SalpêtriereSorbonne UniversitéParis 75013Île-de-FranceFrance department of hepatobiliary Pancreatic and Transplant SurgeryFreeman HospitalNewcastle NE77DNNewcastle upon TyneUnited Kingdom Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy department of General surgery HPB-UnitAcıbadem Maslak HospitalIstanbul 34398Türkiye

Malignant gastric outlet obstruction(mGOO)is a major condition affecting patients with periampullary tumors,including pancreatic *** current treatment options include surgical gastroenterostomy,endoscopic stenting and more recently EUS-guided *** studies comparing the outcomes of the three procedures focus on technical success,clinical success and ***“occult”outcomes relevant to the patient’s viewpoints and perspective may ultimately impact on cancer-related and overall survival,such as body mass composition,nutritional biomarkers,chemotherapy tolerance and patient-reported quality of *** aim of this review is to provide an overview of potential key outcomes that should be explored in future comparative research around mGOO treatment options.

关键词： Malignant gastric outlet obstruction Endoscopic ultrasound-guided gastroenterostomy Patient-reported outcomes Body composition Nutrition Quality of life

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liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review

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hepatobiliary & pancreatic Diseases International 2024年第2期23卷 139-145页

作者： Wellington Andraus Francisco Tustumi Alexandre Chagas Santana Rafael Soares Nunes Pinheiro Daniel Reis Waisberg Liliana Ducatti Lopes Rubens Macedo Arantes Vinicius Rocha Santos Rodrigo Bronze de Martino Luiz Augusto Carneiro D’Albuquerque department of Gastroenterology Transplantation UnitUniversidade de São PauloSão PauloBrazil

Background:Perihilar cholangiocarcinoma(phCCC)is a dismal *** is no consensus regard-ing the best treatment for patients with unresectable *** present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phCCC and to build better guidance for clinical *** sources:The search was conducted in PubMed,Embase,Cochrane,and *** related references were searched *** criteria were:reports in English or Portuguese literature that a)patients with confirmed diagnosis of phCCC;b)patients treated with a curative intent;c)patients with the outcomes of liver resection and liver *** reports,reviews,letters,editorials,conference abstracts and papers with full-text unavailability were excluded from the ***:Most of the current literature is based on observational retrospective studies with low grades of *** resection has better long-term outcomes than systemic chemotherapy or palliation ther-apy and liver transplantation is a good alternative for selected patients with unresectable *** candidates for resection or transplantation should be medically fit and free of intrahepatic or extrahep-atic *** a general rule,patients presenting with a tumor having a longitudinal size>3 cm or extending below the cystic duct,lymph node disease,confirmed extrahepatic dissemination;intraoper-atively diagnosed metastatic disease;a history of other malignancies within the last five years,and did not complete chemoradiation regimen and were medically unfit should not be considered for *** of these criteria should be individually *** transplantation or resection should only be considered in highly experienced hepatobiliary centers,and any decision-making must be based on a multidisciplinary ***:phCCC is a complex condition with high *** therapies,including hepatec-tomy and liv

关键词： liver transplantation Cholangiocarcinoma liver neoplasms

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Protein neddylation and its role in health and diseases

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Signal Transduction and Targeted Therapy 2024年第5期9卷 1869-1904页

作者： Shizhen Zhang Qing Yu Zhijian Li Yongchao Zhao Yi Sun department of Breast surgery the Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310029China Cancer Institute(Key Laboratory of Cancer Prevention and Intervention China National Ministry of Education)the Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310029China Institute of Translational Medicine Zhejiang University School of MedicineHangzhou 310029China department of Thyroid surgery Zhejiang Cancer HospitalInstitute of Basic Medicine and Cancer(IBMC)Chinese Academy of SciencesHangzhou 310022China Key Laboratory of Head&Neck Cancer Translational Research of Zhejiang Province Hangzhou 310022China department of hepatobiliary and pancreatic surgery Zhejiang University School of MedicineHangzhou 310029China Zhejiang Provincial Key Laboratory of pancreatic Disease The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310029China Zhejiang University Cancer Center Hangzhou 310029China Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang Hangzhou 310024China Research Center for Life Science and Human Health Binjiang Institute of Zhejiang UniversityHangzhou 310053China

NEDD8(Neural precursor cell expressed developmentally downregulated protein 8)is an ubiquitin-like protein that is covalently attached to a lysine residue of a protein substrate through a process known as neddylation,catalyzed by the enzyme cascade,namely NEDD8 activating enzyme(E1),NEDD8 conjugating enzyme(E2),and NEDD8 ligase(E3).The substrates of neddylation are categorized into cullins and non-cullin *** of cullins activates CRLs(cullin RING ligases),the largest family of E3 ligases,whereas neddylation of non-cullin substrates alters their stability and activity,as well as subcellular ***,the neddylation pathway and/or many neddylation substrates are abnormally activated or over-expressed in various human diseases,such as metabolic disorders,liver dysfunction,neurodegenerative disorders,and cancers,among ***,targeting neddylation becomes an attractive strategy for the treatment of these *** this review,we first provide a general introduction on the neddylation cascade,its biochemical process and regulation,and the crystal structures of neddylation enzymes in complex with cullin substrates;then discuss how neddylation governs various key biological processes via the modification of cullins and non-cullin *** further review the literature data on dysregulated neddylation in several human diseases,particularly cancer,followed by an outline of current efforts in the discovery of small molecule inhibitors of neddylation as a promising therapeutic ***,few perspectives were proposed for extensive future investigations.

关键词： NEDD8 attached attractive

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pancreatic neuroendocrine tumors:Are tumors smaller than 2 cm truly indolent?

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1756-1762页

作者： Sergio Hoyos Pablo Posada-Moreno Natalia Guzman-Arango Romario Chanci-Drago Jaime Chavez Alvaro Andrés-Duarte Santiago Salazar-Ochoa Hepatobilary and liver Transplant Unit Hospital Pablo Tobon Uribe and Gastrohepathology Group Universidad de AntioquiaMedellin 050034AntioquiaColombia department of General surgery Universidad Pontificia BolivarianaMedellín 050034AntioquiaColombia

BACKGROUND pancreatic neuroendocrine tumors(PNETs)are relatively rare but rank as the second most common pancreatic *** can be functional,causing early metabolic disturbances due to hormone secretion,or non-functional and diagnosed later based on tumor size-related *** diagnoses of PNETs under 2 cm in size have sparked debates about their management;some practitioners advocate for surgical removal and others suggest observation due to the tumors’lower potential for ***,it is unclear whether managing these small tumors expectantly is truly *** To evaluate poor prognostic factors in PNETs based on tumor size(>2 cm orsurgery,followed by semi-annual con-sultations at the hospital's hepatobiliary surgery *** variables were described using absolute and relative frequencies,and quantitative variables were expressed using measures of central tendency and their corresponding measures of *** The presence of lymph node involvement,neural involvement,and lymphovascular invasion were all associated with an increased risk of mortality,with hazard ratios of 5.68(95%CI:1.26–25.61,P=0.024),6.44(95%CI:1.43–28.93,P=0.015),and 24.87(95%CI:2.98–207.19,P=0.003),*** involvement and lymphovascular invasion were present in tumors smaller than 2 cm in diameter and those larger than 2 cm in *** recurrence rates between the two tumor groups were furthermore similar:18.2%for tumors smaller than 2 cm and 21.4%for tumors larger than 2 *** survival was additionally comparable between the two tumor *** Tumor size does not dictate prognosis;lymph node and lymphovascular involvement a

关键词： Neuroendocrine tumor pancreatic neoplasm Pancreas pancreatic neuroendocrine neoplasm pancreatic neuroendocrine tumors

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Fully umbilical cord-derived adhesive materials enable to recruit and segregate immune cells for the reversal of acute liver failure

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Engineered Regeneration 2024年第1期5卷 70-79页

作者： Xiao Yi Feng Chen Kunjie Gao Huayan Li Yuan Xie Shao Li Jiajun Zhang Qing Peng Weijie Zhou Shutao Wang Jun-Bing Fan Yi Gao Research Centre for Artificial Organ and Tissue Engineering&Institute of Regenerative Medicine department of hepatobiliary surgery II Zhujiang Hospital Cancer Research InstituteSchool of Basic Medical SciencesSouthern Medical UniversityGuangzhouGuangdong Province 510515P R China department of Gynecology Zhujiang HospitalSouthern Medical UniversityGuangzhou 510515P R China CAS Key Laboratory of Bio-inspired Materials and Interfacial Science CAS Center for Excellence in NanoscienceTechnical Institute of Physics and ChemistryChinese Academy of SciencesBeijing 100190P R China department of Hepato-Biliary-pancreatic and Hernia surgery The First People’s Hospital of ZhaoqingZhaoqingGuangdong 526000P R China department of Pathology School of Basic Medical SciencesSouthern Medical UniversityGuangzhou 510515P R China

Inflammatory cytokine storms can trigger disease exacerbation and even death and have reached a consensus in the clinical treatment of acute organ ***,the existing strategies remain a great challenge to efficiently suppress inflammatory cytokine storms for promoting organ repair and ***,fully human umbilical cord(UC)-derived adhesive materials(UCAM)that integrate decellularized extracellular matrix(ECM)nanofiber hydrogel and homologous mesenchymal stem cells(MSCs)are demonstrated to greatly suppress inflammatory cytokine storms,demonstrating high efficacy in treating acute liver failure(ALF)in rats with 90%*** UC-derived adhesive materials have the capacity to secrete a significant quantity of cytokines by MSCs to recruit activated immune cells to migrate into their ECM nanofiber networks,segregating them away from the infection area and thereby greatly suppressing the inflammatory cytokine *** expected,the UC-derived adhesive materials can significantly promote hepatocyte proliferation to achieve functional recovery and regeneration of the liver,significantly improving the survival rate in *** fully human UC-derived adhesive materials provide a new avenue in suppressing inflammatory cytokine storms for promoting organ regeneration that would be really utility in clinical organ transplantation-related treatment.

关键词： Interfacial adhesive materials Extracellular matrix nanofibers Hydrogel Mesenchymal stem cells Acute liver failure

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Isolated antibody to hepatitis B core antigen in patients with chronic hepatitis C virus infection

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World Journal of Gastroenterology 2006年第27期12卷 4406-4410页

作者： Ahmed Helmy Mohammed Ibrahim Al-Sebayel department of liver transplantation Hepatobiliary and Pancreatic SurgeryKing Faisal Specialist Hospital & Research CenterRiyadhSaudi Arabiaand also affiliated to Faculty of MedicineAssiut University HospitalAssiutEgypt department of liver transplantation Hepatobiliary and Pancreatic SurgeryKing Faisal Specialist Hospital & Research CenterRiyadhSaudi Arabia

AIM： To evaluate the prevalence of isolated anti-HBc in patients with chronic hepatitis C virus （HCV） infection, and its relation to disease severity. METHODS： We screened all patients with chronic HCV infection referred to King Faisal Specialist Hospital and Research Center for hepatitis B surface antigen （HBsAg）, antibody to hepatitis B surface antigen （anti- HBs）, and anti-HBc. One hundred and sixty nine patients who tested negative for both HBsAg and anti-HBs were included in this study. RESULTS： Pathologically, 59 had biopsy-proven cirrhosis and 110 had chronic active hepatitis （CAH）. Of these 169 patients, 85 （50.3%） tested positive for anti-HBc. Patients with CAH had significantly higher prevalence of isolated anti-HBc than patients with cirrhosis, 71 （6d.5%） and 14 （23.7%） respectively （P 〈 0.001）. Twenty-five patients were tested for HBV DNA by qualitative PCR. The test was positive in 3 of them （12%; occult HBV infection）. CONCLUSION： Isolated anti-HBc alone is common in Saudi patients with chronic HCV infection, and is significantly more common in those with CAH than those with cirrhosis. Therefore, a screening strategy that only tests for HBsAg and anti-HBs in these patients will miss a large number of individuals with isolated anti-HBc, who may be potentially infectious.

关键词： Cirrhosis Chronic hepatitis Dual infection Co-infection Hepatitis B screening Super-infection

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Reassessment of palliative surgery in conversion therapy of previously unresectable hepatocellular carcinoma: Two case reports and review of literature

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World Journal of Gastrointestinal surgery 2024年第10期16卷 3312-3320页

作者： Yang-Bo Zhu Jia-Yi Qin Ting-Ting Zhang Wen-Jin Zhang Qi Ling Division of hepatobiliary and pancreatic surgery Department of SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Key Lab of Combined Multi-Organ transplantation Ministry of Public HealthThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina department of Clinical Pharmacy The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina department of Medical Imaging The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Most patients with hepatocellular carcinoma(HCC)have lost the opportunity for direct surgery at the time of *** chemoembolization(TACE)combined with immune checkpoint inhibitors or tyrosine kinase inhibitors(TKI)can partially transform some unresectable HCC and improve the prognosis ***,based on the promising prospects of combined targeted and immunotherapy for the effective treatment of HCC,the positive role of palliative surgery in the conversion treatment of advanced HCC urgently needs further in-tensive *** SUMMARY In this study,we describe two successful cases of"conversion therapy for un-resectable HCC"achieved mainly by palliative surgery combined with TACE plus immunotherapy and TKIs.A 48-year-old patient with newly diagnosed HCC,presenting with a 6-cm mass in the segment VII/VIII of the right liver with mul-tiple intrahepatic metastases,could not undergo one-stage radical surgical *** underwent palliative surgery with radiofrequency of metastatic lesions and the palliative resection of the primary mass,and received subsequent TACE treatments twice in the early postoperative period(2 weeks and 6 weeks),in addition to targeted and immune combination therapy with sintilimab injection and oral *** evidence of recurrence was observed during the 11-month follow-up period after *** other patient was a 47-year-old patient with massive HCC(18 cm×15 cm×4.5 cm)in the left liver with severe *** left portal branch was occluded and a tumor thrombus formed,and the tumor partly involved the middle hepatic *** patient underwent palliative surgery of left hemihepatectomy(including resection of the middle hepatic vein)for HCC,followed by three TACE procedures and oral TKIs 2 weeks after *** months later,the re-examination via computed tomography revealed no tumour activity in the remaining right liver,while magnetic resonance imaging revealed slight local tumor enh

关键词： Hepatocellular carcinoma Transarterial chemoembolization Immunotherapy Conversion Therapy Tyrosine kinase inhibitors Case report

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