AIM： To evaluate whether contrast enhanced ultra- sound （CEUS） might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colore...AIM： To evaluate whether contrast enhanced ultra- sound （CEUS） might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.METHODS： Thirty consecutive patients with non prima- ry resectable liver metastases from colorectal cancer underwent CEUS before treatment （CEUS date 1） and before the second （CEUS date 2） and fourth （CEU5 date 3） cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak （l-I-P） and RISE RATE]were correlated with radiological response.RESULTS： For neoadjuvant purpose a reduction of tu- mour mass was required to assume clinical response. Based on these response criteria there was a significant （P 〈 0.001） correlation in TTP between metastases of responders （9.08 s） and non-responders （14.76 s） ar- chived on CEUS date 1. By calculating a standardized quotient （metastases divided by normal liver tissue） we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting -FI-P was also significantly （P 〈 0.01） dif- ferent between responders and non-responders. In con- trast, Peak and Rise rate did not show any significant difference between responder and non-responder. CONCLUSION： CEUS might serve as a surrogate mark- er to predict treatment response in patients with me- tastasized colorectal cancer who receive antiangiogenic therapy.展开更多
MicroRNAs(miRNAs) are small RNAs regulate gene expression by inhibiting the turnover of their target mRNAs. In the last years, it became apparent that miRNAs are released into the circulation and circulating miRNAs em...MicroRNAs(miRNAs) are small RNAs regulate gene expression by inhibiting the turnover of their target mRNAs. In the last years, it became apparent that miRNAs are released into the circulation and circulating miRNAs emerged as a new class of biomarkers for various diseases. In this review we summarize available data on the role of circulating miRNAs in the context of acute and chronic liver diseases including hepatocellular and cholangiocellular carcinoma. Data from animal models are compared to human data and current challenges in the field of miRNAs research are discussed.展开更多
Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver. Prognosis and treatment options are stage dependent. In general, prognosis of patients with unresectable HCC is poor, especially for those...Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver. Prognosis and treatment options are stage dependent. In general, prognosis of patients with unresectable HCC is poor, especially for those patients with impaired liver function. Whereas treatment with the novel molecular tyrosine kinase inhibitor sorafenib (Nexavar) was shown to result in prolonged survival in patients with preserved liver function, its' possible application in HCC-patients with strongly impaired liver function has not been clearly assessed. Here, we report on a 47-year-old male patient who presented with Child-Pugh class C liver cirrhosis and multifocal, non-resectable HCC. The patient was treated for 27 mo with Sorafenib, which was not associated with major drug-related side effects. During treatment, a reduction in tumour size of 24% was achieved, as assessed by regular CT scan. Moreover,within the 27 mo interval of stable tumour disease, liver function improved from Child-Pugh class C to class A.展开更多
文摘AIM： To evaluate whether contrast enhanced ultra- sound （CEUS） might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.METHODS： Thirty consecutive patients with non prima- ry resectable liver metastases from colorectal cancer underwent CEUS before treatment （CEUS date 1） and before the second （CEUS date 2） and fourth （CEU5 date 3） cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak （l-I-P） and RISE RATE]were correlated with radiological response.RESULTS： For neoadjuvant purpose a reduction of tu- mour mass was required to assume clinical response. Based on these response criteria there was a significant （P 〈 0.001） correlation in TTP between metastases of responders （9.08 s） and non-responders （14.76 s） ar- chived on CEUS date 1. By calculating a standardized quotient （metastases divided by normal liver tissue） we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting -FI-P was also significantly （P 〈 0.01） dif- ferent between responders and non-responders. In con- trast, Peak and Rise rate did not show any significant difference between responder and non-responder. CONCLUSION： CEUS might serve as a surrogate mark- er to predict treatment response in patients with me- tastasized colorectal cancer who receive antiangiogenic therapy.
文摘MicroRNAs(miRNAs) are small RNAs regulate gene expression by inhibiting the turnover of their target mRNAs. In the last years, it became apparent that miRNAs are released into the circulation and circulating miRNAs emerged as a new class of biomarkers for various diseases. In this review we summarize available data on the role of circulating miRNAs in the context of acute and chronic liver diseases including hepatocellular and cholangiocellular carcinoma. Data from animal models are compared to human data and current challenges in the field of miRNAs research are discussed.
文摘Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver. Prognosis and treatment options are stage dependent. In general, prognosis of patients with unresectable HCC is poor, especially for those patients with impaired liver function. Whereas treatment with the novel molecular tyrosine kinase inhibitor sorafenib (Nexavar) was shown to result in prolonged survival in patients with preserved liver function, its' possible application in HCC-patients with strongly impaired liver function has not been clearly assessed. Here, we report on a 47-year-old male patient who presented with Child-Pugh class C liver cirrhosis and multifocal, non-resectable HCC. The patient was treated for 27 mo with Sorafenib, which was not associated with major drug-related side effects. During treatment, a reduction in tumour size of 24% was achieved, as assessed by regular CT scan. Moreover,within the 27 mo interval of stable tumour disease, liver function improved from Child-Pugh class C to class A.
