AIM: To assess whether metformin, which has a chemopreventive effect in chronic liver disease, has any chemotherapeutic effect in hepatocellular carcinoma.
Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA)constitute the main subtypes of primary liver cancers(PLCs)as a major cause of cancer-related mortality and incidence.They emerge from varying quan...Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA)constitute the main subtypes of primary liver cancers(PLCs)as a major cause of cancer-related mortality and incidence.They emerge from varying quantities and levels of differentiation among major liver cells,comprising hepatocytes,mucin-or non-mucin-producing cholangiocytes,and hepatic progenitor cells(HPCs)with the capability to differentiate into either hepatocytes or cholangiocytes.展开更多
Immunocompromised status and interrupted routine care may render patients with cirrhosis vulnerable to the coronavi-rus disease 2019(COVID-19)pandemic.A nationwide data-set that includes more than 99%of the decedents ...Immunocompromised status and interrupted routine care may render patients with cirrhosis vulnerable to the coronavi-rus disease 2019(COVID-19)pandemic.A nationwide data-set that includes more than 99%of the decedents in the U.S.between April 2012 and September 2021 was used.Projected age-standardized mortality during the pandemic were esti-mated according to prepandemic mortality rates,stratified by season.Excess deaths were determined by estimating the difference between observed and projected mortality rates.A temporal trend analysis of observed mortality rates was also performed in 0.83 million decedents with cirrhosis between April 2012 and September 2021 was included.Following an increasing trend of cirrhosis-related mortality before the pandemic,with a semiannual percentage change(SAPC)of 0.54%[95%confidence interval(CI):(0.0-1.0%),p=0.036],a precipitous increase with seasonal variation occurred dur-ing the pandemic(SAPC 5.35,95%CI:1.9-8.9,p=0.005).Significantly increased mortality rates were observed in those with alcohol-associated liver disease(ALD),with a SAPC of 8.44(95%CI:4.3-12.8,p=0.001)during the pandemic.All-cause mortality of nonalcoholic fatty liver disease rose stead-ily across the entire study period with a SAPC of 6.79(95%CI:6.3-7.3,p<0.001).The decreasing trend of HCV-related mortality was reversed during the pandemic,while there was no significant change in HBV-related deaths.While there was significant increase in COVID-19-related deaths,more than 55%of the excess deaths were the indirect impact of the pandemic.We observed an alarming increase in cirrhosis-related deaths during the pandemic especially for ALD,with evidence in both direct and indirect impact.Our findings have implications on formulating policies for patients with cirrhosis.展开更多
Introduction Hepatic sinusoidal obstruction syndrome(HSOS)is a hepatic vascular disease characterized by injury of the endothelial cells in the sinusoidal hepatic and interlobular veins,intra-hepatic congestion,liver ...Introduction Hepatic sinusoidal obstruction syndrome(HSOS)is a hepatic vascular disease characterized by injury of the endothelial cells in the sinusoidal hepatic and interlobular veins,intra-hepatic congestion,liver dysfunction,and portal hypertension[1].In Western countries,HSOS is often associated with myeloablative regimens used for hematopoietic stem-cell transplantation,while,in China,it is often associated with oral intake of Gynura segetum plants that contain pyrrolidine alkaloids[2].In addition,new-onset HSOS after solid-organ transplantation has received increasing attention[3-8].展开更多
Hepatocellular carcinoma(HCC)is among the leading causes of cancer incidence and mortality worldwide.Surveillance of individuals with cirrhosis or other conditions that confer a high risk of HCC development is essenti...Hepatocellular carcinoma(HCC)is among the leading causes of cancer incidence and mortality worldwide.Surveillance of individuals with cirrhosis or other conditions that confer a high risk of HCC development is essential for early detection and improved overall survival.Biannual ultrasonography with or without alpha-fetoprotein is widely recommended as the standard method for HCC surveillance,but it has limited sensitivity in early disease and may be inadequate in certain individuals.This review article will provide a comprehensive overview of the current landscape of HCC surveillance,including the rationale and indications for HCC surveillance,standard methods for HCC surveillance,and their strengths/limitations.Alternative surveillance methods such as the role of cross-sectional imaging,emerging circulating biomarkers,as well as the problem of under-utilization of HCC surveillance and surveillance-related harms will also be discussed in this review.展开更多
基金Supported by National Institutes of Health,No.NCI CA165076Mayo Clinic Center for Cell Signaling in Gastroenterology,No.NIDDK P30DK084567+1 种基金Mayo Clinic Cancer Center,No.NCI CA15083Mayo Clinic Center for Clinical and Translational Science,No.NCATS UL1 TR000135
文摘AIM: To assess whether metformin, which has a chemopreventive effect in chronic liver disease, has any chemotherapeutic effect in hepatocellular carcinoma.
文摘Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA)constitute the main subtypes of primary liver cancers(PLCs)as a major cause of cancer-related mortality and incidence.They emerge from varying quantities and levels of differentiation among major liver cells,comprising hepatocytes,mucin-or non-mucin-producing cholangiocytes,and hepatic progenitor cells(HPCs)with the capability to differentiate into either hepatocytes or cholangiocytes.
文摘Immunocompromised status and interrupted routine care may render patients with cirrhosis vulnerable to the coronavi-rus disease 2019(COVID-19)pandemic.A nationwide data-set that includes more than 99%of the decedents in the U.S.between April 2012 and September 2021 was used.Projected age-standardized mortality during the pandemic were esti-mated according to prepandemic mortality rates,stratified by season.Excess deaths were determined by estimating the difference between observed and projected mortality rates.A temporal trend analysis of observed mortality rates was also performed in 0.83 million decedents with cirrhosis between April 2012 and September 2021 was included.Following an increasing trend of cirrhosis-related mortality before the pandemic,with a semiannual percentage change(SAPC)of 0.54%[95%confidence interval(CI):(0.0-1.0%),p=0.036],a precipitous increase with seasonal variation occurred dur-ing the pandemic(SAPC 5.35,95%CI:1.9-8.9,p=0.005).Significantly increased mortality rates were observed in those with alcohol-associated liver disease(ALD),with a SAPC of 8.44(95%CI:4.3-12.8,p=0.001)during the pandemic.All-cause mortality of nonalcoholic fatty liver disease rose stead-ily across the entire study period with a SAPC of 6.79(95%CI:6.3-7.3,p<0.001).The decreasing trend of HCV-related mortality was reversed during the pandemic,while there was no significant change in HBV-related deaths.While there was significant increase in COVID-19-related deaths,more than 55%of the excess deaths were the indirect impact of the pandemic.We observed an alarming increase in cirrhosis-related deaths during the pandemic especially for ALD,with evidence in both direct and indirect impact.Our findings have implications on formulating policies for patients with cirrhosis.
基金supported by Beijing Municipal Science and Technology Commission Funding Project[Z161100000116058]302 Military Hospital Project[YNKT 2014006].
文摘Introduction Hepatic sinusoidal obstruction syndrome(HSOS)is a hepatic vascular disease characterized by injury of the endothelial cells in the sinusoidal hepatic and interlobular veins,intra-hepatic congestion,liver dysfunction,and portal hypertension[1].In Western countries,HSOS is often associated with myeloablative regimens used for hematopoietic stem-cell transplantation,while,in China,it is often associated with oral intake of Gynura segetum plants that contain pyrrolidine alkaloids[2].In addition,new-onset HSOS after solid-organ transplantation has received increasing attention[3-8].
基金funded by the American College of Gastroenterology,grant name“Junior Faculty Development Award”United States Department of Defense,grant number CA191051National Institutes of Health,grant number R01CA246304,R01CA253651,R01CA255727,R21CA235340,and R21CA240887.
文摘Hepatocellular carcinoma(HCC)is among the leading causes of cancer incidence and mortality worldwide.Surveillance of individuals with cirrhosis or other conditions that confer a high risk of HCC development is essential for early detection and improved overall survival.Biannual ultrasonography with or without alpha-fetoprotein is widely recommended as the standard method for HCC surveillance,but it has limited sensitivity in early disease and may be inadequate in certain individuals.This review article will provide a comprehensive overview of the current landscape of HCC surveillance,including the rationale and indications for HCC surveillance,standard methods for HCC surveillance,and their strengths/limitations.Alternative surveillance methods such as the role of cross-sectional imaging,emerging circulating biomarkers,as well as the problem of under-utilization of HCC surveillance and surveillance-related harms will also be discussed in this review.
