摘要
AIM To analyze the incidence of hepatocellular carcinoma (HCC) in a population that underwent health checkups and had high serum miR-106b levels. METHODS A total of 335 subjects who underwent checkups in the Digestive and Liver Disease Department of our hospital were randomly selected. RT-PCR was used to detect the level of miR-106b in serum samples. Laboratory and imaging examinations were carried out to confirm the HCC diagnosis in patients who had a > 2-fold change in miR-106b levels. Ultrasound-guided biopsy was also used for HCC diagnosis when necessary. On this basis, the clinical data of these subjects, including history of hepatitis virus infection, obesity, long-term history of alcohol use and stage of HCC, were collected. Then, the impact of these factors on the level of miR1-06b in serum was analyzed. Furthermore, receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of miR-106b for HCC. RESULTS A total of 35 subjects had abnormal serum miR-106b levels, of which 20 subjects were diagnosed with HCC. t-test revealed that the difference in serum miR-106b level in terms of sex, age, history of hepatitis virus infection, obesity and long-term history of alcohol use was not statistically significant. However, serum miR-106b levels in patients with advanced HCC (stage. /.) was higher than in patients with early HCC (stage./.), and the difference was statistically significant (P = 0.000). Moreover, the ROC curve revealed that the area under the curve value for miR-106b was 0.885, which shows that serum miR-106b level has a certain clinical value for HCC diagnosis. CONCLUSION The random sampling survey shows that serum miR-106b level is a valuable diagnostic marker for HCC. However, the diagnostic threshold value needs to be further researched.
AIM To investigate the short-term outcomes and risk factors indicating postoperative death of patients with lesions adjacent to the hepatocaval confluence.METHODS We retrospectively analyzed 54 consecutive patients who underwent hepatectomy combined with inferior vena cava(IVC)and/or hepatic vein reconstruction(HVR)from January 2012 to January 2016 at our liver surgery center.The patients were divided into5 groups according to the range of IVC and hepatic vein involvement.The patient details,indications for surgery,operative techniques,intra-and postoperative outcomes were compared among the 5 groups.Univariate and multivariate analyses were performed to explore factors predictive of overall operative death.RESULTS IVC replacement was carried out in 37(68.5%)patients and HVR in 17(31.5%)patients.Type I2H2 had the longest operative blood loss,operative duration and overall liver ischemic time(all,p<0.05).Three patients of Type I3H1 with totally occluded IVC did not need IVC reconstruction.Total postoperative morbidity rate was40.7%(22 patients)and the operative mortality rate was 16.7%(9 patients).Factors predictive of operative death included IVC replacement(p=0.048),duration of liver ischemia(p=0.005)and preoperative liver function being Child-pugh B(p=0.025). CONCLUSION IVC replacement,duration of liver ischemia and preoperative poor liver function were risk factors predictive of postoperative death.We should be cautious about IVC replacement,especially in Type I2H2.For Type I3H1,it was unnecessary to replace IVC when the collateral circulation was established.
