Hepatocellular carcinoma (HCC) has a decisive influence on the prognosis of cirrhotic patients. Although α-fetoprotein (AFP) is a known and specific tumor maker for HCC, it is not suitable for the screening and s...Hepatocellular carcinoma (HCC) has a decisive influence on the prognosis of cirrhotic patients. Although α-fetoprotein (AFP) is a known and specific tumor maker for HCC, it is not suitable for the screening and surveillance of HCC because of its poor predictive value and low sensitivity. The use of imaging modalities is essential for the screening, diagnosis and treatment of HCC. Ultrasound (US) plays a major role among them, because it provides real-time and non-invasive observation by a simple and easy technique. In addition, US-guided needle puncture methods are frequently required for the diagnosis and/or treatment process of HCC. The development of digital technology has led to the detection of blood flow by color Doppler US, and the sensitivity for detecting tumor vascularity has shown remarkable improvement with the introduction of microbubble contrast agents. Moreover, near realtime 3-dimensional US images are now available. As for the treatment of HCC, high intensity focused ultrasound (HIFU) was developed as a novel technology that provides transcutaneous ablation effect without needle puncture. These advancements in the US field have led to rapid progress in HCC management, and continuing advances are expected. This article reviews the current application of US for HCC in clinical practice.展开更多
AIM: To characterise expression of known E-cadherin repressors; Snail, Slug and Twist in the development of esophageal adenocarcinoma. METHODS: E-cadherin, Slug, Snail and Twist mRNA expression in Barrett's metapl...AIM: To characterise expression of known E-cadherin repressors; Snail, Slug and Twist in the development of esophageal adenocarcinoma. METHODS: E-cadherin, Slug, Snail and Twist mRNA expression in Barrett's metaplasia and esophageal adenocarcinoma specimens was examined by real-time reverse transcription-polymerase chain reaction (RT-PCR). Semi-quantitative immunohistochemistry was used to examine cellular localisation and protein levels. The effect of Slug on epithelial mesenchymal transition (EMT) markers was examined by transfection of Slug into an adenocarcinoma line OE33.RESULTS: Cellular localisation of Slug in Barrett's metaplasia was largely cytoplasmic whilst in adenocarcinoma it was nuclear. Semi-quantitative analysis indicated that Slug was more abundant in adenocarcinoma compared to matched Barrett's metaplastic specimens. Snail and Twist were expressed in adenocarcinoma but were cytoplasmic in location and not induced compared to Barrett's mucosa. These observations were supported by mRNA studies where only Slug mRNA was shown to be over-expressed in adenocarcinoma and inversely correlated to E-cadherin expression. Overexpression of Slug in OE33 mediated E-cadherin repression and induced the mesenchymal markers vimentin and fibronectin.CONCLUSION: Progression to adenocarcinoma is associated with increased Slug expression and this may represent a mechanism of E-cadherin silencing.展开更多
Objective: To investigate the efficiency of helical CT comparing with contrast-enhanced ultrasound, and to im- prove the diagnosis efficiency of renal cell carcinoma (RCC). Methods: Thirty RCCs confirmed pathologicall...Objective: To investigate the efficiency of helical CT comparing with contrast-enhanced ultrasound, and to im- prove the diagnosis efficiency of renal cell carcinoma (RCC). Methods: Thirty RCCs confirmed pathologically were studied retrospectively. The un-enhanced CT scan and the triphasic enhanced helical CT scan were performed in all cases, the gray-scale US and angiosonography with SonoVue were performed in all cases meantime. Results: 22 cases (73.3%) were diagnosed correctly by helical CT alone before operation. 7 cases (23.3%) were suspected as RCC with helical CT. One case (3.3%) was misdiagnosed with helical CT. 25 cases (83.3%) were diagnosed correctly with contrast-enhanced ultrasound alone pre-operation. One case (3.3%) was suspected as RCC with angiosonography. Four cases (13.3%) were misdiagnosed with angiosonography alone. 29 cases (96.7%) were diagnosed correctly by helical CT combining with angiosonography before operation, one case (3.3%) was diagnosed as renal mass with both helical CT and angiosonography. Conclusion: Contrast-enhanced ultrasound is sensitive in detecting blood flow, it can detect the enhancement of the tumor which cannot be detected by helical CT. CT and angiosonography have strong complement each other in the diagnosis of RCC.展开更多
Diagnosis of hepatocellular carcinoma (HCC), a common digestive malignancy, remains a challenge. The aim of this study was to evaluate the feasibility of performing laparoscopy and laparoscopic ultrasound with local a...Diagnosis of hepatocellular carcinoma (HCC), a common digestive malignancy, remains a challenge. The aim of this study was to evaluate the feasibility of performing laparoscopy and laparoscopic ultrasound with local anesthesia as a diagnostic procedure in HCC. Laparoscopy and laparoscopic ultrasound with local anesthesia was performed in the gastrointestinal endoscopy unit in three patients diagnosed of HCC. Endoscopy staged diffuse liver disease. Laparoscopic ultrasonography identified all liver tumors not visible during endoscopy and guided needle biopsy in one case. No complications happened. In conclusion, laparoscopy and laparoscopic ultrasound,performed as a minimally invasive diagnostic procedure can be a safe and very promising tool in planning therapy of HCC.展开更多
文摘Hepatocellular carcinoma (HCC) has a decisive influence on the prognosis of cirrhotic patients. Although α-fetoprotein (AFP) is a known and specific tumor maker for HCC, it is not suitable for the screening and surveillance of HCC because of its poor predictive value and low sensitivity. The use of imaging modalities is essential for the screening, diagnosis and treatment of HCC. Ultrasound (US) plays a major role among them, because it provides real-time and non-invasive observation by a simple and easy technique. In addition, US-guided needle puncture methods are frequently required for the diagnosis and/or treatment process of HCC. The development of digital technology has led to the detection of blood flow by color Doppler US, and the sensitivity for detecting tumor vascularity has shown remarkable improvement with the introduction of microbubble contrast agents. Moreover, near realtime 3-dimensional US images are now available. As for the treatment of HCC, high intensity focused ultrasound (HIFU) was developed as a novel technology that provides transcutaneous ablation effect without needle puncture. These advancements in the US field have led to rapid progress in HCC management, and continuing advances are expected. This article reviews the current application of US for HCC in clinical practice.
基金Supported by City Hospital Trust Fundthe University of Birmingham Scientific Project Grant
文摘AIM: To characterise expression of known E-cadherin repressors; Snail, Slug and Twist in the development of esophageal adenocarcinoma. METHODS: E-cadherin, Slug, Snail and Twist mRNA expression in Barrett's metaplasia and esophageal adenocarcinoma specimens was examined by real-time reverse transcription-polymerase chain reaction (RT-PCR). Semi-quantitative immunohistochemistry was used to examine cellular localisation and protein levels. The effect of Slug on epithelial mesenchymal transition (EMT) markers was examined by transfection of Slug into an adenocarcinoma line OE33.RESULTS: Cellular localisation of Slug in Barrett's metaplasia was largely cytoplasmic whilst in adenocarcinoma it was nuclear. Semi-quantitative analysis indicated that Slug was more abundant in adenocarcinoma compared to matched Barrett's metaplastic specimens. Snail and Twist were expressed in adenocarcinoma but were cytoplasmic in location and not induced compared to Barrett's mucosa. These observations were supported by mRNA studies where only Slug mRNA was shown to be over-expressed in adenocarcinoma and inversely correlated to E-cadherin expression. Overexpression of Slug in OE33 mediated E-cadherin repression and induced the mesenchymal markers vimentin and fibronectin.CONCLUSION: Progression to adenocarcinoma is associated with increased Slug expression and this may represent a mechanism of E-cadherin silencing.
基金Supported by a grant from Scientific Committee of Guangzhou, China(No. 2004Z3–E0481)
文摘Objective: To investigate the efficiency of helical CT comparing with contrast-enhanced ultrasound, and to im- prove the diagnosis efficiency of renal cell carcinoma (RCC). Methods: Thirty RCCs confirmed pathologically were studied retrospectively. The un-enhanced CT scan and the triphasic enhanced helical CT scan were performed in all cases, the gray-scale US and angiosonography with SonoVue were performed in all cases meantime. Results: 22 cases (73.3%) were diagnosed correctly by helical CT alone before operation. 7 cases (23.3%) were suspected as RCC with helical CT. One case (3.3%) was misdiagnosed with helical CT. 25 cases (83.3%) were diagnosed correctly with contrast-enhanced ultrasound alone pre-operation. One case (3.3%) was suspected as RCC with angiosonography. Four cases (13.3%) were misdiagnosed with angiosonography alone. 29 cases (96.7%) were diagnosed correctly by helical CT combining with angiosonography before operation, one case (3.3%) was diagnosed as renal mass with both helical CT and angiosonography. Conclusion: Contrast-enhanced ultrasound is sensitive in detecting blood flow, it can detect the enhancement of the tumor which cannot be detected by helical CT. CT and angiosonography have strong complement each other in the diagnosis of RCC.
文摘Diagnosis of hepatocellular carcinoma (HCC), a common digestive malignancy, remains a challenge. The aim of this study was to evaluate the feasibility of performing laparoscopy and laparoscopic ultrasound with local anesthesia as a diagnostic procedure in HCC. Laparoscopy and laparoscopic ultrasound with local anesthesia was performed in the gastrointestinal endoscopy unit in three patients diagnosed of HCC. Endoscopy staged diffuse liver disease. Laparoscopic ultrasonography identified all liver tumors not visible during endoscopy and guided needle biopsy in one case. No complications happened. In conclusion, laparoscopy and laparoscopic ultrasound,performed as a minimally invasive diagnostic procedure can be a safe and very promising tool in planning therapy of HCC.