Hepatocellular carcinoma(HCC) is one of the most common cancers worldwide. Surgery, percutaneous ablation and liver transplantation are the only curative treatment modalities for HCC. However, the majority of patients...Hepatocellular carcinoma(HCC) is one of the most common cancers worldwide. Surgery, percutaneous ablation and liver transplantation are the only curative treatment modalities for HCC. However, the majority of patients have unresectable disease at diagnosis. Therefore, effective treatment options for patients with advanced HCC are required. In advanced HCC, according to current international guidelines, sorafenib, a molecular targeted agent, is the standard treatment. However, alternative treatment modalities are required because of the low response rates and unsuitability of molecular agents in real practice. In various treatment modalities, mostly in Asia, hepatic arterial infusion chemotherapy(HAIC) has been applied to advanced HCC with a view to increasing the therapeutic efficacy. HAIC provides direct drug delivery into the tumor feeding vessels and also minimizes systemic toxicities through a greater first-pass effect in the liver. However, the sample sizes of studies on HAIC have been small and large randomized trials are still lacking. In this article, we describe the treatment efficacy of HAIC for advanced stage HCC and discuss future therapeutic possibilities.展开更多
AIM: To explore the role of SF/HGF-Met autocrine and parscrine in metastasis of hepatocellular carcinoma (HCC).METHODS: SF/HGF and c-met transcription and protein expression in HCC were examined by RT-PCR and Western ...AIM: To explore the role of SF/HGF-Met autocrine and parscrine in metastasis of hepatocellular carcinoma (HCC).METHODS: SF/HGF and c-met transcription and protein expression in HCC were examined by RT-PCR and Western Blot in 4 HCC cell lines, including HepG2, Hep3B,SMMC7721 and MHCC-1, the last cell line had a higher potential of metastasis. Sf/hgf cDNA was transfected by the method of Lipofectin into SMMC7721. SF/HGF and c-met antibody were used to stimulate and block SF/HGF-c-met signal transduction. Cell morphology, mobility, and proliferation were respectively compared by microscopic observation, wound healing assay and cell growth curve.RESULTS: HCC malignancy appeared to be relative to its met-SF/HGF expression. In MHCC-1, c-met expression was much stronger than that in other cell lines with lower potential of metastasis and only SF/HGF autocrine existed in MHCC-1. After sf/hgf cDNA transfection or conditioned medium of MHCC-1 stimulation, SMMC7721 changed into elongated morphology, and the abilities of proliferation ( P < 0.05) and mobility increased. Such bio-activity could he blocked by c-met antibody ( P< 0.05).CONCLUSION: The system of SF/HGF-c-met autocrine and paracrine played an important role in development and metastasis potential of HCC. Inhibition of SF/HGF-c-met signal transduction system may reduce the growth and metastasis of HCC.展开更多
AIM:To assess the diagnostic performance of followup liver computed tomography(CT) for the detection of high-risk esophageal varices in patients treated with locoregional therapy for hepatocellular carcinoma(HCC).METH...AIM:To assess the diagnostic performance of followup liver computed tomography(CT) for the detection of high-risk esophageal varices in patients treated with locoregional therapy for hepatocellular carcinoma(HCC).METHODS:We prospectively enrolled 100 patients with cirrhosis who underwent transcatheter arterial chemoembolization,radiofrequency ablation or both procedures for HCCs.All patients underwent upper endoscopy and subsequently liver CT.Three radiologists independently evaluated the presence of high-risk esophageal varices with transverse images alone and with three orthogonal multiplanar reformation(MPR) images,respectively.With endoscopic grading as the reference standard,diagnostic performance was assessed by using receiver operating characteristic(ROC) curve analysis.RESULTS:The diagnostic performances(areas under the ROC curve) of three observers with transverse images alone were 0.947 ± 0.031,0.969 ± 0.024,and 0.916 ± 0.038,respectively.The mean sensitivity,specificity,positive predicative value(PPV),and negative predicative value(NPV) with transverse images alone were 90.1%,86.39%,70.9%,and 95.9%,respectively.The diagnostic performances,mean sensitivity,specificity,PPV,and NPV with three orthogonal MPR images(0.965 ± 0.025,0.959 ± 0.027,0.938 ± 0.033,91.4%,89.5%,76.3%,and 96.6%,respectively) were not superior to corresponding values with transverse images alone(P > 0.05),except for the mean specificity(P = 0.039).CONCLUSION:Our results showed excellent diagnostic performance,sensitivity and NPV to detect high-risk esophageal varices on follow-up liver CT after locoregional therapy for HCC.展开更多
Hepatocellular carcinoma(HCC)is the fifth most common cancer and the third most common cause of cancer-related deaths worldwide.Curative resection is frequently limited in Hong Kong by hepatitis B virus-related cirrho...Hepatocellular carcinoma(HCC)is the fifth most common cancer and the third most common cause of cancer-related deaths worldwide.Curative resection is frequently limited in Hong Kong by hepatitis B virus-related cirrhosis,and liver transplantation is the treatment of choice.Liver transplanta-tion has been shown to produce superior oncological benefits,when compared to hepatectomy for HCC.New developments in the context of patient selection criteria,modification of organ allocation,bridging therapy,salvage liver transplanta-tion and pharmaceutical breakthrough have improved the survival of HCC patients.In this article,we will share our experience in transplanting hepatitis B virus-related HCC patients in Hong Kong and discuss the recent progress in several areas of liver transplantation.展开更多
The composite tumors of the liver are very rare,including the coexistence of HCC(hepatocellular carcinoma)with NEC(neuroendocrine carcinoma).The rare occurrence of these tumors necessitates more reported cases in orde...The composite tumors of the liver are very rare,including the coexistence of HCC(hepatocellular carcinoma)with NEC(neuroendocrine carcinoma).The rare occurrence of these tumors necessitates more reported cases in order to fully understand their clinical characteristics,behaviors and treatments.Herein is described an incidental collision tumor of HCC-NEC,along with a review of the literature focusing on their clinicopathological findings and prognosis.The tumor presented here was found incidentally in the hepatectomy specimen of a 56-yearold man who had undergone liver transplantation for rapidly progressive liver failure because of alcoholic hepatitis and cirrhosis.Imaging and laboratory examinations did not demonstrate tumor-related findings.During macroscopic examination,two sharply defined and distinctive areas(1.7 cm and 0.6 cm dimension respectively)were detected among the cirrhotic nodules.The characteristic histopathological features and immunohistochemical findings allowed a diagnosis of HCCNEC to be made.There was no evidence of recurrence and metastasis after 10months following surgery.The present case and review revealed that these tumors are frequently found in older ages and males.Although serum markers are valuable in the discrimination of malignant tumors,their absence cannot completely rule out composite HCC-NEC.Diagnosis requires a comprehensive histopathological evaluation together with immunohistochemistry.The NEC component might influence the treatment strategy and eventually the outcome of the patient.In conclusion,the rare occurrence of HCC-NEC and the lack of diagnostic clinical signs and symptoms do not exclude their consideration in the differential diagnosis of liver tumors,especially in patients with the chronic liver disease.展开更多
文摘Hepatocellular carcinoma(HCC) is one of the most common cancers worldwide. Surgery, percutaneous ablation and liver transplantation are the only curative treatment modalities for HCC. However, the majority of patients have unresectable disease at diagnosis. Therefore, effective treatment options for patients with advanced HCC are required. In advanced HCC, according to current international guidelines, sorafenib, a molecular targeted agent, is the standard treatment. However, alternative treatment modalities are required because of the low response rates and unsuitability of molecular agents in real practice. In various treatment modalities, mostly in Asia, hepatic arterial infusion chemotherapy(HAIC) has been applied to advanced HCC with a view to increasing the therapeutic efficacy. HAIC provides direct drug delivery into the tumor feeding vessels and also minimizes systemic toxicities through a greater first-pass effect in the liver. However, the sample sizes of studies on HAIC have been small and large randomized trials are still lacking. In this article, we describe the treatment efficacy of HAIC for advanced stage HCC and discuss future therapeutic possibilities.
基金Supported by Natural Science Foundation of China No.39970290
文摘AIM: To explore the role of SF/HGF-Met autocrine and parscrine in metastasis of hepatocellular carcinoma (HCC).METHODS: SF/HGF and c-met transcription and protein expression in HCC were examined by RT-PCR and Western Blot in 4 HCC cell lines, including HepG2, Hep3B,SMMC7721 and MHCC-1, the last cell line had a higher potential of metastasis. Sf/hgf cDNA was transfected by the method of Lipofectin into SMMC7721. SF/HGF and c-met antibody were used to stimulate and block SF/HGF-c-met signal transduction. Cell morphology, mobility, and proliferation were respectively compared by microscopic observation, wound healing assay and cell growth curve.RESULTS: HCC malignancy appeared to be relative to its met-SF/HGF expression. In MHCC-1, c-met expression was much stronger than that in other cell lines with lower potential of metastasis and only SF/HGF autocrine existed in MHCC-1. After sf/hgf cDNA transfection or conditioned medium of MHCC-1 stimulation, SMMC7721 changed into elongated morphology, and the abilities of proliferation ( P < 0.05) and mobility increased. Such bio-activity could he blocked by c-met antibody ( P< 0.05).CONCLUSION: The system of SF/HGF-c-met autocrine and paracrine played an important role in development and metastasis potential of HCC. Inhibition of SF/HGF-c-met signal transduction system may reduce the growth and metastasis of HCC.
基金Supported by Grant from the Samsung Medical Center Clinical Research Development Program,No. CRS108-12-1
文摘AIM:To assess the diagnostic performance of followup liver computed tomography(CT) for the detection of high-risk esophageal varices in patients treated with locoregional therapy for hepatocellular carcinoma(HCC).METHODS:We prospectively enrolled 100 patients with cirrhosis who underwent transcatheter arterial chemoembolization,radiofrequency ablation or both procedures for HCCs.All patients underwent upper endoscopy and subsequently liver CT.Three radiologists independently evaluated the presence of high-risk esophageal varices with transverse images alone and with three orthogonal multiplanar reformation(MPR) images,respectively.With endoscopic grading as the reference standard,diagnostic performance was assessed by using receiver operating characteristic(ROC) curve analysis.RESULTS:The diagnostic performances(areas under the ROC curve) of three observers with transverse images alone were 0.947 ± 0.031,0.969 ± 0.024,and 0.916 ± 0.038,respectively.The mean sensitivity,specificity,positive predicative value(PPV),and negative predicative value(NPV) with transverse images alone were 90.1%,86.39%,70.9%,and 95.9%,respectively.The diagnostic performances,mean sensitivity,specificity,PPV,and NPV with three orthogonal MPR images(0.965 ± 0.025,0.959 ± 0.027,0.938 ± 0.033,91.4%,89.5%,76.3%,and 96.6%,respectively) were not superior to corresponding values with transverse images alone(P > 0.05),except for the mean specificity(P = 0.039).CONCLUSION:Our results showed excellent diagnostic performance,sensitivity and NPV to detect high-risk esophageal varices on follow-up liver CT after locoregional therapy for HCC.
文摘Hepatocellular carcinoma(HCC)is the fifth most common cancer and the third most common cause of cancer-related deaths worldwide.Curative resection is frequently limited in Hong Kong by hepatitis B virus-related cirrhosis,and liver transplantation is the treatment of choice.Liver transplanta-tion has been shown to produce superior oncological benefits,when compared to hepatectomy for HCC.New developments in the context of patient selection criteria,modification of organ allocation,bridging therapy,salvage liver transplanta-tion and pharmaceutical breakthrough have improved the survival of HCC patients.In this article,we will share our experience in transplanting hepatitis B virus-related HCC patients in Hong Kong and discuss the recent progress in several areas of liver transplantation.
文摘The composite tumors of the liver are very rare,including the coexistence of HCC(hepatocellular carcinoma)with NEC(neuroendocrine carcinoma).The rare occurrence of these tumors necessitates more reported cases in order to fully understand their clinical characteristics,behaviors and treatments.Herein is described an incidental collision tumor of HCC-NEC,along with a review of the literature focusing on their clinicopathological findings and prognosis.The tumor presented here was found incidentally in the hepatectomy specimen of a 56-yearold man who had undergone liver transplantation for rapidly progressive liver failure because of alcoholic hepatitis and cirrhosis.Imaging and laboratory examinations did not demonstrate tumor-related findings.During macroscopic examination,two sharply defined and distinctive areas(1.7 cm and 0.6 cm dimension respectively)were detected among the cirrhotic nodules.The characteristic histopathological features and immunohistochemical findings allowed a diagnosis of HCCNEC to be made.There was no evidence of recurrence and metastasis after 10months following surgery.The present case and review revealed that these tumors are frequently found in older ages and males.Although serum markers are valuable in the discrimination of malignant tumors,their absence cannot completely rule out composite HCC-NEC.Diagnosis requires a comprehensive histopathological evaluation together with immunohistochemistry.The NEC component might influence the treatment strategy and eventually the outcome of the patient.In conclusion,the rare occurrence of HCC-NEC and the lack of diagnostic clinical signs and symptoms do not exclude their consideration in the differential diagnosis of liver tumors,especially in patients with the chronic liver disease.
