肝癌TACE术后复发危险因素的Meta分析

目的 系统评价肝癌经动脉化疗栓塞术(transcatheter arterial chemoembolization, TACE)后影响复发的危险因素,为预防TACE术后复发提供科学依据。方法 检索PubMed、EmBase、Cochrane Library、Web of Science、中国知网、万方数据库、维普、中国生物医学文献数据库自建库至2023年2月1日发表的有关肝癌TACE术后复发危险因素的文献报道。由2名研究者根据纳入和排除标准进行文献筛选、数据提取和质量评价。使用软件Rev Man 5.3对纳入文献进行Meta分析和发表偏倚评估。结果 通过筛选最终共纳入9篇高质量队列研究进行Meta分析。分析结果显示差异有统计学意义的危险因素包括甲胎蛋白(OR=3.05,95%CI:1.11~8.38,P=0.03)、白蛋白(OR=5.79,95%CI:2.46~13.62,P<0.0001)、肿瘤分化程度(OR=2.64,95%CI:1.00~6.92,P=0.05)、肿瘤数量(OR=3.76,95%CI:1.71~8.27,P=0.001)、肿瘤ADC值(OR=0.01,95%CI:0.00~0.09,P<0.0001)。结论 肿瘤直径、甲胎蛋白、白蛋白、肿瘤分化程度、肿瘤数量和肿瘤ADC值是TACE术后复发的危险因素。

血清miR-122作为肝癌手术预后的血清标志物的研究

目的:评估mi R-122是否可以作为肝癌术后结局的血清标志物。方法:我们采用连续入组的方式入组在我院行肝癌切除术的患者,在入院时检测血清mi R-122的水平,术后随访患者结局。用多因素Cox风险比例模型评估mi R-122水平与肝癌患者术后的生存期之间的关系。结果:共有103名患者纳入分析,在术后的随访中,总共有38名(36.9%,38/103)患者死亡。术后12个月,24个月,36个月,60个月的总生存率分别为95.6%,79.8%,69.4%和55.7%。单因素和多因素Cox风险比例模型显示高水平的mi R-122预示良好的mi R-122水平预示患者良好的结局(P=0.012)。结论:血清mi R-122水平可以作为预测肝癌术后的血清标志物。

Contrast-enhanced ultrasound for predicting differentiation degree of hepatocellular carcinoma

Objective To explore the value of contrast-enhanced ultrasound(CEUS)for predicting differentiation degree of hepatocellular carcinoma(HCC).Methods Totally 86 HCC patients confirmed by postoperative pathology were retrospectively enrolled and divided into poorly differentiated,moderately differentiated and highly differentiated groups according to postoperative Edmondson-Steiner grading.Preoperative CEUS parameters were compared among groups,and binary logistic regression was used to analyze CEUS-related independent predictors of HCC with different differentiation.The receiver operating characteristic curves of parameters being significant different among groups were drawn,the areas under the curve(AUC)were calculated,and the efficacy for predicting HCC with different differentiation degree was evaluated.Results There were 29 cases in poorly differentiated group,37 in moderately differentiated group and 20 cases in highly differentiated group.The arrival time of contrast agent in poorly differentiated group was earlier than that in moderately and high differentiated groups(both P<0.05),while in moderately differentiated group was not significantly different with that in highly differentiated group(P>0.05).The washout grade were significantly different between each 2 groups(all P<0.05).The arrival time of contrast agent and washout grade were independent predictors of highly or poorly differentiated,moderately or poorly differentiated,moderate-highly or poorly differentiated HCC,and washout grade also was independent predictor of highly or moderately differentiated HCC(all P<0.05).The AUC of the arrival time of contrast agent for predicting highly or moderately differentiated,highly or poorly differentiated,moderately or poorly differentiated,moderate-highly or poorly differentiated HCC was 0.615,0.787,0.690 and 0.724,respectively,while of washout grade was 0.801,0.927,0.795 and 0.841,respectively.Conclusion CEUS could be used to effectively predict differentiation degree of HCC.

Preparation and evaluation of As_2O _3 nanoparticles for treatment of human liver cancer cells in vitro

This paper studies the preparation method of As_2O_3 nanoparticles and theirantitumor effect on human liver cancer cells. As_2O_3 nanoparticles were prepared by sol-gel method.As_2O_3 nanoparticles were characterized by transmission electron microscope ( TEM), energydispersive spectrometer ( EDS) and computer color magic image analysis system (CMIAS). A methylthiazolyl tetrazolium (MTT) assay and a flow cytometry (FCM) assay were performed to examine theantitumor effect of As_2O_3 nanoparticlesat various concentrations(1, 2, 5, 10 mumol/L). We alsocompared the antitumor effect of As_2O_3 nanoparticles with that of As_2O_3 solution. The averagediameters of two kinds of As_2O_3 nanoparticles prepared were about 80 nm and 40 nm. It wasidentified that the prepared nanoparticles were As_2O_3 and there were no other components by EDS.After 48 h of treatment with As_2O_3 nanoparticles, the survival ratio of cells was significantlylower than that of the As2O3 solution with the same concentration(P < 0. 05). Experimental resultsdemonstrate that by sol-gel method As_2O_3 can be prepared into nanoparticles. As_2O_3 nanoparticlescan produce a better cytotoxic effect on tumor cells than the As_2O_3 solution.

Apoptosis of Human Hepatoma Cells Induced by Gynostemma Pentaphyllum Makino

Objective： To identify the proapoptotic effects of Gynostemma pentaphyllum Makino （GpM） on human hepatoma cells. Methods： The effects of GpM on the cell apoptosis of human hepatoma cell line Huh-7 was assessed by flow cytomety. The expression of Bcl-2, Bcl-XL, Bax and Bad molecules in hepatoma cells treated with GpM was detected by Western blot. Results： After treatment with 20 mg/mL GpM for 24 h, 56% of Huh-7 cells were undergoing apoptosis, while cell death was only observed in 12% of humaa fibroblast cells treated with GpM. Western blot demonstrated that, Bcl-2 was markedly decreased in Huh-7 cells treated with GpM. Whereas, Bax was significantly up-regulated in Huh-7 cells treated with GpM. Conclusion： Treatment of human hepatoma cells with GpM induced apoptosis through the down-regulation of Bcl-2, and up-regulation of Bax.

Anticancer Effect of PS-T on the Experimental Hepatocellular Carcinoma

Objective: To apply PS-T in di?erent phases of carcinoma formation and development, and research the mechanism of anti-carcinoma of PS-T in the cytological level. Methods: N-nitrosodiethylamine (DENA) and CCl4 were applied jointly to duplicate the rat hepatocirrhosis and hepatic cancer model. The rats were divided into 7 groups and were administrated via nasal-stomach tube with PS-T in di?erent phases to interfere the cancer genesis and development. All the rats were killed in 20 weeks for pathological observation. Results: The loss of body weight of rats slowed down in the PS-T-treated group, and the carcinogenesis rate was signi?cantly decreased correspondingly. PS-T could also inhibit the carcinogenesis by supressing the hepatocirrhosis, which showed the positive correlation between the curative e?ect and the curative period. Conclusion: Application of PS-T during cancer induction showed a signi?cant e?ect on preventing and supressing cancer. PS-T might be an ideal drug for clinical anti-cancer therapy. And it will be a main drug in both combined and single treatments for tumor.

Regulation of Bcl-2 Family in TIP30-Induced Apoptosis in Hepatoblastoma Cells

Objective: To investigate the role of TIP30 in the apoptotic signal pathwayin HepG2, and Hep3B and Hu-7 hepatoblastoma cell lines. Methods: In order to confirm whether TIP30conducted Bcl-2 family was involved in apoptosis signal pathway, MTT assay, in situ 3' end labellingof DNA assay and Western blot were carried out to detect the diverse apoptotic function of TIP30and the regulation of Bcl-2 family. Results: TIP30 induced apoptosis as evidenced by morphologicalchanges in hepatoblastoma cells, which was accompanied by up-regulating Bax and Bad proteins andstimulating them from cytoplasm to mitochondria, and down-regulating Bcl-xl, while it had no effecton the level of Bak protein. Conclusion: TIP30 induced apoptosis partly by modulating the proteinlevels of members of Bcl-2 family in hepatoblastoma cells. Elucidating the mechanism by which TIP30induces cell death might establish it as an anticancer factor.

Pathological Study of Excised Specimens from Resectable Large Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization

Objective: To investigate pathological changes in surgically excised specimens from resectable large hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE ) and their signi?cance. Methods: From January 2002 to January 2003, 83 patients with resectable large HCC were randomized into two groups: group A, 36 patients who underwent preoperative TACE, and group B, 47 patients who underwent one-stage operation without TACE. Hepatectomy was performed in 31 patients of group A (two-stage operation group) and 47 patients of group B (one-stage operation group). The remaining 5 patients in group A were not operable. The diagnosis of HCC was pathologically con?rmed in all 78 patients after hepatectomy. Pathological changes of the excised specimens between the two groups were compared, including main tumors, capsular containment, daughter nodules, tumor thrombi and liver cirrhosis. Results: There were no signi?cant di?erences in the incidence of daughter nodules , portal vein tumor thrombi (PVTT) and extrahepatic metastasis between the two groups, but the area of main tumor necrosis was more extensive and the rate of encapsulation was higher in two-stage operation group than those in one-stage operation group. No signi?cant shrinkage in the average tumor size was seen in two- stage operation group, where daughter nodules and PVTT necrosis were less, and liver cirrhosis was more serious. Conclusion: Preoperative TACE for resectable large HCC should be used on the basis of strict selection because it does not provide complete tumor necrosis and may result in delayed surgery in some cases.

A Novel Replication-competent Adenovirus CNHK500 in the Treatment of Heptocellular Carcinoma In Vitro

Objective: To evaluate the therapeutic efficacy of replicative adenovirus CNHK500 in the treatment of hepatocellular carcinoma. Methods: Virus proliferation assay, cell viability assay and Western blot were performed to assess the selective replication and cytolysis of CNHK500 in telomerase positive liver cancer cells Hep3B, HepGII, SMMC7721 and in normal cells. Results: The replicative multiples of CNHK500 in HepGII, Hep3B and SMMC7221 after 96 h of virus proliferation were 52 000, 396 984.9 and 632 911.3 fold respectively, similar to those of wtAd5. However, CNHK500 demonstrated more significant attenuated replicative ability in normal cell lines than wtAd5. CNHK500 replicated only 3.1-100 fold at 96 h, while the wtAd5 still reached 3160-17 357 fold. CNHK500 could cause half of HepGII cells death within 7 days at MOI 2, in Hep3B cell lines the IC50 was as low as MOI 0.01, whereas the IC50 in BJ cell was as high as MOI 1000. CNHK500 E1A protein could only be detected in hepatocellular cancer cells but not in normal cells under normoxia. E1B protein could only be detected under hypoxia condition at a MOI of 1. Conclusion: CNHK500 can efficiently replicate in and kill liver cancer cells as well as wtAd5 do while it is severely attenuated in proliferation and cytolysis among normal cells. It would be a prominsing strategy for liver cancer tratment.

Percutaneous Microwave Coagulation Therapy for Patients with Primary and Metastatic Hepatic Tumors

Objective: To evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) for patients with primary and metastatic hepatic tumors.Methods: The enrolled 100 patients with 186 tumor nodules who underwent PMCT included 79 cases of primary or recurrent liver cancers and 21 cases of metastatic liver cancer. The tumors were divided into two groups according to the tumor size in diameter: group A, 0.5 cm?<3 cm; group B, ≥3 cm?<5 cm. Under local and/or epidural anesthesia, a single percutaneous microwave antenna (or two antennas array applicator) was inserted directly into the tumor in the liver for thermo-coagulation with the aid of ultrasound guidance.Results: Among the 186 lesions in 100 patients with primary and metastatic liver cancers, in group A, 123 (66%) were coagulated once. A Follow-up of 6–12 months demonstrated that 112 lesions (91%) showed no local recurrence by CT or MRI; In group B, of the 63 lesions (33.87%) coagulated twice, 31 (49%) showed no local recurrence by CT or MRI during a follow-up of 6 months. There were no serious clinical side effects or complications in all the PMCT patients.Conclusion: PMCT gives satisfactory curative effect on tumors with <3 cm in size. It is partly effective on lesions ≥3 cm?<5 cm in size. It is a minimally invasive and effective therapy, can be used safely in the field of percutaneous hepatis surgery, and carried out even in patients with poor liver function. Key words hepatocellular carcinoma - microwave - coagulation - therapy

An Analysis of Prospective Outcome of Re-resection for Recurrent Live Cancer and Extrahepatic Metastases,a Follow-up of 267\Cass

Objective To evaluate the prospective outcome and summarize experience in re-resection for recurrent liver cancer and extrahepatic metastases. Methods The clinical data of 267 patients with recurrent primary liver cancer (PLC) after re-resection from January 1960 to July 2000 were retrospectively analyzed. Re-hepatectomy was performed on 205 cases, resection of extrahepatic metastases on 51 cases and combined resection of recurrent liver cancer and extrahepatic metastases on 11 cases. The clinico-pathologic features, operation type and survival were compared. Results The types of liver re-resection included left lateral lobectomy in 11.2% of patients, hemihepatetomy and extended hemi-hepatectomy in 4.4%, local radical resection in 68.3%, other subsegmentectomy in 17.1%. The peak recurrence rate (64.4%) occurred at 1–2 years. The overall 1-, 3, 5- and 10-year survival rates after second resection were 81.0%, 40.3%, 19.4% and 9.0% respectively, while they were 77.5%, 29.8%, 13.2% and 6.61% respectively after the third resection. The median survival time was 44 months. The re-resection with extrahepatic metastases also provided the possibility of longer survival. Conclusion The results suggest that subsegmentectomy and local excision is appropriate for the hepatic repeat resection. The peak recurrence may be correlated with portal thrombus and operative factor. The re-resection can be indicated not only in intrahepatic recurrent metastases but also in extrahepatic metastases in selected patients. Re-resection has become the treatment of choice for recurrence of PLC, as neither chemotherapy nor other nonsurgical therapies can achieve such favorable results. Key words prospective outcome - re-resection - primary liver cancer - recurrence - extrahepatic metastases

Relationship between Vascular Elasticity and Spontaneous Rupture of Hepatocellular Carcinoma

Objective Spontaneous rupture of hepatocellular carcinoma (HCC) is common in Asia and Africa with unclear mechanism. In our previous study, we found that the deposition of immune complex on vascular wall and vascular injury were related to the HCC rupture. In this study, the structure of elastin around the small artery was deeply investigated to confirm our previous study. Methods Immunohistochemical technique and transmission electron microscopy were used to study 23 specimens from ruptured HCC and 30 cases of nonruptured HCC. Results The layer of elastin around the vascular wall was significant thicker in patients with ruptured HCC than that in nonruptured HCC. The proliferation of elastin, abnormal distribution of neutrophil elastase and degradation of collagen fibril were predominantly present in the specimens from ruptured HCC. The phenomenon of electron—dense deposit in the elastic lamina that represented the deposition of immune complex, and the signs of infiltrated neutrophils from bloodstream into the vascular wall that caused the vascular injury, also can be found in ruptured HCC. Since the damaged vessels could become stiff and weak, which would more prone to be splitting and results in hemorrhage and the rupture of HCC, we postulated that the preexisting of immune complex deposition and vascular injury may be relate to the ruptured HCC. Conclusion The vascular injury caused by immune complex deposition might relate to ruptured HCC. Key words hepatocellular carcinoma - rupture - elastin - elastase

Effect of Quercetin on the Proliferation and Mitochondrial Transmembrane Potential of CBRH-7919 Cells

[Objective] To investigate the effect of quercetin on the proliferation and mitochondrial transmembrane potential of CBRH-7919 cells. [Method] The CBRH-7919 cells of hepatocarcinoma were cultured in vitro. After treated with different concentrations of quercetin, the OD405 nm of CBRH-7919 cells was detected by using the acid phosphatase assy （APA）; morphologic changes of the cells were observed under inverted microscope; the mitochondrial transmembrane potential （△ψm） intensity changes of CBRH-7919 cells were analyzed by flow cytometry after stained with Rhodamine 123. [Result] Quercetin inhibited the proliferation of CBRH-7919 cells significantly, and the growth inhibitory effect presented time- and dose-dependent relationship. Typical decrease of cell density was observed by optical microscopy on the quercetin-treated cells. With the effect of 10 μg/ml quercetin on CBRH-7919 cells for 12, 24 and 48 h, the percentage of Rhodamine 123 stained hypofluorescence cells increased, while the mitochondrial transmembrane potential（△ψm） intensity of CBRH-7919 cells decreased. [Conclusion] Quercetin could inhibit the proliferation of CBRH-7919 cells in vitro, causing the decrease in mitochondrial transmembrane potential.

Retrograde Hepatectomy for Difficultly Resected Liver Cancer: A Report of 244 Cases

Objective To report our experience of retrograde hepatectomy in 244 cases of difficultly resected liver cancer. Methods Large, poor-exposure and inferior vena cava (IVC)-involving liver cancers that were difficult to remove by classical hepatectomy, have been resected successfully by retrograde hepatectomy combined with vascular surgical techniques in 244 patients (group A). Thirty one patients with similar circumstances undergoing classical hepatectomy duing the same period served as controls (group B). Results There were no perioperative mortalities in both groups. The comparison between group A and group B, the estimated intraoperative blood loss was 1290±998 ml versus 2286±1363 ml, post-operative pleural effusions occurred in 26/244 versus 10/31, ascites in 72/244 versus 19/31, moderate to severe jaundice in 14/244 versus 5/31, effusion in the operative area in 17/244 versus 7/31, subphrenic infection in 3/244 versus 1/31, bile leakage in 2/244 versus 1/31, wound infection in 3/244 versus 1/31, respectively. The time until ALT normalizaton in the groups A and B was 13.8±5.1 days and 18.9±8.9 days respectively. The difference between the two groups were statistically significant (P<0.01). Conclusion Retrograde hepatectomy is a safe and effective method for difficultly resected liver cancer. Key words cancer - liver - liver surgery - retrograde

Expression of the Glypican-3 Gene in α-fetoprotein-negative Human Hepatocellular Carcinoma

Objective： To investigate the expression of Glypican-3 gene in （α-fetoprotein （AFP）-negative hepatocellular carcinoma （HCC） and clarify whether Glypican-3 expression is a useful parameter for the diagnosis of hepatocelhllar carcinoma （HCC）, especially for AFP-negative ones. Methods： Forty-one specimens of AFP-negative hepatocellular carcinoma and para-carcimoma tissue were studied for the expression of Glypican-3 by Northern blot. The expression of Glypican-3 protein was detected immunohistochemically with specific polyclonal antibody. Results： Northern blot analysis indicated that the expression of Glypican-3 mRNA was intensively detected in 30 of 41 AFP-negative HCC （73.17%）. In contrast, Glypican-3 mRNA was only weakly detected in 4 of the surrounding non-tumor liver tissues. There was significant difference in the Glypican-3 mRNA expression in large tumors （〉5 cm） （79.31%） and in small tumors （〈5 cm） （41.67%） （P〈0.01）. Gypican-3 mRNA was more frequently overexpressed in poorly differentiated HCC than in well differentiated ones （76.47% vs. 42.86%, P〈0.05）. The Glypican-3 expression was not correlated with age. sex. ttbsAg seropositivity, fibroeapsule, portal venous embolus and intrahepatic metastasis. The overexpression of Glypican-3 protein in HCC was targeted in tumor cells, not in bile duct cells and other interstitial cells. Conclusion： Glypican-3 was specially overexpressed in AFP-negative HCC, and its expression was closely correlated with the tumor size and tumor grade. Glypican-3 gene may play important roles in hepatocareinogenesis, and can be used as a new biochemical marker of HCC, especially for AFP-negative HCC.

Studies on Mitomycin C Dextran-microspheres

In this paper,the preparation and properties of mitomycin C dextran-microspheres(MMC-DMS)were reported.The characteristics of pharmacokinetics and embolization effects of MMC-DMS in vivo were studied in dogs.The average diameter of the microspheres was 75±19μm and the content was 5% of MMC.In in vitro experiment, the release rate of drug demonstrated that the microspheres had sustained-release properties. The microspheres and conventional MMC were infused into the hepatic artery of dogs through a catheter for embolization,respectively.The plasma concentration of MMC was de- termined by HPLC.Results showed that the peak concentration of conventional MMC was 2.6 times as much as MMC-DMS.Angiograms revealed that peripheral blood vessels de- creased obviously in liver.The histopathologic examination showed that the microspheres lodged in the hepatic artery and displayed nodular necrosis in the embolized segment.The MMC-DMS were used in clinical trial in 100 patients with hepatic cancer.The tumor reduc- tion and improvement of symptoms in patients were observed after hepatic arterial embolization.The survival duration was prolonged.Results showed that the MMC-DMS is a promising embolic agent for treatment of hepatic cancer.It could aid in the use of intensive chemotherapy with minimum systemic side effect.

Importance of Percutaneous Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma

Objective: To study the importance of percutaneous radiofrequency ablation (PRFA) guided by ultrasound for inoperable recurrent hepatocellular carcinoma.Methods: Forty-seven patients with inoperable recurrent hepatocellular carcinoma underwent percutaneous radiofrequency ablation (PRFA) under ultrasond between October 1999 and July 2001. Twenty-four patients had single recurrent tumor and 23 patients had multiple lesions. Twelve patients had single lesion with less than 3.5 cm in diameter. All patients were followed up to examine the value of AFP, MRI or CT after PRFA. Kaplan-Meier estimation was used to analyze the survival rate.Results: The 1-, 2- and 3-year survival rate in single lesion group was 65.2%, 37.5% and 37.5% respectively. The survival rate of 1 and 2 years was 41.7% and 19.5% in the multiple lesions group. The 1-, 2-and 3-year survival rate in single lesion groups with less than 3.5 cm in diameter was 83.3%, 51.4% and 51.4% respectively.Conclusion: PRFA is one of the important comprehensive methods for recurrent hepatocellular carcinoma. According to the size, number and recurrent time, PRFA can be performed separately or combined with transcatheter arterial chemoembolization for inoperable recurrent hepatocellular carcinoma. This method can control the recurrence and increase the survival rate effectively. Key words recurrence - hepatocellular cacinoma - radiofrequency ablation

High Rate of P16 Methylation Associated with Hepatitis B Virus Infection in Hepatocellular Carcinoma

Objective： To investigate the potential linkage between high rate of p16 methylation and hepatitis B virus （HBV） infection, methylation status of p16, HBV infection markers in serum and HBV-DNA replication level in cancerous and non-cancerous tissue of 32 cases of hepatocellular carcinomas （HCC） with HBV infection and 12 HCCs without HBV infection were examined. Methods： p16 methylation was detected with methylation-specific polymerase Chain reaction （PCR）, and HBV markers were examined with real-time PCR and immunologic method. Results： Methylation of p16 promoter was found in 31 （70.5%） of 44 cancerous tissues of HCC, 2 （16.7%） of 12 HCC without HBV infection, 29 （90.6%） of 32 HCCs with HBV infection marker, p16 methylation was detected in 5 （83.3%） of 6 HCCs positive for HBsAg and HBeAg, 17 （94.4%） of 18 HCCs positive for HBsAg and negative for HBeAg, 7/8 （87.5%） of HCCs positive for other HBV infection markers, such as HBsAB, HBcAb, HBeAb. p16 methylation products were also found in non-cancerous tissues of 4 cases of HCCs with HBV infection, not detected in non-cancerous tissues without HBV infection. HBV-DNA was detected in cancerous tissues of 29/32 （90%） HCCs with HBV infection. Surprisingly, Methylation product of p16 promoter was found in all cases （29/29） of HCCs with detectable HBV-DNA in neoplastic tissue. Conclusion： Persistent HBV infection may promote p16 hypermethylation, suggesting that HBV, via enhancing the aberrant methylation of p16, indirectly involved in development of HCC.

Expression Profiles of TRAIL Receptors and Their Clinical Significance in Human Hepatocellular Carcinoma

Objective To investigate the expression profiles and their clinical significance of TRAIL receptors (TRAILR) in human hepatocellular carcinoma (HCC). Methods The expression profiles of TRAILR were determined in 60 samples from hepatocellular carcinoma, 20 from normal liver tissue and two HCC cell lines HepG2, SMMC-7721 by in situ hybridization. Results Both DR4 and DR5 were present in all HCC tissues as well as normal hepatic tissues. In contrast, 54 HCC tissues did not express DcR1 and 25 did not express DcR2. But both DcR were detectable in all of the normal liver tissues. The expression patterns of DR and DcR in HCC samples (higher DR expression level and lower DcR expression level) were quite different from those in normal tissue. DR5, DR4, and DcR2 expressed in both cell lines, while no DcR1 expression was detected. The expression level of DR was correlated with HCC differentiation and stage. The weaker expression was more commonly found in HCC with poor differentiation and late stage, while the stronger expression was more common in HCC with middle to high-differentiation and early stage. No relationship was found between DR and gender, age, negative or positive HBsAg, tumor size, grade or metastasis. Multidrug resistance cell lines expressed lower level DR. Conclusion TRAILR expression was prevalent and discrepancy of receptor types was exited in HCC. Loss of DcR1 may contribute for TRAIL therapy for HCC. Key words TRAILR - apoptosis - hepatocellular carcinoma Supported by the Major Fundation of Ministry of Health, NO. 2001–2003

Role of Antivirus Therapy in Treatment of Hepatocellular Carcinoma with Chronic Hepatitis B Infection

Objective： To observe the recurrence and prognosis of hepatocellular carcinoma （HCC） patients coexisting with chronic hepatitis B infection with active virus replication after receiving antivirus therapy using lamivudine and thymosin α1 （Tα1） postoperatively. Methods： From Jan. 2000 to Dec. 2003, 70 patients with HCC coexisting chronic hepatitis B infection with active virus replication were prospectively divided into two groups： control group （n=35） received hepatectomy only; treatment group （n=35） received hepatectomy and lamivudine plus Tα1 therapy postoperatively. The suppression of HBV-DNA, HBeAg seroconverted rate, tumor recurrent rate and the median survival for the two groups were observed and calculated. Results： In treatment group and control group, the 2-year HBV-DNA suppression rate was 100% vs. 4% （P=0.0000）; HBeAg seroconverted rate was 73.0% vs. 7.5% （P〈0.05）; the recurrent rate was 10.0 vs 6.5 months （P=0.0032）; the median survival time was 12.5 vs. 6.0 months （P=0.0023）, respectively. Conclusion： Antivirus therapy using lamivudine and Tα1 postoperatively may suppress the HBV reaction, delay the recurrent time and prolong the survival for HCC patients coexisting chronic HBV infection with active virus replication.