AIM: To study the surgical treatment effect and outcome of hepatocellular carcinoma (HCC) with bile duct tumor thrombi (BDTT). METHODS: Fifty-three consecutive HCC patients with BDTT admitted in our department from Ju...AIM: To study the surgical treatment effect and outcome of hepatocellular carcinoma (HCC) with bile duct tumor thrombi (BDTT). METHODS: Fifty-three consecutive HCC patients with BDTT admitted in our department from July 1984 to December 2002 were reviewed retrospectively. The clinical data, diagnostic methods, surgical procedures and outcome of these patients were collected and analyzed. RESULTS: One patient rejected surgical treatment, 6 cases underwent percutaneous transhepatic cholangial drainage (PTCD) for unresectable primary disease, and the other 46 cases underwent surgical operation. The postoperative mortality was 17.6%, and the morbidity was 32.6%. Serum total bilirubin levels of these patients with obstructive jaundice decreased gradually after surgery. The survival time of six cases who underwent PTCD ranged from 2 to 7 mo (median survival of 3.7 mo). The survival time of the patients who received surgery was as follows: 2 mo for one patient who underwent laparotomy, 5-46 mo (median survival of 23.5 mo, which was the longest survival in comparison with patients who underwent other procedures, P=0.0024) for 17 cases who underwent hepatectomy, 5-17 mo (median survival of 10.0 mo) for 5 cases who underwent HACE, 3-9 mo (median survival of 6.1 mo) for 11 cases who underwent simple thrombectomy and biliary drainage, and 3-8 mo (median survival of 4.3 mo) for four cases who underwent simple biliary drainage. CONCLUSION: Jaundice caused by BDTT in HCC patients is not a contraindication for surgery. Only curative resection can result in long-term survival. Early diagnosis and surgical treatment are the key points to prolong the survival of patients.展开更多
AIM: To investigate the protective effect of ischemic preconditioning (IPC) on hepatocellular carcinoma (HCC) patients with cirrhosis undergoing hepatic resection under hepatic inflow occlusion (HIO) and its possible ...AIM: To investigate the protective effect of ischemic preconditioning (IPC) on hepatocellular carcinoma (HCC) patients with cirrhosis undergoing hepatic resection under hepatic inflow occlusion (HIO) and its possible mechanism.METHODS: Twenty-nine consecutive patients with resectable OHCC were randomized into two groups: IPC group: before HIO, IPC with 5 min of ischemia and 5 min of reperfusion was given; control group: no IPC was given. Uver functions,hepatic Caspase-3 activity, and apoptotic cells were compared between these two groups.RESULTS: On postoperative days (POD) 1, 3 and 7, the aspartate transaminase (AST) and alanine transaminase (ALT) levels in the IPC group were significantly lower than those in the control group (P<0.05). On POD 3 and 7, the total bilirubin level in the IPC group was significantly lower than that in the control group (P<0.05). On POD 1, the albumin level in the IPC group was higher than that in the control group (P = 0.053). After 1 h of reperfusion, both hepatic Caspase-3 activity and apoptotic sinusoidal endothelial cells in the IPC group were significantly lower than those in the control group (P<0.05).CONCLUSION: IPC has a potential protective effect on HCC patients with cirrhosis. Its protective mechanism underlying the suppression of sinusoidal endothelial cell apoptosis is achieved by inhibiting Caspase-3 activity.展开更多
AIM:To explore the dffects of recombinant human growth hormone(rhGH) on the remnant liver after hepatectomy in hepatocellular carcinoma with liver cirrhosis.METHODS:Twenty-four patients with hepoatocellular carcinoma ...AIM:To explore the dffects of recombinant human growth hormone(rhGH) on the remnant liver after hepatectomy in hepatocellular carcinoma with liver cirrhosis.METHODS:Twenty-four patients with hepoatocellular carcinoma who underwent hepatectomy were randomly diveded into 2 groups:parenteral nutrition(PN) group (n=12) and rhGH+PN group (n=12).Liver function,blood glucose,AFP,serum prealbumin and transferrin were detected before operation,at post-operative d 1 and d 6.Albumin (ALB) mRNA in liver biopsy specimens was detected by RT-PCR at post-operative d 6.Liver Ki67 immunohistochemical staining was studied.RESULTS:On post-operative d 6,compared with PN grouop,the levels of blood glucose,serum prealbumin,transferrin,the expression of hepoatic ALB mRNA and liver Ki67 labeling index were higher in rhGH+PN group.CONCLUSION:rhGH can improve protein synthesis and liver regeneration after hipatectomy in hepatocellular carcinoma with liver cirrhosis.展开更多
AIM: To evaluate the therapeutic efficacy of systemic chemo-immunotherapy for advanced hepatocellular carcinoma (HCC). METHODS: Twenty-six patients with advanced HCC were treated by using systemic chemo-immunotherapy ...AIM: To evaluate the therapeutic efficacy of systemic chemo-immunotherapy for advanced hepatocellular carcinoma (HCC). METHODS: Twenty-six patients with advanced HCC were treated by using systemic chemo-immunotherapy (PIAF regimen), which consisted of dsplatin (20 mg/m2) intravenously daily for 4 consecutive day, doxorubicin (40 mg/m2) intravenously on day 1, 5-fluorouracil (400 mg/m2) intravenously daily for 4 consecutive day, and human recombinant a-interferon-2a (5 Mu/m2) subcutaneous injection daily for 4 consecutive day. The treatment was repeated every 3 wk, with a maximum of six cycles. RESULTS: A total of 90 cycles of PIAF treatment were administered, with a mean number of 3.9 cycles per patient. Eight patients received six cycles of treatment (group A), and the remaining 18 were subjected to two to five cycles (group B). There were 0 complete response, 4 partial responses, 9 static diseases and 13 progressive diseases, with a disease control rate of 50% (13/26). The 1-year survival rate was 24.3%, with a median survival time of 6.0 mo. Group A had a remarkably better survival as compared with group B, the 1- and 2-year survival rates were 62.5% vs 6.1% and 32.3% vs 0%, and a median survival time was 12.5 mo vs5.0 mo (P= 0.001). CONCLUSION: Systemic chemo-immunotherapy using PIAF regimen represented an effective treatment and could improve the survival rate and prolong the survival time in selected patients with advanced HCC.展开更多
AIM: To study the changes of quantitative expression, adhering activity and genomic density polymorphism of complement types in erythrocytes (CR1) of patients with gallbladder carcinoma and the related clinical signif...AIM: To study the changes of quantitative expression, adhering activity and genomic density polymorphism of complement types in erythrocytes (CR1) of patients with gallbladder carcinoma and the related clinical significance.METHODS: Polymerase chain reaction (PCR), HindⅢ restrdion enzyme digestion, quantitative assay of CR1 and adhering activity assay of CR1 in erythrocytes were used.RESULIFS: The number and adhering actvity of CR1 in patients with gallbladder carcinoma (0.738±0.23, 45.9±5.7) were significantly lower than those in chronic cholecystitis and cholecystolithiasis (1.078±0.21, 55.1±5.9) and healthy controls (1.252±0.31, 64.2±7.4) (P<0.01). The number and adhering activity of CR1 in patients with chronic cholecystitis and cholecystolithiasis (1.078±0.21, 55.1±5.9) were significantly lower than those in healthy controls (1.252±0.31, 64.2±7.4) (P<0.05). There was a positive correlation between quantitative expression and adhering activity of CR1 (r = 0.79, P<0.01).Compared with those on preoperative day (0.738±0.23,45.4±4.9), the number and adhering activity of CR1 in patients with gallbladder carcinoma decreased greatly on the third postoperative day (0.310±0.25, 31.8±5.1) (P<0.01), and on the first postoperative week (0.480±0.25, 38.9±5.2) (P<0.01), but they were increased slightly than those on the preoperative day (P>0.05). The number and adhering activity of CR1 recovered in the second postoperative week (0.740±0.24, 46.8±5.9) (P<0.01) and increased greatly in the third postoperative week (0.858±0.35, 52.7±5.8) (P<0.01) in comparison with those on the preoperative day and in the first postoperative week. The number and adhering activity of CR1 of gallbladder carcinoma patients with infiltrating, adjacent lymphogenous and distant organ metastases were significantly lower than those of gallbladder carcinoma patients without them (P<0.01). No difference was observed between the patients with gallbladder carcinoma and healthy individuals in the spot mutation rate of CR1 density gen展开更多
AIM: To induce efficient expansion of natural killer (NK) cells from peripheral blood mononuclear cells (PBMCs) using a culture of anchorage-dependent Wilms tumor cell lines, and to provide a reliable supply for adopt...AIM: To induce efficient expansion of natural killer (NK) cells from peripheral blood mononuclear cells (PBMCs) using a culture of anchorage-dependent Wilms tumor cell lines, and to provide a reliable supply for adoptive immunotherapy of hepatocellular carcinoma.METHODS: Culture expansion of NK cells was achieved using PBMCs cultured with Wilms tumor cells. Cytotoxicity was measured using a standard 54^Cr release assay and crystal violet staining technique. The proportions of CD3+,CD4+,CD8+,CD16+, and CD56+ cells were determined by flow cytometry.RESULTS: After PBMCs from healthy donors and hepatocellular carcinoma (HCC) were cultured with irradiated HFWT cells for 10-21 d, CD56+ CD16+ cells shared more than 50% of the cell population, and more than 80% of fresh HFWT cells were killed at an effector/target ratio of 2 over 24 h. NK-enriched lymphocyte population from HCC patients killed HCC-1 and 2 cells with sensitivities comparable to fresh TKB-17RGB cells. HCC cells proliferated 196-fold with the irradiated HFWT cells at 18 d. Stimulation by HFWT cells required intimate cell-cell interaction with PBMC. However, neither the soluble factors released from HFWT cells nor the fixed HFWT cells were effective for NK expansion. The lymphocytes expanded with IL-2 killed fresh HFWT target cells more effectively than the lymphocytes expanded with the 4-cytokine cocktail(IL-1 β, IL-2, IL-4 and IL-6). IL-2 was the sole cytokine required for NK expansion.CONCLUSION: Wilms tumor is sensitive to human NK cells and is highly efficient for selective expansion of NK cells from PBMCs.展开更多
目的分析杂交式单操作孔胸腔镜肺叶切除治疗早期非小细胞肺癌的临床疗效。方法早期非小细胞肺癌病人100例,根据手术方法不同分为观察组和对照组,每组各50例,观察组采取单操作孔胸腔镜肺叶切除术,对照组采取三孔胸腔镜肺叶切除术。比较...目的分析杂交式单操作孔胸腔镜肺叶切除治疗早期非小细胞肺癌的临床疗效。方法早期非小细胞肺癌病人100例,根据手术方法不同分为观察组和对照组,每组各50例,观察组采取单操作孔胸腔镜肺叶切除术,对照组采取三孔胸腔镜肺叶切除术。比较两组病人手术资料、术后恢复情况及并发症发生率。结果所有病人顺利完成手术且术中未出现严重并发症。观察组手术时间及淋巴结清扫数目分别为(163.8±34.0)分钟和(12.5±1.9)个,对照组分别为(153.5±38.4)分钟和(12.3±1.6)个,两组比较差异无统计学意义(P>0.05),观察组术中出血量、切口长度、术后胸腔引流量、术后带管时间、术后住院时间及术后1天视觉模拟评分(visual analog scale,VAS)分别为(174.5±28.0)ml、(1.6±0.3)cm、(455.9±42.7)ml、(2.9±0.4)天、(9.6±1.2)天和(5.2±1.3)分,对照组分别为(225.7±30.0)ml、(4.2±0.6)cm、(620.6±67.3)ml、(3.5±0.5)天、(12.3±2.2)天和(6.5±1.7)分,两组比较差异均有统计学意义(P<0.05)。观察组术后并发症发生率为20.0%,对照组为40.0%,两组比较差异有统计学意义(P<0.05)。两组术后1年肿瘤复发率及生存率比较差异均无统计学意义(P>0.05)。结论对于局限于单个肺叶的早期非小细胞肺癌,杂交式单操作孔胸腔镜下肺叶切除术术中出血量少,术后恢复快,并发症发生率较低。展开更多
文摘AIM: To study the surgical treatment effect and outcome of hepatocellular carcinoma (HCC) with bile duct tumor thrombi (BDTT). METHODS: Fifty-three consecutive HCC patients with BDTT admitted in our department from July 1984 to December 2002 were reviewed retrospectively. The clinical data, diagnostic methods, surgical procedures and outcome of these patients were collected and analyzed. RESULTS: One patient rejected surgical treatment, 6 cases underwent percutaneous transhepatic cholangial drainage (PTCD) for unresectable primary disease, and the other 46 cases underwent surgical operation. The postoperative mortality was 17.6%, and the morbidity was 32.6%. Serum total bilirubin levels of these patients with obstructive jaundice decreased gradually after surgery. The survival time of six cases who underwent PTCD ranged from 2 to 7 mo (median survival of 3.7 mo). The survival time of the patients who received surgery was as follows: 2 mo for one patient who underwent laparotomy, 5-46 mo (median survival of 23.5 mo, which was the longest survival in comparison with patients who underwent other procedures, P=0.0024) for 17 cases who underwent hepatectomy, 5-17 mo (median survival of 10.0 mo) for 5 cases who underwent HACE, 3-9 mo (median survival of 6.1 mo) for 11 cases who underwent simple thrombectomy and biliary drainage, and 3-8 mo (median survival of 4.3 mo) for four cases who underwent simple biliary drainage. CONCLUSION: Jaundice caused by BDTT in HCC patients is not a contraindication for surgery. Only curative resection can result in long-term survival. Early diagnosis and surgical treatment are the key points to prolong the survival of patients.
文摘AIM: To investigate the protective effect of ischemic preconditioning (IPC) on hepatocellular carcinoma (HCC) patients with cirrhosis undergoing hepatic resection under hepatic inflow occlusion (HIO) and its possible mechanism.METHODS: Twenty-nine consecutive patients with resectable OHCC were randomized into two groups: IPC group: before HIO, IPC with 5 min of ischemia and 5 min of reperfusion was given; control group: no IPC was given. Uver functions,hepatic Caspase-3 activity, and apoptotic cells were compared between these two groups.RESULTS: On postoperative days (POD) 1, 3 and 7, the aspartate transaminase (AST) and alanine transaminase (ALT) levels in the IPC group were significantly lower than those in the control group (P<0.05). On POD 3 and 7, the total bilirubin level in the IPC group was significantly lower than that in the control group (P<0.05). On POD 1, the albumin level in the IPC group was higher than that in the control group (P = 0.053). After 1 h of reperfusion, both hepatic Caspase-3 activity and apoptotic sinusoidal endothelial cells in the IPC group were significantly lower than those in the control group (P<0.05).CONCLUSION: IPC has a potential protective effect on HCC patients with cirrhosis. Its protective mechanism underlying the suppression of sinusoidal endothelial cell apoptosis is achieved by inhibiting Caspase-3 activity.
文摘AIM:To explore the dffects of recombinant human growth hormone(rhGH) on the remnant liver after hepatectomy in hepatocellular carcinoma with liver cirrhosis.METHODS:Twenty-four patients with hepoatocellular carcinoma who underwent hepatectomy were randomly diveded into 2 groups:parenteral nutrition(PN) group (n=12) and rhGH+PN group (n=12).Liver function,blood glucose,AFP,serum prealbumin and transferrin were detected before operation,at post-operative d 1 and d 6.Albumin (ALB) mRNA in liver biopsy specimens was detected by RT-PCR at post-operative d 6.Liver Ki67 immunohistochemical staining was studied.RESULTS:On post-operative d 6,compared with PN grouop,the levels of blood glucose,serum prealbumin,transferrin,the expression of hepoatic ALB mRNA and liver Ki67 labeling index were higher in rhGH+PN group.CONCLUSION:rhGH can improve protein synthesis and liver regeneration after hipatectomy in hepatocellular carcinoma with liver cirrhosis.
文摘AIM: To evaluate the therapeutic efficacy of systemic chemo-immunotherapy for advanced hepatocellular carcinoma (HCC). METHODS: Twenty-six patients with advanced HCC were treated by using systemic chemo-immunotherapy (PIAF regimen), which consisted of dsplatin (20 mg/m2) intravenously daily for 4 consecutive day, doxorubicin (40 mg/m2) intravenously on day 1, 5-fluorouracil (400 mg/m2) intravenously daily for 4 consecutive day, and human recombinant a-interferon-2a (5 Mu/m2) subcutaneous injection daily for 4 consecutive day. The treatment was repeated every 3 wk, with a maximum of six cycles. RESULTS: A total of 90 cycles of PIAF treatment were administered, with a mean number of 3.9 cycles per patient. Eight patients received six cycles of treatment (group A), and the remaining 18 were subjected to two to five cycles (group B). There were 0 complete response, 4 partial responses, 9 static diseases and 13 progressive diseases, with a disease control rate of 50% (13/26). The 1-year survival rate was 24.3%, with a median survival time of 6.0 mo. Group A had a remarkably better survival as compared with group B, the 1- and 2-year survival rates were 62.5% vs 6.1% and 32.3% vs 0%, and a median survival time was 12.5 mo vs5.0 mo (P= 0.001). CONCLUSION: Systemic chemo-immunotherapy using PIAF regimen represented an effective treatment and could improve the survival rate and prolong the survival time in selected patients with advanced HCC.
基金Supported by National Postdoctor Natural Science Foundation of China,No.2001-14
文摘AIM: To study the changes of quantitative expression, adhering activity and genomic density polymorphism of complement types in erythrocytes (CR1) of patients with gallbladder carcinoma and the related clinical significance.METHODS: Polymerase chain reaction (PCR), HindⅢ restrdion enzyme digestion, quantitative assay of CR1 and adhering activity assay of CR1 in erythrocytes were used.RESULIFS: The number and adhering actvity of CR1 in patients with gallbladder carcinoma (0.738±0.23, 45.9±5.7) were significantly lower than those in chronic cholecystitis and cholecystolithiasis (1.078±0.21, 55.1±5.9) and healthy controls (1.252±0.31, 64.2±7.4) (P<0.01). The number and adhering activity of CR1 in patients with chronic cholecystitis and cholecystolithiasis (1.078±0.21, 55.1±5.9) were significantly lower than those in healthy controls (1.252±0.31, 64.2±7.4) (P<0.05). There was a positive correlation between quantitative expression and adhering activity of CR1 (r = 0.79, P<0.01).Compared with those on preoperative day (0.738±0.23,45.4±4.9), the number and adhering activity of CR1 in patients with gallbladder carcinoma decreased greatly on the third postoperative day (0.310±0.25, 31.8±5.1) (P<0.01), and on the first postoperative week (0.480±0.25, 38.9±5.2) (P<0.01), but they were increased slightly than those on the preoperative day (P>0.05). The number and adhering activity of CR1 recovered in the second postoperative week (0.740±0.24, 46.8±5.9) (P<0.01) and increased greatly in the third postoperative week (0.858±0.35, 52.7±5.8) (P<0.01) in comparison with those on the preoperative day and in the first postoperative week. The number and adhering activity of CR1 of gallbladder carcinoma patients with infiltrating, adjacent lymphogenous and distant organ metastases were significantly lower than those of gallbladder carcinoma patients without them (P<0.01). No difference was observed between the patients with gallbladder carcinoma and healthy individuals in the spot mutation rate of CR1 density gen
基金Supported by the Natural Science Foundation of Guangdong Province,No.021889
文摘AIM: To induce efficient expansion of natural killer (NK) cells from peripheral blood mononuclear cells (PBMCs) using a culture of anchorage-dependent Wilms tumor cell lines, and to provide a reliable supply for adoptive immunotherapy of hepatocellular carcinoma.METHODS: Culture expansion of NK cells was achieved using PBMCs cultured with Wilms tumor cells. Cytotoxicity was measured using a standard 54^Cr release assay and crystal violet staining technique. The proportions of CD3+,CD4+,CD8+,CD16+, and CD56+ cells were determined by flow cytometry.RESULTS: After PBMCs from healthy donors and hepatocellular carcinoma (HCC) were cultured with irradiated HFWT cells for 10-21 d, CD56+ CD16+ cells shared more than 50% of the cell population, and more than 80% of fresh HFWT cells were killed at an effector/target ratio of 2 over 24 h. NK-enriched lymphocyte population from HCC patients killed HCC-1 and 2 cells with sensitivities comparable to fresh TKB-17RGB cells. HCC cells proliferated 196-fold with the irradiated HFWT cells at 18 d. Stimulation by HFWT cells required intimate cell-cell interaction with PBMC. However, neither the soluble factors released from HFWT cells nor the fixed HFWT cells were effective for NK expansion. The lymphocytes expanded with IL-2 killed fresh HFWT target cells more effectively than the lymphocytes expanded with the 4-cytokine cocktail(IL-1 β, IL-2, IL-4 and IL-6). IL-2 was the sole cytokine required for NK expansion.CONCLUSION: Wilms tumor is sensitive to human NK cells and is highly efficient for selective expansion of NK cells from PBMCs.
文摘目的分析杂交式单操作孔胸腔镜肺叶切除治疗早期非小细胞肺癌的临床疗效。方法早期非小细胞肺癌病人100例,根据手术方法不同分为观察组和对照组,每组各50例,观察组采取单操作孔胸腔镜肺叶切除术,对照组采取三孔胸腔镜肺叶切除术。比较两组病人手术资料、术后恢复情况及并发症发生率。结果所有病人顺利完成手术且术中未出现严重并发症。观察组手术时间及淋巴结清扫数目分别为(163.8±34.0)分钟和(12.5±1.9)个,对照组分别为(153.5±38.4)分钟和(12.3±1.6)个,两组比较差异无统计学意义(P>0.05),观察组术中出血量、切口长度、术后胸腔引流量、术后带管时间、术后住院时间及术后1天视觉模拟评分(visual analog scale,VAS)分别为(174.5±28.0)ml、(1.6±0.3)cm、(455.9±42.7)ml、(2.9±0.4)天、(9.6±1.2)天和(5.2±1.3)分,对照组分别为(225.7±30.0)ml、(4.2±0.6)cm、(620.6±67.3)ml、(3.5±0.5)天、(12.3±2.2)天和(6.5±1.7)分,两组比较差异均有统计学意义(P<0.05)。观察组术后并发症发生率为20.0%,对照组为40.0%,两组比较差异有统计学意义(P<0.05)。两组术后1年肿瘤复发率及生存率比较差异均无统计学意义(P>0.05)。结论对于局限于单个肺叶的早期非小细胞肺癌,杂交式单操作孔胸腔镜下肺叶切除术术中出血量少,术后恢复快,并发症发生率较低。
