Hepatocellular carcinoma(HCC)is a frequent cancer with a high mortality.For early stage cancer there are potentially curative treatments including local ablation,resection and liver transplantation.However,for more ad...Hepatocellular carcinoma(HCC)is a frequent cancer with a high mortality.For early stage cancer there are potentially curative treatments including local ablation,resection and liver transplantation.However,for more advanced stage disease,there is no optimal treatment available.Even in the case of a"curative"treatment,recurrence or development of a new cancer in the precancerous liver is common.Thus,there is an urgent need for novel and effective(adjuvant)therapies to treat HCC and to prevent recurrence after local treatment in patients with HCC.The unique immune response in the liver favors tolerance,which remains a genuine challenge for conventional immunotherapy in patients with HCC.However,even in this"immunotolerant"organ,spontaneous immune responses against tumor antigens have been detected,although they are insufficient to achieve significant tumor death.Local ablation therapy leads to immunogenic tumor cell death by inducing the release of massive amounts of antigens,which enhances spontaneous immune response.New immune therapies such as dendritic cell vaccination and immune checkpoint inhibition are under investigation.Immunotherapy for cancer has made huge progress in the last few years and clinical trials examining the use of immunotherapy to treat hepatocellular carcinoma have shown some success.In this review,we discuss the current status of and offer some perspectives on immunotherapy for hepatocellular carcinoma,which could change disease progression in the near future.展开更多
BACKGROUND Emphysematous hepatitis(EH)is a rare,rapidly progressive fulminant gasforming infection of the liver parenchyma.It is often fatal and mostly affects diabetes patients.CASE SUMMARY We report a case of EH suc...BACKGROUND Emphysematous hepatitis(EH)is a rare,rapidly progressive fulminant gasforming infection of the liver parenchyma.It is often fatal and mostly affects diabetes patients.CASE SUMMARY We report a case of EH successfully managed by a step-up approach consisting of aggressive hemodynamic support,intravenous antibiotics,and percutaneous drainage,ultimately followed by laparoscopic deroofing.Of 11 documented cases worldwide,only 1 of the patients survived,treated by urgent laparotomy and surgical debridement.CONCLUSION EH is a life-threatening infection.Its high mortality rate makes timely diagnosis essential,in order to navigate treatment accordingly.展开更多
基金Supported by Grant from Kankerplan Action 29,Ministry of health,Belgium(to Aerts M)Van Vlierberghe H is senior researcher of the Flemish Fund for Research(FWO)
文摘Hepatocellular carcinoma(HCC)is a frequent cancer with a high mortality.For early stage cancer there are potentially curative treatments including local ablation,resection and liver transplantation.However,for more advanced stage disease,there is no optimal treatment available.Even in the case of a"curative"treatment,recurrence or development of a new cancer in the precancerous liver is common.Thus,there is an urgent need for novel and effective(adjuvant)therapies to treat HCC and to prevent recurrence after local treatment in patients with HCC.The unique immune response in the liver favors tolerance,which remains a genuine challenge for conventional immunotherapy in patients with HCC.However,even in this"immunotolerant"organ,spontaneous immune responses against tumor antigens have been detected,although they are insufficient to achieve significant tumor death.Local ablation therapy leads to immunogenic tumor cell death by inducing the release of massive amounts of antigens,which enhances spontaneous immune response.New immune therapies such as dendritic cell vaccination and immune checkpoint inhibition are under investigation.Immunotherapy for cancer has made huge progress in the last few years and clinical trials examining the use of immunotherapy to treat hepatocellular carcinoma have shown some success.In this review,we discuss the current status of and offer some perspectives on immunotherapy for hepatocellular carcinoma,which could change disease progression in the near future.
文摘BACKGROUND Emphysematous hepatitis(EH)is a rare,rapidly progressive fulminant gasforming infection of the liver parenchyma.It is often fatal and mostly affects diabetes patients.CASE SUMMARY We report a case of EH successfully managed by a step-up approach consisting of aggressive hemodynamic support,intravenous antibiotics,and percutaneous drainage,ultimately followed by laparoscopic deroofing.Of 11 documented cases worldwide,only 1 of the patients survived,treated by urgent laparotomy and surgical debridement.CONCLUSION EH is a life-threatening infection.Its high mortality rate makes timely diagnosis essential,in order to navigate treatment accordingly.
