Objective To summarize the mechanism of microRNA in the recurrence and metastasis of hepatocellular carcinoma (HCC) and its possible clinical application. Methods The relevant literatures at home and abroad were reviewed to summarize the results of various scholars. Results microRNA played an important role in cell proliferation and apoptosis of HCC. microRNA of different types promoted or inhibited the recurrence and metastasis of HCC through different action targets and molecular pathways. Conclusions microRNA has a regulation role in the recurrence and metastasis of HCC, and the depth mechanisms study of microRNA in the recurrence and metastasis of HCC provides great significance to clinical therapy. The miRNA is expected to be one of the new target on the prediction and treatment of recurrence and metastasis in HCC.
ObjectiveTo predict the risk factors affecting postoperative recurrence of granulomatous lobular mastitis (GLM) in the mass stage by machine learning algorithm, and to provide a reference for the early identification and prevention of postoperative recurrence of GLM in the mass stage. MethodsThe electronic medical records and follow-up data of patients with GLM in the Department of Breast Disease Unit, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from October 2020 to January 2023 were selected. A total of 340 patients with GLM in the mass stage who met the inclusion and exclusion criteria were selected as the research subjects. According to whether the patients relapsed after surgery, they were divided into recurrence group and non-recurrence group. The collected cases were randomly divided into training set and test set according to the ratio of 7:3. In the training set, the recurrence prediction model was constructed by using traditional logistic regression and three machine learning algorithms: artificial neural network, random forest and XGBoost (extrem gradient boosting). In the test set, the performance of the model was evaluated by sensitivity, specificity, accuracy,positive predictive value, negative predictive value, F1 value and area under the curve (AUC) value. The Shapley Additive exPlanation (SHAP) method was used to explore the important variables that affect the optimal model in identifying postoperative recurrence in the GLM mass phase. The optimal risk cutoff value of the prediction model was determined by the Youden index. Based on this, the postoperative patients in the GLM mass phase of the external test set were divided into high-risk and low-risk groups. ResultsA total of 392 patients who met the GLM mass stage were included, and 52 cases were excluded according to the exclusion criteria, and 340 cases were finally included, including 60 cases in the recurrence group and 280 cases in the non-recurrence group. Based on the results of univariate analysis, correlation analysis and clinically meaningful influencing factors, 12 non-zero coefficient characteristic variables were screened for the construction of the prediction model, and these 12 characteristic variables included other disease history, number of miscarriages, breastfeeding duration of the affected breast, history of milk stasis, lesion location, nipple indentation, fluctuation sensation, low-density lipoprotein, testosterone, previous antibiotic therapy, previous oral hormone medication, and perioperative traditional Chinese medicine treatment duration. The logistic regression prediction model, artificial neural network, random forest and XGBoost prediction models were constructed, and the results showed that the accuracy, positive predictive value and negative predictive value of the four prediction models were all >75%, among which the XGBoost model had the best performance, with accuracy, specificity, sensitivity, AUC, positive predictive value, negative predictive value and F1 values of 0.93, 0.99, 0.65, 0.87, 0.92, 0.93 and 0.76, respectively. SHAP method found that the duration of traditional Chinese medicine treatment during perioperative period, the duration of breast-feeding on the affected side, low density lipoprotein, testosterone and previous hormone drugs were the top five factors affecting XGBoost model to identify postoperative recurrence of GLM in mass stage. ConclusionsCompared with the traditional Logistic regression prediction model, the models based on machine learning for identifying postoperative recurrence in the GLM mass phase showed better performance, among which the XGBoost model performed best. Targeted preventive measures can be given based on the above risk factors to improve the postoperative prognosis of the GLM mass phase.
Objective To investigate the situation and prospect of local recurrence of rectal cancer by using CT and MRI. Method Relevant references about the imaging diagnosis of local recurrence of rectal cancer， which were published domestic and abroad in recent years， were collected and reviewed. Results In the diagnosis of local recurrence of rectal cancer， the sensitivity of CT was higher than that of MRI， while the specificity and accuracy were not. Perfusion CT， dynamic contrast-enhanced MRI， and diffusion weighted imaging were valuable in diagnosing local recurrence of rectal cancer， as new diagnostic techniques. Conclusion Both CT and MRI are important and valuable methods in diagnosing for local recurrence of rectal cancer.
【Abstract】ObjectiveTo review the relationship between T helper cell 1/T helper cell 2 （Th1/Th2） shift and tumor recurrence. MethodsLiteratures on Th1/Th2 shift and tumor recurrence were collected and reviewed. ResultsTh1/Th2 shift can be detected in the host after therapy of the tumor. Tumor cells escape from host immune surveillance by altering Th1/Th2, which could lead to tumor recurrence. ConclusionTh1/Th2 shift is related to tumor recurrence after therapy. Impelling the reverse of Th2 to Th1 and renewing the balance of T helper cells come out to be a new way for tumor therapy.
ObjectiveTo explore the level of hope of patients with tumor recurrence and its affecting factors. MethodsPatients with tumor recurrence admitted in West China Hospital from March 2014 to March 2015 were included in this study. Questionnaire survey was conducted to collect the general information of the patients and the information on their coping style, level of hope and social support. The structural equation model was used to analyze the factors that affect the level of hope in patients with tumor recurrence. ResultsA total of 431 patients were included. The average score of hope in patients with tumor recurrence was 32.88±5.83. Among these patients, 27 (6.26%) had low level of hope, 277 (64.27%) had medium level of hope and 127 (29.47%) had high level of hope. The result of univariate analysis showed that, the level of hope in different genders, marital status, education levels, income levels and types of tumors had significant differences (all P values＜0.05). The result of structural equation model showed that gender (r=-0.322, P<0.001), marital status (r=-0.243, P<0.001), education level (r=-0.219, P<0.001), income (r=0.116, P=0.021) and coping style (r=0.182, P=0.029) had direct effect on the level of hope in patients with tumor recurrence. Social support (r=0.255, P=0.027) and income (r=0.224, P=0.019) could indirectly affect patients’ coping style and therefore the level of hope. ConclusionMost patients with tumor recurrence have medium to high level of hope. Gender, marital status, education level, income and coping style have influence on the level of hope. More attention should be given to patients with low level of hope, and measures should be taken to improve the level of hope basing on the individual situations of patients with tumor recurrence.
ObjectiveTo investigate the expression change characteristic of stemness-related markers for recurrent hepatocellular carcinoma (HCC), and to discuss the relationship between stemness-related markers and clinicopathologic characteristics of HCC.MethodsWe collected 25 recurrent HCC patients who also had the first liver resection for HCC in Sichuan Cancer Hospital from Jan. 2010 to Oct. 2018. Immunohistochemistry was used to compare expressions of CD133, CD90, CD117, and epithelial cell adhesion molecule (EpCAM) in HCC tissues. Fluorescence in situ hybridization was used to detect telomere length.ResultsThe primary HCC had higher platelet count, larger tumor, less microvascular invasion (MVI), and less multiple HCC than the recurrent HCC (P<0.05), but the expressions of CD90, CD133, CD117, and EpCAM were not significantly differed after recurrence (P>0.05). The expressions of CD90, CD133, CD117, and EpCAM were not associated with tumor size, tumor number, Barcelona Clinic Liver Cancer Staging (BCLC staging), satellite nodules, and differentiation (P>0.05). The MVI-positive group had a significantly higher expression level of EpCAM (P=0.016) and longer telomere length (P=0.001). The telomere length was longer for tumors diameter less than 5 cm (P=0.038) and poor differentiation (P=0.046). Correlation analysis found that there was no relationship between telomere length and expression levels of EpCAM (r=–0.092, P=0.513), CD90 (r=–0.235, P=0.100), CD133 (r=0.024, P=0.867), and CD117 (r=–0.277, P=0.052), but an apparent positive correlation between expression levels of EpCAM and CD133 was found (r=0.358, P=0.011). Survival analysis found that poor differentiation (P=0.003) and BCLC B–C staging (P=0.040) were the risk factors of disease-free survival for patients after first HCC resection, and BCLC B–C staging (P=0.017) and tumor diameter more than 5 cm (P=0.035) were the risk factors for recurrent HCC.ConclusionsRecurrent HCC had similar stemness-related markers expression and longer telomere length. Expression level of EpCAM and telomere length were associated with MVI.
Objective To investigate the risk factors, clinical characteristics and prognostic factors of venous thrombosis (and pulmonary embolism) in patients with idiopathic hypereosinophilia (IHE) so as to provide a theoretical basis for clinical prevention of venous thrombosis and improve prognosis.Methods Thirty-nine patients with IHE admitted to West China Hospital of Sichuan University from January 2010 to January 2022 were collected in this retrospective case-control study to explore the risk factors of venous thrombosis (including pulmonary embolism) and thrombosis recurrence after treatment. Results There were 17 (43.5%) patients combined with venous thrombosis of 39 patients with IHE. In the patients with vascular involvement, pulmonary embolism was the initial expression of IHE accounted for 29% (5/17). patients of IHE with pulmonary embolism were younger [44 (24.5 - 51.0) vs. 56 (46.3 - 67.8) year, P=0.035] and had higher peak absolute eosinophil counts [11.7 (7.2 - 26.5)×109/L vs. 3.8 (2.9 - 6.7)×109/L, P=0.020] than those without pulmonary embolism. After a mean follow-up of 13 months (2 - 21 months), thrombosis recurred in 35.3% (6/17) of patients. Persistent increasing in eosinophils (>0.5×109/L) was an independent risk factor for thrombus recurrence (odds ratio 13.33, 95% confidential interval 1.069 - 166.374). Conclusions Thrombosis is a common vascular impaired complication in IHE , and increased eosinophilia is a risk factor for thrombosis and thrombus recurrence after therapy. Controlling and monitoring the eosinophilic cell levels in patients with IHE may avoid severe comorbidities.
【Abstract】ObjectiveTo investigate the prophylactic effect of lamivudine monotherapy on the recurrence of hepatitis B after liver transplantation. MethodsThirtyone patients with hepatitis B related benign decompensated cirrhosis who underwent liver transplantation between February 1999 to June 2002 and survived more than 3 months were analyzed retrospectively. Lamivudine was administered to each patient after operation and some patients before operation for the prophylaxis of HBV recurrence. The HBV markers and HBV DNA in serum and bioptic liver tissues in all patients were evaluated before and after operation. ResultsTotal HBV recurrence rate was 19.4％（6/31） during average 38.2 months (3.2-70.2 months) follow up. HBV recurrence rate was 7.1％(2/28), 16.0％(4/25), 26.1％(6/23) and survival rate was 87.1％(27/31), 80.6％(25/31), 66.1％(20.5/31) after 1-, 3-and 5-year, respectively. One hundred milligram lamivudine administration peroral daily for 2 weeks prior to transplantation enable HBeAg 54.5％(6/11) and HBV DNA 50.0％(5/10) positive patients convert to negative respectively. ConclusionPreoperative administration of lamivudine monotherapy can effectively prevent allograft from HBV re-infection after liver transplantation. Lamivudine should be used to convert HBV DNA and HBeAg to negative.
ObjectiveTo compare clinical effect of percutaneous radiofrequency ablation (RFA) and open repeated hepatectomy (ORH) in treatment of liver cancer with late recurrence (recurrence time >12 months) and single tumor diameter ≤5 cm.MethodsThe patients with advanced intrahepatic recurrence after first operation for liver cancer in this hospital from January 2013 to December 2019 were retrospectively collected, who were treated with ORH (ORH group) or percutaneous RFA (RFA group) and met the inclusion criteria. The overall survival rate and disease-free survival rate of the two groups were compared after 1∶1 matching by propensity score matching (PSM), while the factors affecting survival were stratified.ResultsA total of 244 patients with recurrent liver cancer were collected, including 134 patients in the ORH group, 110 patients in the RFA group. The patients in the two groups were matched with 1∶1 by PSM, 90 patients in each group. The median overall survival time of the ORH group and the RFA group was 54 months and 45 months, respectively. There were no significant differences in the curves of cumulative overall survival and cumulative disease-free survival between the two groups (P=0.221, P=0.199). The incidence of severe complications in the ORH group was higher than that in the RFA group (10.00% versus 2.22%, P=0.029). A further subgroup analysis showed that the overall survival time of the ORH group was longer than that of the RFA group when the diameter of recurrent liver cancer was 3 to 5 cm (P=0.035), which had no significant differences for the patients with AFP (>400 μg/L or ≤400 μg/L), tumors number (single or multiple), and tumor diameter ≤3 cm between the two groups (P>0.05).ConclusionsPercutaneous RFA is effective and safe in treatment of advanced recurrent liver cancer, its overall survival and disease-free survival are similar to ORH treatment. However, when diameter of recurrent tumor is3–5 cm, ORH treatment has a advantage in prolonging survival time of patients.
Hemodynamic situation is an important factor of recurrence of postoperative carotid artery aneurysm. In order to investigate the hemodynamic factors of postoperative carotid artery aneurysm affect carotid artery aneurysm recurrence, we established a 3D finite element carotid artery aneurysm for the preoperative and postoperative periods using the three-dimensional reconstruction techniques. And then we measured the hemodynamic factors of carotid artery aneurysm of preoperative and postoperative by the finite element method. The carotid artery aneurysm model has an accurate and realistic shape; the pressure of the recurrence of aneurysm was reduced significantly after surgery,wall shear stress increased significantly at residual neck, and blood flow velocity increased significantly, which will increase the risk of recurrence. The hemodynamic analysis provides a reference for development of aneurysm clinical treatment programs and prevention of recurrence.