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iliver 2024年第1期3卷 82-89页

作者： Guang-Yu Ding Jie-Yi Shi Xiao-Dong Wang Bo Yan Xi-Yang Liu Qiang Gao Department of liver surgery and transplantation Liver Cancer InstituteZhongshan HospitalShanghai 200032China Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education Fudan UniversityShanghai 200032China School of Computer Science and Technology Xidian UniversityXi'an 710126China School of Computer Science Shanghai Key Laboratory of Intelligent Information ProcessingFudan UniversityShanghai 200433China Institute of Biomedical Sciences Fudan UniversityShanghai 200030China State Key Laboratory of Genetic Engineering Fudan UniversityShanghai 200433China

In recent years,significant advances have been achieved in liver cancer management with the development of artificial intelligence(AI).AI-based pathological analysis can extract crucial information from whole slide images to assist clinicians in all aspects from diagnosis to prognosis and molecular ***,AI techniques have a“black box”nature,which means that interpretability is of utmost importance because it is key to ensuring the reliability of the methods and building trust among clinicians for actual clinical *** this paper,we provide an overview of current technical advancements in the AI-based pathological analysis of liver cancer,and delve into the strategies used in recent studies to unravel the“black box”of AI's decision-making process.

关键词： liver cancer Artificial intelligence Pathology Interpretative model

Three-dimensional modeling in complex liver surgery and liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 318-324页

作者： Jian-Peng Liu Jan Lerut Zhe Yang Ze-Kuan Li Shu-Sen Zheng Department of Hepatobiliary and Pancreatic surgery Department of Liver TransplantationShulan(Hangzhou)HospitalZhejiang Shuren University School of MedicineHangzhou 310000China Starzl Unit of Abdominal transplantation University Hospitals Saint LucUniversitécatholique LouvainBrusselsBelgium Division of Hepatobiliary Pancreatic surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China National Clinical Research Center of Infectious Diseases Hangzhou 310003China

liver resection and transplantation are the most effective therapies for many hepatobiliary tumors and ***,these surgical procedures are challenging due to the anatomic complexity and many anatomical variations of the vascular and biliary ***-dimensional(3D)printing models can clearly locate and describe blood vessels,bile ducts and tumors,calculate both liver and residual liver volumes,and finally predict the functional status of the liver after resection *** 3D printing models may be particularly helpful in the preoperative evaluation and surgical planning of especially complex liver resection and transplantation,allowing to possibly increase resectability rates and reduce postoperative *** the continuous developments of imaging techniques,such models are expected to become widely applied in clinical practice.

关键词： 3D printing models liver surgery liver transplantation

Reinforcing the management of type 1 gastric esophageal varices

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World Journal of Gastroenterology 2024年第19期30卷 2615-2617页

作者： Zain Majid Ghazi Abrar Department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan

Variceal bleed represents an important complication of cirrhosis,with its presence reflecting the severity of liver *** varices,though less frequently seen than esophageal varices,present a distinct clinical challenge due to its higher intensity of bleeding and associated *** upon the Sarin classification,GOV1 is the most common subtype of gastric varices seen in clinical practice.

关键词： Gastric varices Sarin classification Gastroesophageal varices Cyanoacrylate Endoscopic variceal ligation Trans jugular intrahepatic portosystemic shunt

Association of Pringle maneuver with postoperative recurrence and survival following hepatectomy for hepatocellular carcinoma: a multicenter propensity score and competing-risks regression analysis

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Hepatobiliary surgery and Nutrition 2024年第3期13卷 412-424,I0003-I0010页

作者： Shi-Chuan Tang Yong-Kang Diao Kong-Ying Lin Chao Li Xiao Xu Lei Liang Jie Kong Qing-Jing Chen Xian-Ming Wang Fu-Bao Liu Wei-Min Gu Ya-Hao Zhou Ying-Jian Liang Hong-Zhi Liu Ming-Da Wang Lan-Qing Yao Timothy M.Pawlik Feng Shen Wan Yee Lau Tian Yang Yong-Yi Zeng Department of Hepatobiliary surgery Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina Department of Hepatobiliary surgery Eastern Hepatobiliary Surgery HospitalNavy Medical University(Second Military Medical University)ShanghaiChina Department of Hepatobiliary surgery Affiliated Hospital of Nantong UniversityNantongChina Department of Hepatobiliary surgery People’s Hospital of Zhejiang ProvincialPeople’s Hospital of Hangzhou Medical CollegeHangzhouChina Department of Hepatobiliary Heze Municiple HospitalHezeChina Department of general surgery First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan HospitalJinanChina Department of Hepatobiliary surgery First Affiliated Hospital of Anhui Medical UniversityHefeiChina The First Department of general surgery Fourth Hospital of HarbinHarbinChina Department of Hepatobiliary surgery Pu’er People’s HospitalPu’erChina Department of Hepatobiliary surgery First Affiliated Hospital of Harbin Medical UniversityHarbinChina Department of surgery Ohio State UniversityWexner Medical CenterColumbusOHUSA Faculty of Medicine The Chinese University of Hong KongHong KongChina Department of Hepatopancreatobiliary surgery First Affiliated Hospital of Fujian Medical UniversityFuzhouChina The liver Disease Research Center of Fujian Province FuzhouChina

Background:The application of Pringle maneuver(PM)during hepatectomy reduces intraoperative blood loss and the need for perioperative transfusion,but its effect on long-term recurrence and survival for patients with hepatocellular carcinoma(HCC)remains *** sought to determine the association between the application of PM and post-hepatectomy oncologic outcomes for patients with ***:Patients who underwent curative hepatectomy for HCC at 9 Chinese hospitals from January 2010 to December 2018 were *** two propensity score methods[propensity score matching(PSM)and inverse probability of treatment weight(IPTW)],cumulative recurrence rate and cancer-specific mortality(CSM)were compared between the patients in the PM and non-PM *** competing-risks regression models were performed to adjust for the effect of non-cancer-specific mortality and other prognostic risk ***:Of the 2,798 included patients,2,404 and 394 did and did not adopt PM(the PM and non-PM groups),*** rates of intraoperative blood transfusion,postoperative 30-day mortality and morbidity were comparable between the two groups(all P>0.05).In the PSM cohort by the 1:3 ratio,compared to 382 patients in the non-PM group,1,146 patients in the PM group also had the higher cumulative 5-year recurrence rate and CSM(63.9%and 39.1%vs.55.3%and 31.6%,both P<0.05).Similar results were also yielded in the entire cohort and the IPTW *** competing-risks regression analyses demonstrated that no application of the PM was independently associated with lower recurrence rate and CSM based on various analytical cohorts[hazard ratio(HR),0.82 and 0.77 in the adjusted entire cohort,HR 0.80 and 0.73 in the PSM cohort,and HR 0.80 and 0.76 in the IPTW cohort,respectively].Conclusions:The findings suggested that no application of PM during hepatectomy for patients with HCC reduced the risk of postoperative recurrence and cancer-specific death by appr

关键词： Hepatocellular carcinoma(HCC) Pringle maneuver(PM) recurrence survival hepatectomy

Research progress on venous thrombosis development in patients with malignant tumors

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World Journal of Clinical Cases 2024年第11期12卷 1900-1908页

作者： Teng-Fei Wang Qian Chen Jie Deng Shi-Liang Li Yuan Xu Si-Xing Ma Department of Vascular surgery The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550000Guizhou ProvinceChina Department of Organ transplantation The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550000Guizhou ProvinceChina

The coexistence of venous thromboembolism(VTE)within patients with cancer,known as cancer-associated thrombosis(CAT),stands as a prominent cause of mortality in this *** recent years,the incidence of VTE has demonstrated a steady increase across diverse tumor types,influenced by several factors such as patient management,tumor-specific risks,and treatment-related ***,mutations in specific genes have been identified as potential contributors to increased CAT occurrence in particular cancer *** conducted an extensive review encompassing pivotal historical and ongoing studies on *** review elucidates the risks,mechanisms,reliable markers,and risk assessment methodologies that can significantly guide effective interventions in clinical practice.

关键词： Malignant tumor Venous thromboembolism Cancer-associated thrombosis Research progress

FGF21-mediated autophagy:Remodeling the homeostasis in response to stress in liver diseases

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Genes & Diseases 2024年第3期11卷 264-274页

作者： Wei Shen Modan Yang Hao Chen Chiy He Huigang Li Xinyu Yang Jianyong Zhuo Zuyuan Lin Zhihang Hu Di Lu Xiao Xu Zhejiang University School of Medicine HangzhouZhejiang 310058China Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Department of Hepatobiliary and Pancreatic SurgeryAffiliated Hangzhou First People's HospitalZhejiang University School of MedicineHangzhouZhejiang 310006China The Institute for Organ Repair and Regenerative Medicine of Hangzhou HangzhouZhejiang 310006China Institute of Organ transplantation Zhejiang UniversityHangzhouZhejiang 310003China National Center for Healthcare Quality Management in liver Transplant HangzhouZhejiang 310003China

liver diseases are worldwide problems closely associated with various stresses,such as endoplasmic reticulum *** exact interplay between stress and liver diseases remains *** plays an essential role in maintaining homeostasis,and recent studies indicate tight crosstalk between stress and autophagy in liver *** the bal-ance between damage and autophagy is broken,autophagy can no longer resist injury or main-tain *** recent years,FGF21(fibroblast growth factor 21)-induced autophagy has attracted much ***21 is regarded as a stress hormone and can be up-regulated by an abundance of signaling pathways in response to ***,increased FGF21 activates autophagy by a complicated signaling network in which mTOR plays a pivotal *** review summarizes the mechanism of FGF21-mediated autophagy and its derived application in the defense of stress in liver diseases and offers a glimpse into its promising prospect in future clinical practice.

关键词： Autophagy Fibroblast growth factor 21 liver diseases mTOR Stress

Long-term normothermic machine perfusion of fatty livers:towards transplanting untransplantable livers?

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Hepatobiliary surgery and Nutrition 2024年第4期13卷 681-685页

作者： Damiano Patrono Nicola De Stefano Elena Vissio Alessandro Gambella Renato Romagnoli general surgery 2U–liver Transplant Unit Azienda Ospedaliero Universitaria Cittàdella Salute e della Scienza di TorinoTurinItaly Pathology Unit Azienda Ospedaliero Universitaria Cittàdella Salute e della Scienza di TorinoTurinItaly Department of Medical Sciences University of TurinTurinItaly

Since the very early days of clinical liver transplantation(LT),transplant surgeons and professionals have been confronted with the increased risk of failure associated with the use of fatty liver grafts(1).Notwithstanding the wide variability in steatosis assessment across different centers and pathologists(2),utilization of livers with moderate(≥30%)or severe(≥60%)macrovesicular steatosis has been consistently associated with an increased risk of primary non-function,early allograft dysfunction,acute kidney injury,as well as inferior graft and patient survival(3).The mechanisms behind the increased susceptibility of steatotic livers to ischemia-reperfusion injury(IRI)are multiple,including disturbances to microcirculation due to sinusoidal narrowing,increased oxidative stress upon reperfusion and enhanced lipid peroxidation,leading to an increased release of inflammatory mediators like IL6,IL1βand so-called damage associated molecular patterns(DAMP),like cell-free DNA and mitochondrial ***,this is reflected by hepatocyte death by necrosis rather than apoptosis,pseudopeliotic steatosis(i.e.,the expulsion of lipid droplets into the extracellular space)and lately,by tissue remodelling and fibrosis(4,5).

关键词： liver transplantation(LT) steatosis macrovesicular steatosis large droplet fat normothermic machine perfusion

Efficacy and safety of low-dose cyclophosphamide combined with lenvatinib, pembrolizumab and TACE for unresectable hepatocellular carcinoma:A single-center, prospective,single-arm clinical trial

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Chinese Journal of Cancer Research 2024年第2期36卷 114-123页

作者： Yupeng Ren Yuxuan Li Mingbo Cao Yongchang Tang Feng Yuan Gaoyuan Yang Zhiwei He Zheng Shi Xiaorui Su Zhicheng Yao Meihai Deng Department of Hepatobiliary surgery the Third Affiliated HospitalSun Yat-sen UniversityGuangzhou 510630China Department of general surgery Qilu HospitalShandong UniversityJinan 250012China Department of Hepatobiliary surgery the First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510120China Department of Hepatobiliary and Pancreatic surgery the Third Affiliated HospitalSun Yat-sen UniversityGuangzhou 510630China

Objective: Unresectable hepatocellular carcinoma(uHCC) continues to pose effective treatment options. The objective of this study was to assess the efficacy and safety of combining low-dose cyclophosphamide with lenvatinib, pembrolizumab and transarterial chemoembolization(TACE) for the treatment of ***: From February 2022 to November 2023, a total of 40 patients diagnosed with uHCC were enrolled in this small-dose, single-center, single-arm, prospective study. They received a combined treatment of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE. Study endpoints included progression-free survival(PFS), objective response rate(ORR), and safety assessment. Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors(mRECIST), while survival analysis was conducted through KaplanMeier curve analysis for overall survival(OS) and PFS. Adverse events(AEs) were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events(version 5.0).Results: A total of 34 patients were included in the study. The median follow-up duration was 11.2 [95% confidence interval(95% CI), 5.3-14.6] months, and the median PFS(mPFS) was 15.5(95% CI, 5.4-NA) *** OS(mOS) was not attained during the study period. The ORR was 55.9%, and the disease control rate(DCR) was 70.6%. AEs were reported in 27(79.4%) patients. The most frequently reported AEs(with an incidence rate >10%) included abnormal liver function(52.9%), abdominal pain(44.1%), abdominal distension and constipation(29.4%), hypertension(20.6%), leukopenia(17.6%), constipation(17.6%), ascites(14.7%), and insomnia(14.7%). Abnormal liver function(14.7%) had the most common grade 3 or higher ***: A combination of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE is safe and effective for u HCC, showcasing a promising therapeutic strategy for managing uHCC.

关键词： Hepatocellular carcinoma lenvatinib low-dose cyclophosphamide pembrolizumab transarterial chemoembolization

Impact of sex on the outcomes of deceased donor liver transplantation

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World Journal of transplantation 2024年第1期14卷 120-129页

作者： Oya M Andacoglu Isabel S Dennahy Nicole C Mountz Luisa Wilschrey Arzu Oezcelik Division of transplantation and Advanced Hepatobiliary surgery University of UtahSalt Lake CityUT 84112United States Department of surgery University of EssenEssen D-45122Germany Department of surgery The University of Oklahoma Health Sciences CenterOklahoma CityOK 73117United States Department of surgery University of Oklahoma College of MedicineOklahoma CityOK 73117United States

BACKGROUND Data examining the impact of sex on liver transplant(LT)outcomes are *** is clear that further research into sex-related differences in transplant patients is necessary to identify areas for *** of these differences may help to identify specific areas of focus to improve on the organ matching process,as well as the peri-and post-operative care of these *** To utilize data from a high-volume Eurotransplant center to compare characteristics of male and female patients undergoing liver transplant and assess association between sex-specific variables with short-and long-term post-transplant *** A retrospective review of the University of Essen’s transplant database was performed with collection of baseline patient characteristics,transplant-related data,and short-term *** of these data were made with Shapiro-Wilk,Mann-Whitney U,χ2 and Bonferroni tests applied where appropriate.A P value ofliver failure and lower incidences of alcohol-related or viremic liver disease(P=0.001).Female patients were more likely to have received an organ from a female donor with a higher donor risk index score,and as a high urgency offer(all Pliver Disease score and donor cause of death were associated with long-term outcomes in ***-operative diagnosis of hepatocellular carcinoma,age at time of listing,duration of surgery,and units transfused during surgery,were associated with long-term outcomes in *** of complications was associated with long-term outcomes in both *** survival was similar in both males and females;however,when stratified by age,females<50 y

关键词： liver transplant Outcomes Survival Peri-and post-operative care

Genome-wide Studies Reveal Genetic Risk Factors for Hepatic Fat Content

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Genomics, Proteomics & Bioinformatics 2024年第2期22卷 57-68页

作者： Yanni Li Eline H.van den Berg Alexander Kurilshikov Dasha V.Zhernakova Ranko Gacesa Shixian Hu Esteban A.Lopera-Maya Alexandra Zhernakova Lifelines Cohort Study Vincent E.de Meijer Serena Sanna Robin P.F.Dullaart Hans Blokzijl Eleonora A.M.Festen Jingyuan Fu Rinse K.Weersma Department of Gastroenterology and Hepatology University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Department of Genetics University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Department of Gastroenterology and Hepatology Tianjin Medical University General HospitalTianjin Medical UniversityTianjin 300052China Laboratory of Genomic Diversity Center for Computer TechnologiesITMO UniversitySaint Petersburg 199034Russia Institute of Precision Medicine the First Affiliated HospitalSun Yat-sen UniversityGuangzhou 510080China Department of surgery Section of Hepatobiliary Surgery and Liver TransplantationUniversity of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Department of Endocrinology University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Department of Pediatrics University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands 不详

Genetic susceptibility to metabolic associated fatty liver disease(MAFLD)is complex and poorly *** characterization of the genetic background of hepatic fat content would provide insights into disease etiology and causality of risk *** performed genome-wide association study(GWAS)on two noninvasive definitions of hepatic fat content:magnetic resonance imaging proton density fat fraction(MRI-PDFF)in 16,050 participants and fatty liver index(FLI)in 388,701 participants from the United Kingdom(UK)Biobank(UKBB).Heritability,genetic overlap,and similarity between hepatic fat content phenotypes were analyzed,and replicated in 10,398 participants from the University Medical Center Groningen(UMCG)Genetics Lifelines Initiative(UGLI).Meta-analysis of GWASs of MRI-PDFF in UKBB revealed five statistically significant loci,including two novel genomic loci harboring CREB3L1(rs72910057-T,P=5.40E−09)and GCM1(rs1491489378-T,P=3.16E−09),respectively,as well as three previously reported loci:PNPLA3,TM6SF2,and *** of FLI in UKBB identified 196 genome-wide significant loci,of which 49 were replicated in UGLI,with top signals in ZPR1(P=3.35E−13)and FTO(P=2.11E−09).Statistically significant genetic correlation(rg)between MRI-PDFF(UKBB)and FLI(UGLI)GWAS results was found(rg=0.5276,P=1.45E−03).Novel MRI-PDFF genetic signals(CREB3L1 and GCM1)were replicated in the FLI *** identified two novel genes for MRI-PDFF and 49 replicable loci for *** a difference in hepatic fat content assessment between MRI-PDFF and FLI,a substantial similar genetic architecture was *** is identified as an easy and reliable approach to study hepatic fat content at the population level.

关键词： Hepatic fat content MAFLD Genome-wide association study Fatty liver index Magnetic resonance imaging proton density fat fraction