AIM To evaluate the efficacy of main portal vein stents combined with iodine-125(^(125)Ⅰ) to treat main portal vein tumor thrombus.METHODS From January 1, 2010 to January 1, 2015, 111 patients were diagnosed with liv...AIM To evaluate the efficacy of main portal vein stents combined with iodine-125(^(125)Ⅰ) to treat main portal vein tumor thrombus.METHODS From January 1, 2010 to January 1, 2015, 111 patients were diagnosed with liver cancer combined with main portal vein tumor thrombus. They were non-randomly assigned to undergo treatment with transarterial chemoembolization(TACE)/transarterial embolization(TAE) + portal vein stents combined with ^(125)Ⅰ implantation(Group A) and TACE/TAE + portal vein stents only(Group B). After the operation, scheduled follow-up was performed at 6, 12 and 24 mo. The recorded information included clinical manifestations, survival rate, and stent restenosis rate. Kaplan–Meier curves, log-rank test and Cox regression were used for data analyses. RESULTS From January 1, 2010 to January 1, 2015, 54 and 57 patients were allocated to Groups A and B, respectively. The survival rates at 6, 12 and 24 mo were 85.2%, 42.6% and 22.2% in Group A and 50.9%, 10.5% and 0% in Group B. The differences were significant [log rank P < 0.05, hazard ratio(HR): 0.37, 95%CI: 0.24-0.56]. The rates of stent restenosis were 18.5%, 55.6% and 83.3% in Group A and 43.9%, 82.5% and 96.5% in Group B. The differences were significant(log rank P < 0.05, HR: 0.42, 95%CI: 0.27-0.63). Cox regression identified that treatment was the only factor affecting survival rate in this study.CONCLUSION Main portal vein stents combined with ^(125)Ⅰ can significantly improve survival rate and reduce the rate of stent restenosis.展开更多
BACKGROUND Main portal vein tumor thrombus(MPVTT), which has a high incidence, is the major complication of terminal liver cancer. The occurrence of MPVTT is always a negative prognostic factor for patients with hepat...BACKGROUND Main portal vein tumor thrombus(MPVTT), which has a high incidence, is the major complication of terminal liver cancer. The occurrence of MPVTT is always a negative prognostic factor for patients with hepatocellular carcinoma(HCC).Therefore, attention should be paid to the treatment of MPVTT and its complications.AIM To evaluate the efficacy of transarterial chemoembolization/transarterial embolization(TACE/TAE)+^(125)I seeds implantation with transjugular intrahepatic portosystemic shunt(TIPS) in treating MPVTT and its complications.METHODS From January 2007 to March 2015, 85 consecutive patients with MPVTT were nonrandomly assigned to undergo treatment with TACE/TAE + TIPS and ^(125)I implantation(TIPS-^(125)I group) or TACE/TAE + TIPS only(TIPS only group) in Beijing Shijitan Hospital, and all clinical data were collected. During 24 mo follow-up, the incidence of overall survival, stent stenosis and symptom recurrence was analyzed to evaluate the efficacy of TIPS-^(125)I.RESULTS During 24 mo follow-up of all patients, we collected data at 6, 12 and 24 mo. The rates of survival were 80%, 45%, and 20%, respectively, in the TIPS-^(125)I group,whereas those in the TIPS only group were 64.4%, 24.4%, and 4.4%, respectively(P < 0.05). The rates of symptom recurrence were 7.5%, 22.5%, and 35%,respectively, in the TIPS-^(125)I group, whereas those in the TIPS only group were31.1%, 62.2%, and 82.2%(P < 0.05). The rates of stent restenosis were 12.5%,27.5%, and 42.5%, respectively, in the TIPS-^(125)I group, and 42.2%, 68.9%, and84.4%, respectively, in the TIPS only group(P < 0.05). TIPS-^(125)I was found to be significantly favorable in treating MPVTT and its complications in patients with HCC.CONCLUSION TACE/TAE+^(125)I combined with TIPS is effective in treating MPVTT and its complications, improving quality of life of patients and reducing mortality.展开更多
Objective:To study the effect of iodine-125 interstitial brachytherapy on liver cancer. Methods: Animal model of human liver cancer was established by injecting SMMC-7721 cells cultivated in vitro subcutaneously int...Objective:To study the effect of iodine-125 interstitial brachytherapy on liver cancer. Methods: Animal model of human liver cancer was established by injecting SMMC-7721 cells cultivated in vitro subcutaneously into the flank of BALB/c nude mice. Nude mice with tumor of 5 mm in diameter were randomly divided into 2 groups (n = 10). One iodine-125 seed of apparent activity 0.8 mCi was implanted into the center of tumor in treatment group, whereas an inactive seed was implanted in control group. The other 20 nude mice with tumor reaching 10 mm in diameter were also treated as above. The size of tumor was determined weekly after implantation, and pathological examination and blood routine were taken on the 28th day. Results: Tumor growth was obviously inhibited in treatment group of tumor of 5 mm in diameter, and there was statistically significant difference in tumor volume between treatment and control groups (P〈0.01). Around iodine-125 seed, apparent necrosis of tumor was shown in treatment group, accompanied by karyopyknosis and reduced plasma in residual tumor cells microscopically. Tumor growth was not inhibited in either treatment or control group of tumor of 10 mm in diameter. There was no obvious adverse effect except for decreased white blood cells in treatment groups. Conclusion: There is certain effect of iodine-125 interstitial braehytherapy on liver cancer, which is associated with the size of tumor.展开更多
Objective: To determine whether CA-125 is elevated in medically stable patients with chronic atrial fibrillation (AF) compared with patients without AF and to examine whether levels of CA-125 are associated with de...Objective: To determine whether CA-125 is elevated in medically stable patients with chronic atrial fibrillation (AF) compared with patients without AF and to examine whether levels of CA-125 are associated with demographic and clinical variables in a sample of patients under study. Methods: 55 patients with chronic AF and 58 control patients in sinus rhythm were included into the study. Patients with acute heart failure (HF), chronic inflammatory or neoplastic disease were excluded from the study. Circulating levels of CA-125 were assessed; all patients underwent clinical examination, assessment and medical records including demographic data, history of comorbid conditions, current use of cardiac medications, and the results of cardiac tests including electrocardiograms. Results: The mean age of the study sample was 53.2±6.5 years and 48% were men. Patients with sinus rhythm were significantly more likely to have lower heart rates, smaller dimensions of left atrium, and to be treated with aspirin. Coumadin, coumadin and digoxin were more often prescribed in patients with chronic AF. The CA-125 levels were significantly higher in patients with chronic AF than in patients in sinus rhythm (48.5±7.65 U/ml and 28.43±5.48 U/ml, P〈0.005). An inverse relation was found between CA-125 levels and left ventricular ejection fraction (LVEF) (r=-0.48, P〈0.001). CA-125 was significantly related to the left atrium (LA) diameter, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and brain natriuretic peptide (BNP). There was no significant correlation between CA-125 and age. Conelusion: In subjects with chronic AF, CA-125 levels are increased; CA-125 was significantly related to the LA diameter, LVEDD, LVESD and BNP.展开更多
基金Supported by the Beijing Municipal Science and Technology Commission projectthe Capital of the Public Health Cultivation-Transcatheter active particles implantation combined with TACE/TAE in the treatment of portal vein tumor thrombus in clinical research,No.Z171100000417031
文摘AIM To evaluate the efficacy of main portal vein stents combined with iodine-125(^(125)Ⅰ) to treat main portal vein tumor thrombus.METHODS From January 1, 2010 to January 1, 2015, 111 patients were diagnosed with liver cancer combined with main portal vein tumor thrombus. They were non-randomly assigned to undergo treatment with transarterial chemoembolization(TACE)/transarterial embolization(TAE) + portal vein stents combined with ^(125)Ⅰ implantation(Group A) and TACE/TAE + portal vein stents only(Group B). After the operation, scheduled follow-up was performed at 6, 12 and 24 mo. The recorded information included clinical manifestations, survival rate, and stent restenosis rate. Kaplan–Meier curves, log-rank test and Cox regression were used for data analyses. RESULTS From January 1, 2010 to January 1, 2015, 54 and 57 patients were allocated to Groups A and B, respectively. The survival rates at 6, 12 and 24 mo were 85.2%, 42.6% and 22.2% in Group A and 50.9%, 10.5% and 0% in Group B. The differences were significant [log rank P < 0.05, hazard ratio(HR): 0.37, 95%CI: 0.24-0.56]. The rates of stent restenosis were 18.5%, 55.6% and 83.3% in Group A and 43.9%, 82.5% and 96.5% in Group B. The differences were significant(log rank P < 0.05, HR: 0.42, 95%CI: 0.27-0.63). Cox regression identified that treatment was the only factor affecting survival rate in this study.CONCLUSION Main portal vein stents combined with ^(125)Ⅰ can significantly improve survival rate and reduce the rate of stent restenosis.
基金the Beijing Municipal Science and Technology Commission project,the Capital of the Public Health Cultivation-Transcatheter Implantation combined with TACE/TAE in the treatment of portal vein tumor thrombus in clinical research,No.Z171100000417031
文摘BACKGROUND Main portal vein tumor thrombus(MPVTT), which has a high incidence, is the major complication of terminal liver cancer. The occurrence of MPVTT is always a negative prognostic factor for patients with hepatocellular carcinoma(HCC).Therefore, attention should be paid to the treatment of MPVTT and its complications.AIM To evaluate the efficacy of transarterial chemoembolization/transarterial embolization(TACE/TAE)+^(125)I seeds implantation with transjugular intrahepatic portosystemic shunt(TIPS) in treating MPVTT and its complications.METHODS From January 2007 to March 2015, 85 consecutive patients with MPVTT were nonrandomly assigned to undergo treatment with TACE/TAE + TIPS and ^(125)I implantation(TIPS-^(125)I group) or TACE/TAE + TIPS only(TIPS only group) in Beijing Shijitan Hospital, and all clinical data were collected. During 24 mo follow-up, the incidence of overall survival, stent stenosis and symptom recurrence was analyzed to evaluate the efficacy of TIPS-^(125)I.RESULTS During 24 mo follow-up of all patients, we collected data at 6, 12 and 24 mo. The rates of survival were 80%, 45%, and 20%, respectively, in the TIPS-^(125)I group,whereas those in the TIPS only group were 64.4%, 24.4%, and 4.4%, respectively(P < 0.05). The rates of symptom recurrence were 7.5%, 22.5%, and 35%,respectively, in the TIPS-^(125)I group, whereas those in the TIPS only group were31.1%, 62.2%, and 82.2%(P < 0.05). The rates of stent restenosis were 12.5%,27.5%, and 42.5%, respectively, in the TIPS-^(125)I group, and 42.2%, 68.9%, and84.4%, respectively, in the TIPS only group(P < 0.05). TIPS-^(125)I was found to be significantly favorable in treating MPVTT and its complications in patients with HCC.CONCLUSION TACE/TAE+^(125)I combined with TIPS is effective in treating MPVTT and its complications, improving quality of life of patients and reducing mortality.
文摘Objective:To study the effect of iodine-125 interstitial brachytherapy on liver cancer. Methods: Animal model of human liver cancer was established by injecting SMMC-7721 cells cultivated in vitro subcutaneously into the flank of BALB/c nude mice. Nude mice with tumor of 5 mm in diameter were randomly divided into 2 groups (n = 10). One iodine-125 seed of apparent activity 0.8 mCi was implanted into the center of tumor in treatment group, whereas an inactive seed was implanted in control group. The other 20 nude mice with tumor reaching 10 mm in diameter were also treated as above. The size of tumor was determined weekly after implantation, and pathological examination and blood routine were taken on the 28th day. Results: Tumor growth was obviously inhibited in treatment group of tumor of 5 mm in diameter, and there was statistically significant difference in tumor volume between treatment and control groups (P〈0.01). Around iodine-125 seed, apparent necrosis of tumor was shown in treatment group, accompanied by karyopyknosis and reduced plasma in residual tumor cells microscopically. Tumor growth was not inhibited in either treatment or control group of tumor of 10 mm in diameter. There was no obvious adverse effect except for decreased white blood cells in treatment groups. Conclusion: There is certain effect of iodine-125 interstitial braehytherapy on liver cancer, which is associated with the size of tumor.
文摘Objective: To determine whether CA-125 is elevated in medically stable patients with chronic atrial fibrillation (AF) compared with patients without AF and to examine whether levels of CA-125 are associated with demographic and clinical variables in a sample of patients under study. Methods: 55 patients with chronic AF and 58 control patients in sinus rhythm were included into the study. Patients with acute heart failure (HF), chronic inflammatory or neoplastic disease were excluded from the study. Circulating levels of CA-125 were assessed; all patients underwent clinical examination, assessment and medical records including demographic data, history of comorbid conditions, current use of cardiac medications, and the results of cardiac tests including electrocardiograms. Results: The mean age of the study sample was 53.2±6.5 years and 48% were men. Patients with sinus rhythm were significantly more likely to have lower heart rates, smaller dimensions of left atrium, and to be treated with aspirin. Coumadin, coumadin and digoxin were more often prescribed in patients with chronic AF. The CA-125 levels were significantly higher in patients with chronic AF than in patients in sinus rhythm (48.5±7.65 U/ml and 28.43±5.48 U/ml, P〈0.005). An inverse relation was found between CA-125 levels and left ventricular ejection fraction (LVEF) (r=-0.48, P〈0.001). CA-125 was significantly related to the left atrium (LA) diameter, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and brain natriuretic peptide (BNP). There was no significant correlation between CA-125 and age. Conelusion: In subjects with chronic AF, CA-125 levels are increased; CA-125 was significantly related to the LA diameter, LVEDD, LVESD and BNP.