ObjectiveTo explore it's advantages and disadvantages through analyzed the data of associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) operation in 3 cases of liver cancer patients with cirrhosis. MethodsThe data of 3 patients perfomed ALPPS operation were retrospectively analyzed, through the preoperative evaluation, intraoperative and postoperative treatment points analyzed to explore the pros and cons. ResultsOne case died of hepatic failure, and the remaining two cases were still alive. The highest score of MELD of liver failure in death case was 18.8 scores, and the other cases of MELD score were decreased after second operation. The average increased volume of liver was 225 mL, and the liver volume was significantly increased (P=0.002). ConclusionsALPPS make a portion of huge liver cancer patients combining with cirrhosis having a chance to surgery. But it is necessary to consider in patients with preoperative state, surgical risk, prognosis and economic conditions,in order to determine whether patients can benefit from ALPPS.
ObjectiveTo understand the role of metformin on reducing incidence of type 2 diabetes mellitus (T2MD) patients complicated with liver cancer. MethodThe related literatures of metformin treated patients with T2MD complicated with liver cancer at home and abroad in recent years were reviewed. ResultsA large number of epidemiological and clinical data showed that the metformin might prevent the occurrence of the T2MD patients complicated with liver cancer, its mechanism was mainly inhibited the proliferation of hepatoma cells through the ATM-LKB1-AMPK-mTOR pathway, PI3K/Akt/mTOR pathway, or miRNA. The current controversy was the authenticity of the data, the influencing factors included the aging problem and characteristics of metformin user. The prospective study design rigorous remained to be clarified. ConclusionMetformin could reduce the incidence of T2MD patients complicated with liver cancer, and could inhibit the growth of liver cancer cells, which provides a new way of thinking for the comprehensive treatment of liver cancer.
Objective To evaluate the outcome of liver transplantation in patients with recurrent liver cancer after resection. Methods Data of 23 patients underwent liver transplantation for recurrent liver cancer from April 2001 to March 2008 were retrospectively collected and analyzed. Results Previous history of liver resection had little negative effect in subsequent liver transplantation in technical aspect. Liver function recovered uneventfully after transplantation in all cases. Alpha fetoprotein (AFP) recovered to normal value in 13 of 17 cases with elevated AFP before transplantation within one month after operation. Five cases (21.74%) had postoperative complications. Nineteen cases (82.61%) were followed up, average follow-up duration were 610 days. There were 5 cases (26.32%) of cancer recurrence and 6 deaths during follow-up, survival rate was 68.42%. Conclusion Liver transplantation is a reasonable treatment for recurrent liver cancer after resection.
ObjectiveTo investigate the expression of adrenomedullin (ADM) in human liver cancer and to evaluate its clinical signigicance. MethodsA total of 54 patients with liver cancer who underwent surgery between January 2012 and November 2013 and another 18 benigh tissue samples were selected. Immuohistochemical staining (SP staining) was performed to detect the expression of ADM in liver cancer, and enzyme-linked immunosorbent assay was applied to determine the concentration of ADM in the patients and controls, and the relationship was retrospectively analyzed between the expression of ADM in liver cancer and the clinicobiological features. Besides, 60 inpatients with liver cancer and 40 health people under went physical examination between January and June 2013 were selected, whose expression of ADM in plasma was deteced. ResultsThe expression of ADM in liver cancer was significantly higher than that in the normal tissues (P<0.01). There was a significant relationship between the expression of ADM and the differentiation grade in liver cancer (P<0.05), and there was no relationship between the expression of ADM and age, histological type and American Joint Committen on Cancer (AJCC) stage (P>0.05). The expression of ADM in the plasma in liver cancer group was significantly higher than that in the control group (P<0.05). There was a significant relationship between the expression of ADM in the plasma and AJCC stage (P<0.05). ConclusionThe expression of ADM significantly increases in patients with liver cancer, which is associated with the differentiation grades of the liver cancer. ADM may play an important role in the occurrence and development of liver cancer.
【Abstract】ObjectiveTo construct the eukaryotic expressing plasmid of tumor necrosis factor-related apoptosisinducing ligand（TRAIL），and study its inhibitory effect on hepatic tumor which implanted subcutaneously in nude BALB/c mice.MethodsTotal RNA of U937 cell was extracted, and its extracellular domain (114-281aa) was amplified by RTPCR, then signal peptide was ligated. The recombinant secreting plasmid for TRAIL was constructed successfully which was confirmed by enzyme cleavage identification and sequencing identification. Liver cancer cell (strain No.7402) was implanted subcutaneously in 32 nude BALB/c mice. These mice were randomly divided into two groups: study group and control group. The mice in study group received muscular injection of plasmids for transfection, and the mice in control group received the injection of normal saline at the same time. The size of implanted tumors were measured continuously till the day of sacrificing, tumor cell apoptosis effect was examined by TUNEL method. ResultsIn study group，tumor volume was smaller than that in control group and the bluepurple apoptosis cells were observed under microscope. ConclusionTRAIL plasmid can induce apoptosis of liver cancer cell and can inhibit the growth of liver tumor.
Health technology assessment (HTA) is becoming more and more popular recently. For populations in China that share at least half of the global disease burden of liver cancer, it is extremely vital to give rise to an efficient secondary prevention strategy. The China central government launched liver cancer screening program in rural areas in 2005, and then extended to populations in urban in 2012. The studies of health technology assessment of liver cancer screening are based on available evidence, from an HTA perspective, aims to evaluate performance of liver screening, economic burden and cost-effectiveness and some other issues, in order to raise suggestions for possible directions in research and public health program related to liver cancer screening in China.
Objective To explore the diagnosis and treatment for spontaneous rhexis hemorrhage of liver cancer. Methods Clinical data of thirty patients who suffered from spontaneous rhexis hemorrhage of liver cancer from January 1995 to March 2009 were collected and analyzed retrospectively. Results Twenty-six cases were stanched by surgical therapy, in which 14 cases underwent liver cancer resection, 10 cases underwent bleeding transfixion and hepatic artery ligation (or intubation), and 2 cases underwent omentum stuff transfixion. Four cases died one week after surgery, one died after 15 d, 9 cases died 1 to 3 months after operation, 5 cases survived after 4 to 6 months, 3 cases survived after 7 to 12 months, and in 4 cases survival time was longer than 12 months (in which one patient’s survival time was 16 months, one was 5 years and two patients were still alive with survival time of 3 and 13 years respectively). Four patiens went through the non-surgical therapy and survival time was 3 to 14 d. Conclusion The spontaneous rhexis hemorrhage of the liver cancer is not the telephase of the liver cancer. Early diagnosis and operation can stanch bleeding effectively. The surgical therapy is better than the non-surgical therapy. Resection of liver neoplasms in time can raise long-term survival time.
Objective To construct the expression vector of HLA-G-shRNA and investigate the effect of HLA-GshRNA from NK cell lysis. Methods Four HLA-G shRNA plasmids were constructed and transiently transfected to Bel-7402 cell lines， the levels of mRNA and protein of HLA-G were detected by Real-Time PCR and Western blot. The cytotoxicity of NK-92MI cells against the transfected cells was analyzed by LDH releasing assay. Results The gel electrophoresis and sequencing showed that the inserted sequence was identical to the one which we designed, and no aberrations such as mutation，deletion or insertion occurred. The expressions of HLA-G confirmed by Real Time-PCR and Western blot were significantly down-regulated. Bel-7402 cell lines transfected HLA-G shRNA showed higher lytic activity （P＜0.01）. After KIR2DL4 receptor blocked，lytic activity of NK-92 MI cell were decreased （P＜0.01）. Conclusions HLA-G shRNA plasmids are successfully constructed and HLA-G down-regulated can increase NK cytolysis against Bel-7402 cell. After HLA-G combines with KIR2DL4 receptor at the surface of NK cells， the inhibition effect is transferred.
Objective To probe into the significance of tuftsin in patients with liver cancer. MethodsThe serum tuftsin level of 12 patients with liver cancer before and after the resection，20 cirrhostic and 20 normal controls were measured by radioimmunoassay (RIA). ResultsTuftsin level in preoperative group （449±106） ng/ml was much lower than that in postoperative group (588±129) ng/ml，cirrhotics group (580±187) ng/ml and control group (703±128) ng/ml (P＜0.01). The tuftsin level in postoperative group was also quite lower than that in control group (P＜0.01). Conclusion We should try our best to excise the liver cancer so that a higher tuftsin level might be obtained which can activate NK cell and T cell.
Objective To analyze the trend of changes in the burden of liver cancer diseases attributed to alcohol consumption in China from 1990 to 2019. Methods Data on liver cancer burden attributed to drinking in China from 1990 to 2019 were obtained from the global burden of disease 2019. Joinpoint regression model was used to analyze the temporal trend of disease burden, and age-period-cohort model was used to evaluate age, period, and cohort effects. Results From 1990 to 2019, the standardized incidence rate of liver cancer attributable to drinking among the total population, men and women showed a downward trend. The AAPC was −2.52% (95%CI −2.83% to −2.21%), 3.26% (95%CI −3.62% to −2.89%) and −2.24% (95%CI −2.61% to −1.86%), respectively; The standardized mortality rates showed a decreasing trend, with AAPC values of −2.86% (95%CI −3.46% to −2.26%), −3.48% (95%CI −4.20% to −2.76%), and −2.67% (95%CI −2.99% to −2.34%), respectively; The standardized DALY rates showed a downward trend, with AAPC values of −3.09% (95%CI −3.65% to −2.53%), −2.92% (95%CI −3.25% to −2.58%), and −3.77 (95%CI −4.21% to −3.31%), respectively. The trend changes were statistically significant (P<0.05). From 1990 to 2019, the overall risk of liver cancer incidence and death attributed to drinking in China, both in males and females, showed a trend of first increasing and then decreasing with age; As the period increased, both the overall population and the male population showed a downward trend, followed by an upward trend, while the female population remained relatively stable; The lower the risk of liver cancer incidence and death attributed to drinking as the queue progressed. Conclusion The standardized incidence rate, mortality and DALY rates of liver cancer attributable to drinking in China are generally declining, we should strengthen health education and early diagnosis and treatment for both male and elderly people to reduce the burden of liver cancer.