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Science China Life Sciences 2025年第1期 297-299页

作者： Junbin Zhou Rongli Wei Guanghan Fan Zhengxing Lian Xuanyu Zhang Linsong Tang Zhetuo Qi Haiyang Xie Shusen Zheng Qiang Wei Xiao Xu Department of hepatobiliary and pancreatic Surgery People's Hospital of LishuiAffiliated Lishui Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Lishui University NHFPC Key Laboratory of Combined Multi-Organ Transplantation Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Department of Hepatobiliary and Pancreatic SurgeryHangzhou First People's Hospital Department of hepatobiliary and pancreatic Surgery The First Affiliated HospitalZhejiang University School of Medicine Department of Urology The Second Affiliated HospitalZhejiang University School of Medicine Department of hepatobiliary and pancreatic Surgery Department of Liver TransplantationShulan (Hangzhou) Hospital Hangzhou Medical College Zhejiang University School of Medicine

Dear Editor, Liver transplantation(LT) is the only curative therapy for patients with endstage liver disease(He et al., 2023; Ling et al., 2022). Post-transplant hypertriglyceridemia(PTHT), which has an incidence of up to 32.8% in 6 months after LT, is one of the major post-transplant complications(Toshima et al., 2020).

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Potential prognostic biomarkers in pancreatic juice of resectable pancreatic ductal adenocarcinoma

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World Journal of Clinical Oncology 2017年第3期8卷 255-260页

作者： Shefali Agrawal hepatobiliary and pancreatic Surgery Department of Surgical OncologyIndraprastha Apollo Hospitals

Despite potentially curative surgery pancreatic cancer has a dismal *** cancer antigen 19-9(CA 19-9) correlates with tumor burden,resectability and survival in patients with pancreatic ductal *** of novel biomarkers may facilitate early diagnosis of pancreatic cancer and improve *** juice is a rich source of cancer-specific proteins rendering it a promising tool for identifying *** proteomic and micro RNA expression analyses have identified several biomarkers of potential diagnostic and prognostic *** markers CA 19-9 and carcinoembryonic antigen(CEA) are widely used in the characterization of premalignant and malignant lesions of the *** level of CEA in bile is a marker for malignancy and a predictor of hepatic *** potential value of CA 19-9,CEA and lactate dehydrogenase as prognostic biomarkers in pancreatic juice and bile is *** of pancreatic juice and bile can be readily collected during surgical resection of the *** of pancreatic juice and bile to identify novel prognostic biomarkers may improve selection of patients for adjuvant therapy with a favorable impact on overall survival in patients diagnosed with pancreatic cancer.

关键词： Prognostic biomarkers pancreatic juice Bile pancreatic adenocarcinoma Surgery

Prognosis of hepatocellular carcinoma with bile duct tumor thrombus after R0 resection:a matched study

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hepatobiliary & pancreatic Diseases International 2016年第6期15卷 626-632页

作者： Ding-Ding Wang Li-Qun Wu Zu-Sen Wang Division of hepatobiliary pancreatic Surgery The Affiliated Hospital of Qingdao University

BACKGROUND： Hepatocellular carcinoma （HCC） with bile duct tumor thrombus （BDTT） is rare. The present study aimed to determine post-surgical prognoses in HCC patients with BDTT, as outcomes are currently unclear. METHODS： We compared the prognoses of 110 HCC patients without BDTT （group A） to 22 cases with BDTT （group B）. The two groups were matched in age, gender, tumor etiology, size, number, portal vascular invasion, and TNM stage. Additionally, 28 HCC patients with BDTT were analyzed to identify prognostic risk factors. RESULTS： The 1-, 3-, and 5-year overall survival rates were 90.9%, 66.9%, and 55.9% for group A and 81.8%, 50.0%, and 37.5% for group B, respectively. The median survival time in groups A and B was 68.8 and 31.4 months, respectively （P=0.043）. The patients for group B showed higher levels of serum total bilirubin, alanine aminotransferase and gammaglutamyl transferase, a larger hepatectomy range, and a higher rate of anatomical resection. In subgroup analyses of patients with BDTT who underwent R0 resection, TNM stage Ⅲ-Ⅳ was an independent risk factor for overall survival; these patients had worse prognoses than those with TNM stage Ⅰ-Ⅱ after R0 resection （hazard ratio=6.056, P=0.014）. Besides, univariate and multivariate analyses revealed that non-R0 resection and TNM stage Ⅲ-Ⅳ were independent risk factors for both disease-free survival and overall survival of 28 HCC patients with BDTT. The median overall survival time of patients with BDTT who underwent R0 resection was longer than that of patients who did not undergo R0 resection （31.0 vs 4.0 months, P=0.007）.CONCLUSIONS： R0 resection prolonged survival time in HCC patients with BDTT, although prognosis remains poor. For such patients, R0 resection is an important treatment that determines long-term survival.

关键词： hepatocellular carcinoma bile duct tumor thrombus prognosis recurrence R0 resection

Cancer-associated fibroblasts in hepatocellular carcinoma

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World Journal of Gastroenterology 2016年第30期22卷 6841-6850页

作者： Norio Kubo Kenichiro Araki Hiroyuki Kuwano Ken Shirabe Department of hepatobiliary and pancreatic Surgery Gunma University Graduate School of Medicine Department of General surgical Science Gunma University Graduate School of Medicine

The hepatic stellate cells in the liver are stimulated sustainably by chronic injury of the hepatocytes, activating myofibroblasts, which produce abundant collagen. Myofibroblasts are the major source of extracellular proteins during fibrogenesis, and may directly, or secreted products, contribute to carcinogenesis and tumor progression. Cancer-associated fibroblasts(CAFs) are one of the components of the tumor microenvironment that promote the proliferation and invasion of cancer cells by secreting various growth factors and cytokines. CAFs crosstalk with cancer cells stimulates tumor progression by creating a favorable microenvironment for progression, invasion, and metastasis through the epithelial-mesenchymal transition. Basic studies on CAFs have advanced, and the role of CAFs in tumors has been elucidated. In particular, for hepatocellular carcinoma, carcinogenesis from cirrhosis is a known fact, and participation of CAFs in carcinogenesis is supported. In this review, we discuss the current literature on the role of CAFs and CAF-related signaling in carcinogenesis, crosstalk with cancer cells, immunosuppressive effects, angiogenesis, therapeutic targets, and resistance to chemotherapy. The role of CAFs is important in cancer initiation and progression. CAF-targeted therapy may be effective for suppression not only of fibrosis but also cancer progression.

关键词： Cancer associated fibroblast Hepatic stellate cell Hepatocellular carcinoma Immunosuppression Therapeutic target

Combined TIM-3 and PD-1 blockade restrains hepatocellular carcinoma development by facilitating CD4+ and CD8+T cellmediated antitumor immune responses

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World Journal of Gastrointestinal Oncology 2023年第12期15卷 2138-2149页

作者： Xu-Sheng Zhang Hong-Cai Zhou Peng Wei Long Chen Wei-Hu Ma Lin Ding Shi-Cai Liang Ben-Dong Chen School of Clinical Medicine Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina Department of hepatobiliary Surgery The General Hospital of Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina hepatobiliary pancreatic surgical Ningxia Hepatobiliary Pancreatic Surgical Diseases Clinical Research CenterYinchuan 750004Ningxia Hui Autonomous RegionChina

BACKGROUND Immune checkpoint inhibitors(ICIs)targeting programmed cell death protein 1(PD-1)and T cell immunoglobulin and mucin domain-containing protein 3(TIM-3)are beneficial to the resumption of anti-tumor immunity response and hold extreme potential as efficient therapies for certain ***,ICIs with a single target exhibit poor overall response rate in hepatocellular carcinoma(HCC)patients due to the complex pathological mechanisms of *** To investigate the effects of combined TIM-3 and PD-1 blockade on tumor development in an HCC mouse model,aiming to identify more effective immunotherapies and provide more treatment options for HCC *** The levels of PD-1 and TIM-3 on CD4+and CD8+T cells from tumor tissues,ascites,and matched adjacent tissues from HCC patients were determined with flow *** HCC xenograft mouse model was established and treated with anti-TIM-3 monoclonal antibody(mAb)and/or anti-PD-1 *** growth in each group was *** and eosin staining and immunohistochemical staining were used to evaluate T cell infiltration in *** percentage of CD4+and CD8+T cells in tissue samples from mice was tested with flow *** percentages of PD-1+CD8+,TIM-3+CD8+,and PD-1+TIM-3+CD8+T cells was accessed by flow *** levels of the cytokines including tumor necrosis factor alpha(TNF-α),interferon-γ(IFN-γ),interleukin(IL)-6,and IL-10 in tumor tissues were gauged with enzyme-linked immunosorbent assay *** We confirmed that PD-1 and TIM-3 expression was substantially upregulated in CD4+and CD8+T cells isolated from tumor tissues and ascites of HCC ***-3 mAb and PD-1 mAb treatment both reduced tumor volume and weight,while combined blockade had more substantial anti-tumor effects than individual *** we showed that combined therapy increased T cell infiltration into tumor tissues,and downregulated PD-1 and TIM-3 expression on CD8+T cells in tumor ***,c

关键词： Hepatocellular carcinoma T cell immunoglobulin and mucin domain-containing protein 3 programmed cell death protein 1 CD4+T cells CD8+T cells

Global standardization of laparoscopic liver resection and challenges for the future

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hepatobiliary Surgery and Nutrition 2019年第4期8卷 386-388页

作者： Kenichiro Araki Norifumi Harimoto Ken Shirabe Division of hepatobiliary and pancreatic Surgery Department of General Surgical Science Gunma University Graduate School of Medicine Gunma Japan

hepatobiliary Surgery and Nutrition recently published a review by X Cai that describes the current status and future of laparoscopic liver resection (LLR) in China. The advent of LLR has led to significant changes in the field of liver surgery, with numerous reports outlining how this procedure offers a better, less invasive approach for the treatment of liver disease. Two international consensus conferences regarding LLR—held in 2008 (Louisville, USA) and 2014 (Morioka, Japan)—highlighted the efficacy and safety of LLR, and discussed the surgical indications, technique, standardizations, and precautions that should be considered when performing LLR (1,2). Delegates deliberated whether open liver resection (OLR) should remain the current standard procedure for liver disease, and the importance of LLR within this arena. There was agreement that minor LLR offers sufficient safety and benefit to be considered standard practice, but major resection requires further investigation. The most recent guidelines from the European meeting on LLR, held in 2017 in Southampton, UK (3), integrate the available evidence and expert knowledge on LLR, taking into consideration relevant stakeholders' opinions and complying with international methodology standards across five domains (indications, patients and complex diseases, procedures, techniques, and implementation). The guidelines emphasize the importance of a team-oriented approach and the need to recruit experts in OLR and laparoscopic surgery within a specialist center.

关键词： resection Surgery standardization

Is irreversible electroporation safe and effective in the treatment of hepatobiliary and pancreatic cancers?

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hepatobiliary & pancreatic Diseases International 2019年第2期18卷 117-124页

作者： Li-Ming Wu Le-Le Zhang Xin-Hua Chen Shu-Sen Zheng Division of hepatobiliary and pancreatic Surgery the First Affiliated Hospital Zhejiang University School of Medicine

Background: Irreversible electroporation(IRE) is a novel ablative technique for hepatobiliary and pancreatic cancers. This review summarizes the data regarding the safety and efficacy of IRE in the treatment of hepatobiliary and pancreatic cancers. Data sources: Studies were identified by searching Pub Med and Embase for articles published in English from database inception through July 31, 2017. For inclusion, each clinical study had to report morbidity and survival data on hepatobiliary and pancreatic cancers treated with IRE and contain at least 10 patients. Studies that met these criteria were included for analysis. Two authors assessed each clinical study for data extraction. The controversial parts were resolved through discussion with seniors. Results: A total of 24 clinical studies were included. Fourteen focused on hepatic ablation with IRE comprising 437 patients with 666 lesions of different tumor types. Two patients(0.5%) died after the IRE procedure. Morbidity of hepatic ablation with IRE ranged from 7% to 35%. Most complications were mild. Complete response for hepatic tumors was reported as 57%–97%. Ten studies with 455 patients focused on pancreatic IRE. The overall mortality of IRE in pancreatic cancer was 2%. Overall severe morbidity of IRE in pancreatic cancer ranged from 0 to 20%. The median overall survival after IRE ranged from 7 to 23 months. Patients treated with IRE combined with surgical resection showed a longer overall survival. Conclusions: IRE significantly improves the prognosis of advanced hepatobiliary and pancreatic malignances, and companied with less complications. Hence, IRE is a relatively safe and effective non-thermal ablation strategy and potentially recommended as an option for therapy of patients with hepatobiliary and pancreatic malignances.

关键词： Irreversible electroporation Hepatic cancer pancreatic cancer

pancreaticoduodenectomy with portal vein/superior mesenteric vein resection for patients with pancreatic cancer with venous invasion

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hepatobiliary & pancreatic Diseases International 2015年第4期14卷 429-435页

作者： Wei-Lin Wang Song Ye Sheng Yan Yan Shen Min Zhang Jian Wu Shu-Sen Zheng Division of hepatobiliary pancreatic Surgery First Affiliated Hospital Zhejiang University School of Medicine

BACKGROUND： With the development of new surgical tech- niques, pancreaticoduodenectomy （PD） with portal vein or superior mesenteric vein （PV/SMV） resection has been used in the treatment of patients with borderline resectable pan- creatic cancer. However, opinions of surgeons differ in the effectiveness of this surgical technique. This study aimed to investigate the effectiveness of this approach in patients with pancreatic cancer. METHODS： Follow-up visits and retrospective analysis were carried out of 208 patients with pancreatic cancer who had undergone PD （PD group） and PD combined with PV/SMV resection and reconstruction （PDVR group） from June 2009 to May 2013 at our center. Statistical analysis was performed to compare the clinical features, the difference of survival time and risk factors of venous invasion in pancreatic cancer. Factors relating to postoperative survival time of pancreatic cancer were also investigated. RESULTS： In the PDVR group, which consisted of 42 cases, the 1-, 2- and 3-year survival rates were 70%, 41% and 16%, respective- ly and the median survival time was 20.0 months. Among the 166 patients in the PD group, the 1-, 2- and 3-year survival rates were 80%, 52%, and 12%, respectively with the median survival time of 26.0 months. No significant difference in survival time and R0 resection ratio was found between the two groups. Lum- bodorsal pain, tumor with pancreatic capsular invasion and bile duct infiltration were found to be independent risk factors for PV invasion in pancreatic cancer. In addition, non R0 resection,large tumor size （〉2 cm） and poorly differentiated tumor were independent risk factors for survival time in post-PD. CONCLUSIONS： The tumor has a higher chance of venous invasion if preoperative imagings indicate that it juxtaposes with the vessel. Lumbodorsal pain is the chief complaint. Pa- tients with pancreatic cancer associated with PV involvement should receive PDVR for R0 resection when preoperational assessment s

关键词： pancreatic cancer pancreaticoduodenectomy portal vein resection superior mesenteric vein

Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma

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Journal of Clinical and Translational Hepatology 2024年第2期12卷 210-217页

作者： Kai-Jian Chu Yoshikuni Kawaguchi Han Wang Xiao-Qing Jiang Kiyoshi Hasegawa Biliary surgical Department No.1 Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina Hepato-Biliary-pancreatic Surgery Division Department of SurgeryGraduate School of MedicineThe University of TokyoTokyoJapan Department of Pathology Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a unique type of liver tumor that contains both hepatocellular carcinoma and cholangiocarcinoma components within a single *** fifth edition of the World Health Organization classification provides a definition and diagnostic criteria for ***,the heterogeneous histomorphology and presentation resulting from variation of the proportion of each component poses challenges for clinical diagnosis and treatment.A diagnosis of cHCC-CCA may be suggested by the synchronous elevation of serum tumor markers for hepatocellular carcinoma and cholangiocarcinoma,a mixed enhancement pattern on imaging,and a discrepancy between the elevation of tumor marker and the imaging enhancement *** examination using hematoxylin and eosin staining is considered the gold standard for diagnosing cHCC-CCA,and comprehensive examination of resection or biopsy specimens is crucial for an accurate ***,there is no standard treatment for cHCC-CCA,and surgery is the *** hepatectomy with lymphadenectomy is among the recommended surgical *** role of liver transplantation in the management of cHCC-CCA is still *** chemoembolization may be effective for unresectable cHCC-CCA,particularly for hypervascular ***,the available evidence does not support systemic therapy for advanced *** prognosis of cHCC-CCA is generally poor,and there is no established staging *** research is needed to better understand the histogenesis and clinical management of *** review provides an overview of the current literature on cHCC-CCA with a focus on its clinical characteristics,pathological diagnosis,and management.

关键词： Combined hepatocellular-cholangiocarcinoma Clinical characteristics Imaging characteristics Pathological diagnosis Treatment

pancreatic cystic neoplasms:a review of preoperative diagnosis and management

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第3期14卷 185-194页

作者： Xue-li BAI Qi ZHANG Noman MASOOD Waqas MASOOD Yun ZHANG Ting-bo LIANG Department of hepatobiliary-pancreatic Surgery the Second Affiliated HospitalSchool of MedicineZhejiang University

pancreatic cystic neoplasms(PCNs) are a diverse group of neoplasms in the pancreas,and are more increasingly encountered with widespread abdominal screening and improved imaging *** most common types of PCNs are serous cystic neoplasms(SCNs),mucinous cystic neoplasms(MCNs),and intraductal papillary mucinous neoplasms(IPMNs).Clinicians frequently feel bewildered in the differential diagnosis and subsequent management among the various types of lesions in the pancreas,which may lead to overtreatment or delayed *** current review provides recent developments in the understanding of the three most common types of PCNs,the latest modalities used in preoperative diagnosis and differential diagnosis,as well as the most up to date *** for diagnosis and differential diagnosis of SCNs,MCNs,and IPMNs are also provided for young *** understanding of these neoplasms is essential for clinicians to make accurate diagnosis and to provide the best management for patients.

关键词： pancreatic cystic neoplasms Serous cystic neoplasms Intraductal papillary mucinous neoplasms Mucinous cystic neoplasms Diagnosis