AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performe...AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performed using PubM ed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria:(1) studies comparing pre-transplant low vs high PLR values;(2) studies reporting post-transplant recurrence rates; and(3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation. RESULTS A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases(80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation(OR = 3.33; 95%CI: 1.78-6.25; P < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins I^2 statistic value.CONCLUSION Pre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.展开更多
Objective：To study the inhibitory effect of Fuzheng Yiliu Granule（扶正抑瘤颗粒,FYG） on hepatocellular cancer（HCC） and investigate the mechanism mediating its bioactivity.Methods：H22 tumor-bearing ICR mice were t...Objective：To study the inhibitory effect of Fuzheng Yiliu Granule（扶正抑瘤颗粒,FYG） on hepatocellular cancer（HCC） and investigate the mechanism mediating its bioactivity.Methods：H22 tumor-bearing ICR mice were treated with FYG[3.6 g/（kg·d）]for 5 days.Tumor volume and tumor weight,percentages of CD3~＋,CD4~＋,CD8~＋,and natural killer（NK） cells in peripheral blood,tumor apoptosis and serum levels of interleukin-2（IL-2）,and tumor necrosis factor-α（TNF-α） were evaluated.FYG-containing serum was prepared from SD rats treated for 7 days[high dose 3.6 g/（kg·d）;middle dose 1.8 g/（kg·d）;low dose 0.9 g/（kg·d）].Cell cycle,cell viability,and apoptosis were evaluated after HepG2 cell line was cultured in FYG-containing serum for 48 h.The levels of IL-2 and TNF-αin FYG-containing serum were also determined.Results：FYG produced a potent antitumor effect（P0.01） and induced marked apoptosis of the tumor tissue（P0.05）.Mice treated with FYG had higher percentages of CD3~＋ and CD4~＋（P0.05）,and more NK cells（P0.01） in the peripheral blood than those in the animals treated with normal saline.Mice receiving FYG had the highest serum levels of IL-2 and TNF-α（P0.01）.High-dose FYG-containing serum significantly decreased HepG2 cell viability,inhibited cell proliferation（P0.05）,and induced apoptosis（P0.01）.In addition,the levels of IL-2 and TNF-αof highdose -containing serum were higher than the blank serum（P0.01）.Conclusion：FYG could inhibit HCC growth by regulating immune function and inducing apoptosis of tumor cells in vivo and in vitro.展开更多
AIM: To evaluate vascular endothelial growth factor(VEGF) and tryptase in hepatocellular cancer(HCC)before and after trans-arterial chemoembolization(TACE).METHODS: VEGF and tryptase serum concentrations were assessed...AIM: To evaluate vascular endothelial growth factor(VEGF) and tryptase in hepatocellular cancer(HCC)before and after trans-arterial chemoembolization(TACE).METHODS: VEGF and tryptase serum concentrations were assessed from 71 unresectable HCC patients before and after hepatic TACE performed by binding DC-Beads?to doxorubicin. VEGF levels were examined for each serum sample using the Quantikine Human VEGF-enzyme-linked immuno-absorbent assay(ELISA),whereas tryptase serum concentrations were assessed for each serum sample by means of fluoro-enzyme immunoassay(FEIA) using the Uni-CAP100 tool.Differences between serum VEGF and tryptase values before and after TACE were evaluated using Student t test. Person's correlation was used to assess the degree of association between the two variables.RESULTS: VEGF levels and serum tryptase in HCCpatients before TACE had a mean value and standard deviation(SD) of 114.31 ± 79.58 pg/mL and 8.13± 3.61 μg/L, respectively. The mean levels and SD of VEGF levels and serum tryptase in HCC patients after TACE were 238.14 ± 109.41 pg/mL and 4.02 ±3.03 μg/L. The changes between the mean values of concentration of VEGF and tryptase before treatment and after treatment was statistically significant(P <0.000231 and P < 0.00124, by Wilcoxon-Mann-Whitney respectively). A significant correlation between VEGF levels before and after TACE and between tryptase levels before and after TACE was demonstrated(r =0.68, P = 0.003; r = 0.84, P = 0.000 respectively).CONCLUSION: Our pilot results suggest that the higher serum VEGF levels and the lower tryptase levels following TACE may be potential biomarkers changing in response to therapy.展开更多
Hepatocellular carcinoma(HCC) is now the second leading cause of cancer-related deaths globally and many patients have incurable disease. HCC predominantly occurs in the setting of liver cirrhosis and is a paradigm fo...Hepatocellular carcinoma(HCC) is now the second leading cause of cancer-related deaths globally and many patients have incurable disease. HCC predominantly occurs in the setting of liver cirrhosis and is a paradigm for inflammation-induced cancer. The causes of chronic liver disease promote the development of transformed or premalignant hepatocytes and predisposes to the development of HCC. For HCC to grow and progress it is now clear that it requires an immunosuppressive niche within the fibrogenic microenvironment of cirrhosis. The rationale for targeting this immunosuppression is supported by responses seen in recent trials with checkpoint inhibitors. With the impact of immunotherapy, HCC progression may be delayed and long term durable responses may be seen. This makes the management of the underlying liver cirrhosis in HCC even more crucial as studies demonstrate that measures of liver function are a major prognostic factor in HCC. In this review, we discuss the development of cancer in the setting of liver inflammation and fibrosis, reviewing the microenvironment that leads to this tumourigenic climate and the implications this has for patient management.展开更多
AIM To evaluate the association of 12 tag single nucleotide polymorphisms(tag SNPs) in three onco-long non-coding RNA(lnc RNA) genes(HOTTIP,CCAT2,MALAT1) with the risk and prognosis of hepatocellular cancer(HCC). METH...AIM To evaluate the association of 12 tag single nucleotide polymorphisms(tag SNPs) in three onco-long non-coding RNA(lnc RNA) genes(HOTTIP,CCAT2,MALAT1) with the risk and prognosis of hepatocellular cancer(HCC). METHODS Twelve tag SNPs covering the three onco-lnc RNAs were genotyped by the KASP method in a total of 1338 samples,including 521 HCC patients and frequencymatched 817 controls. The samples were obtained from an unrelated Chinese population at the First Hospital ofChina Medical University from 2012-2015. The expression quantitative trait loci(e QTL) analyses were conducted to explore further the potential function of the promising SNPs. RESULTS Three SNPs in HOTTIP,one promoter SNP in MALAT1,and one haplotype of HOTTIP were associated with HCC risk. The HOTTIP rs17501292,rs2067087,and rs17427960 SNPs were increased to 1.55-,1.20-,and 1.18-fold HCC risk under allelic models(P = 0.012,0.017 and 0.049,respectively). MALAT1 rs4102217 SNP was increased to a 1.32-fold HCC risk under dominant models(P = 0.028). In addition,the two-way interaction of HOTTIP rs17501292-MALAT1 rs619586 polymorphisms showed a decreased effect on HCC risk(P interaction = 0.028,OR = 0.30) and epistasis with each other. HOTTIP rs3807598 variant genotype showed significantly longer survival time in HBV negative subgroup(P = 0.049,HR = 0.12),and MALAT1 rs591291 showed significantly better prognosis in female and HBV negative subgroups(P = 0.022,HR = 0.37; P = 0.042,HR = 0.25,respectively). In the study,no significant effect was observed in e QTL analysis. CONCLUSION Specific lnc RNA(HOTTIP and MALAT1) SNPs have potential to be biomarkers for HCC risk and prognosis.展开更多
Background: Liver transplantation is the treatment for end-stage liver diseases and well-selected malignancies. The allograft shortage may be alleviated with living donation. The initial UCLouvain experience of adult ...Background: Liver transplantation is the treatment for end-stage liver diseases and well-selected malignancies. The allograft shortage may be alleviated with living donation. The initial UCLouvain experience of adult living-donor liver transplantation(LDLT) is presented. Methods: A retrospective analysis of 64 adult-to-adult LDLTs performed at our institution between 1998 and 2016 was conducted. The median age of 29(45.3%) females and 35(54.7%) males was 50.2 years(interquartile range, IQR 32.9–57.5). Twenty-two(34.4%) recipients had no portal hypertension. Three(4.7%) patients had a benign and 33(51.6%) a malignant tumor [19(29.7%) hepatocellular cancer, 11(17.2%) secondary cancer and one(1.6%) each hemangioendothelioma, hepatoblastoma and embryonal liver sarcoma]. Median donor and recipient follow-ups were 93 months(IQR 41–159) and 39 months(22–91), respectively. Results: Right and left hemi-livers were implanted in 39(60.9%) and 25(39.1%) cases, respectively. Median weights of right-and left-liver were 810 g(IQR 730–940) and 454 g(IQR 394–534), respectively. Graft-to-recipient weight ratios(GRWRs) were 1.17%(right, IQR 0.98%-1.4%) and 0.77%(left, 0.59%-0.95%). One-and five-year patient survivals were 85% and 71%(right) vs. 84% and 58%(left), respectively. Oneand five-year graft survivals were 74% and 61%(right) vs. 76% and 53%(left), respectively. The patient and graft survival of right and left grafts and of very small( < 0.6%), small(0.6%–0.79%) and large( ≥0.8%) GRWR were similar. Survival of very small grafts was 86% and 86% at 3-and 12-month. No donor died while five(7.8%) developed a Clavien–Dindo complication IIIa, IIIb or IV. Recipient morbidity consisted mainly of biliary and vascular complications; three(4.7%) recipients developed a small-for-size syndrome according to the Kyushu criteria. Conclusions: Adult-to-adult LDLT is a demanding procedure that widens therapeutic possibilities of many hepatobiliary diseases. The donor procedure can be done safely with low morbidity. The recipie展开更多
目的系统评价含斑蝥素中药制剂对肝癌患者免疫功能的影响。方法检索PubMed、Cochrane Library、EMBASE、Web of Science、中国期刊全文数据库(CNKI)、万方、维普和中国生物医学文献数据库(CBM),检索时间为2014年9月至2019年9月。纳入含...目的系统评价含斑蝥素中药制剂对肝癌患者免疫功能的影响。方法检索PubMed、Cochrane Library、EMBASE、Web of Science、中国期刊全文数据库(CNKI)、万方、维普和中国生物医学文献数据库(CBM),检索时间为2014年9月至2019年9月。纳入含斑蝥素中药制剂治疗肝癌并结局指标包含免疫功能指标的临床随机对照试验文献,对其进行方法学质量评价,并采用Revman5.3进行Meta分析。结果共纳入14项临床研究,1298例肝癌患者。Meta分析结果显示:斑蝥组与对照组比较,CD3^+[MD=8.45,95%CI(3.12,13.79),P=0.002];CD4^+[MD=6.81,95%CI(3.14,10.48),P=0.003];CD4^+/CD8^+[MD=0.32,95%CI(0.23,0.41),P=0.000];NK细胞[MD=5.54,95%CI(4.28,6.80),P=0.000],差异均有统计学意义;CD8^+[MD=-2.37,95%CI(-9.57,4.82),P=0.520],差异无统计学意义。结论含斑蝥素中药制剂能提高肝癌患者CD3^+、CD4^+、NK细胞水平及CD4^+/CD8^+比值,增强肝癌患者的免疫功能。展开更多
AIM:To evaluate the prognostic value of pretreatment F D G p o s i t r o n e m i s s i o n t o m o g ra p h y c o m p u t e d tomography(PET-CT) in patients with hepatocarcinoma treated by liver transplantation(LT).ME...AIM:To evaluate the prognostic value of pretreatment F D G p o s i t r o n e m i s s i o n t o m o g ra p h y c o m p u t e d tomography(PET-CT) in patients with hepatocarcinoma treated by liver transplantation(LT).METHODS:The authors retrospectively analyzed the data of 27 patients(mean age 58 ± 9 years) who underwent FDG PET-CT before LT for hepatocarcinoma.Mean follow-up was 26 ± 18 mo.The FDG PET/CT was performed according to a standard clinical protocol:4 MBq FDG/kg body weight,uptake 60 min,low-dose non-enhanced CT.The authors measured the SUVmax and SUVmean of the tumor and the normal liver.The tumor/liver activity ratios(RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors:MILAN,CLIP,OKUDA,TNM stage,alphafoetoprotein level,portal thrombosis,size of the largest nodule,tumor differentiation,microvascular invasion,underlying cirrhosis and liver function.RESULTS:Overall and recurrence free survivals were80.7%and 67.4%at 3 years,and 70.6%and 67.4%at 5 years,respectively.According to a multivariate Cox model,only FDG PET/CT RSUVmax predicted recurrence free survival.Even though the MILAN criteria alone were not predictive,it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax<1.15 relapsed.CONCLUSION:FDG PET/CT with an RSUVmax cutoff value of 1.15 is a strong prognostic factor for recurrence and death in patients with HCC treated by LT in this retrospective series.Further prospectivestudies should test whether this metabolic index should be systematically included in the preoperative assessment.展开更多
文摘AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performed using PubM ed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria:(1) studies comparing pre-transplant low vs high PLR values;(2) studies reporting post-transplant recurrence rates; and(3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation. RESULTS A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases(80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation(OR = 3.33; 95%CI: 1.78-6.25; P < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins I^2 statistic value.CONCLUSION Pre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.
基金Supported by CHEN Ke-ji Integrative Medicine Development Fund(No.CKJ2010020)International Science Joint Project of the Ministry of Science and Technology of the People's Republic of China(No.2008DFA32200)Project of Department of Education of Fujian Province(No.JA09136)
文摘Objective：To study the inhibitory effect of Fuzheng Yiliu Granule（扶正抑瘤颗粒,FYG） on hepatocellular cancer（HCC） and investigate the mechanism mediating its bioactivity.Methods：H22 tumor-bearing ICR mice were treated with FYG[3.6 g/（kg·d）]for 5 days.Tumor volume and tumor weight,percentages of CD3~＋,CD4~＋,CD8~＋,and natural killer（NK） cells in peripheral blood,tumor apoptosis and serum levels of interleukin-2（IL-2）,and tumor necrosis factor-α（TNF-α） were evaluated.FYG-containing serum was prepared from SD rats treated for 7 days[high dose 3.6 g/（kg·d）;middle dose 1.8 g/（kg·d）;low dose 0.9 g/（kg·d）].Cell cycle,cell viability,and apoptosis were evaluated after HepG2 cell line was cultured in FYG-containing serum for 48 h.The levels of IL-2 and TNF-αin FYG-containing serum were also determined.Results：FYG produced a potent antitumor effect（P0.01） and induced marked apoptosis of the tumor tissue（P0.05）.Mice treated with FYG had higher percentages of CD3~＋ and CD4~＋（P0.05）,and more NK cells（P0.01） in the peripheral blood than those in the animals treated with normal saline.Mice receiving FYG had the highest serum levels of IL-2 and TNF-α（P0.01）.High-dose FYG-containing serum significantly decreased HepG2 cell viability,inhibited cell proliferation（P0.05）,and induced apoptosis（P0.01）.In addition,the levels of IL-2 and TNF-αof highdose -containing serum were higher than the blank serum（P0.01）.Conclusion：FYG could inhibit HCC growth by regulating immune function and inducing apoptosis of tumor cells in vivo and in vitro.
基金Supported by A research grant from the"Alleanza Contro il Cancro"project(partly),the Italian National Health Institute and the Italian Ministry of Health
文摘AIM: To evaluate vascular endothelial growth factor(VEGF) and tryptase in hepatocellular cancer(HCC)before and after trans-arterial chemoembolization(TACE).METHODS: VEGF and tryptase serum concentrations were assessed from 71 unresectable HCC patients before and after hepatic TACE performed by binding DC-Beads?to doxorubicin. VEGF levels were examined for each serum sample using the Quantikine Human VEGF-enzyme-linked immuno-absorbent assay(ELISA),whereas tryptase serum concentrations were assessed for each serum sample by means of fluoro-enzyme immunoassay(FEIA) using the Uni-CAP100 tool.Differences between serum VEGF and tryptase values before and after TACE were evaluated using Student t test. Person's correlation was used to assess the degree of association between the two variables.RESULTS: VEGF levels and serum tryptase in HCCpatients before TACE had a mean value and standard deviation(SD) of 114.31 ± 79.58 pg/mL and 8.13± 3.61 μg/L, respectively. The mean levels and SD of VEGF levels and serum tryptase in HCC patients after TACE were 238.14 ± 109.41 pg/mL and 4.02 ±3.03 μg/L. The changes between the mean values of concentration of VEGF and tryptase before treatment and after treatment was statistically significant(P <0.000231 and P < 0.00124, by Wilcoxon-Mann-Whitney respectively). A significant correlation between VEGF levels before and after TACE and between tryptase levels before and after TACE was demonstrated(r =0.68, P = 0.003; r = 0.84, P = 0.000 respectively).CONCLUSION: Our pilot results suggest that the higher serum VEGF levels and the lower tryptase levels following TACE may be potential biomarkers changing in response to therapy.
文摘Hepatocellular carcinoma(HCC) is now the second leading cause of cancer-related deaths globally and many patients have incurable disease. HCC predominantly occurs in the setting of liver cirrhosis and is a paradigm for inflammation-induced cancer. The causes of chronic liver disease promote the development of transformed or premalignant hepatocytes and predisposes to the development of HCC. For HCC to grow and progress it is now clear that it requires an immunosuppressive niche within the fibrogenic microenvironment of cirrhosis. The rationale for targeting this immunosuppression is supported by responses seen in recent trials with checkpoint inhibitors. With the impact of immunotherapy, HCC progression may be delayed and long term durable responses may be seen. This makes the management of the underlying liver cirrhosis in HCC even more crucial as studies demonstrate that measures of liver function are a major prognostic factor in HCC. In this review, we discuss the development of cancer in the setting of liver inflammation and fibrosis, reviewing the microenvironment that leads to this tumourigenic climate and the implications this has for patient management.
基金the Natural Science Foundation of Liaoning Province in China,No.20170541001
文摘AIM To evaluate the association of 12 tag single nucleotide polymorphisms(tag SNPs) in three onco-long non-coding RNA(lnc RNA) genes(HOTTIP,CCAT2,MALAT1) with the risk and prognosis of hepatocellular cancer(HCC). METHODS Twelve tag SNPs covering the three onco-lnc RNAs were genotyped by the KASP method in a total of 1338 samples,including 521 HCC patients and frequencymatched 817 controls. The samples were obtained from an unrelated Chinese population at the First Hospital ofChina Medical University from 2012-2015. The expression quantitative trait loci(e QTL) analyses were conducted to explore further the potential function of the promising SNPs. RESULTS Three SNPs in HOTTIP,one promoter SNP in MALAT1,and one haplotype of HOTTIP were associated with HCC risk. The HOTTIP rs17501292,rs2067087,and rs17427960 SNPs were increased to 1.55-,1.20-,and 1.18-fold HCC risk under allelic models(P = 0.012,0.017 and 0.049,respectively). MALAT1 rs4102217 SNP was increased to a 1.32-fold HCC risk under dominant models(P = 0.028). In addition,the two-way interaction of HOTTIP rs17501292-MALAT1 rs619586 polymorphisms showed a decreased effect on HCC risk(P interaction = 0.028,OR = 0.30) and epistasis with each other. HOTTIP rs3807598 variant genotype showed significantly longer survival time in HBV negative subgroup(P = 0.049,HR = 0.12),and MALAT1 rs591291 showed significantly better prognosis in female and HBV negative subgroups(P = 0.022,HR = 0.37; P = 0.042,HR = 0.25,respectively). In the study,no significant effect was observed in e QTL analysis. CONCLUSION Specific lnc RNA(HOTTIP and MALAT1) SNPs have potential to be biomarkers for HCC risk and prognosis.
文摘Background: Liver transplantation is the treatment for end-stage liver diseases and well-selected malignancies. The allograft shortage may be alleviated with living donation. The initial UCLouvain experience of adult living-donor liver transplantation(LDLT) is presented. Methods: A retrospective analysis of 64 adult-to-adult LDLTs performed at our institution between 1998 and 2016 was conducted. The median age of 29(45.3%) females and 35(54.7%) males was 50.2 years(interquartile range, IQR 32.9–57.5). Twenty-two(34.4%) recipients had no portal hypertension. Three(4.7%) patients had a benign and 33(51.6%) a malignant tumor [19(29.7%) hepatocellular cancer, 11(17.2%) secondary cancer and one(1.6%) each hemangioendothelioma, hepatoblastoma and embryonal liver sarcoma]. Median donor and recipient follow-ups were 93 months(IQR 41–159) and 39 months(22–91), respectively. Results: Right and left hemi-livers were implanted in 39(60.9%) and 25(39.1%) cases, respectively. Median weights of right-and left-liver were 810 g(IQR 730–940) and 454 g(IQR 394–534), respectively. Graft-to-recipient weight ratios(GRWRs) were 1.17%(right, IQR 0.98%-1.4%) and 0.77%(left, 0.59%-0.95%). One-and five-year patient survivals were 85% and 71%(right) vs. 84% and 58%(left), respectively. Oneand five-year graft survivals were 74% and 61%(right) vs. 76% and 53%(left), respectively. The patient and graft survival of right and left grafts and of very small( < 0.6%), small(0.6%–0.79%) and large( ≥0.8%) GRWR were similar. Survival of very small grafts was 86% and 86% at 3-and 12-month. No donor died while five(7.8%) developed a Clavien–Dindo complication IIIa, IIIb or IV. Recipient morbidity consisted mainly of biliary and vascular complications; three(4.7%) recipients developed a small-for-size syndrome according to the Kyushu criteria. Conclusions: Adult-to-adult LDLT is a demanding procedure that widens therapeutic possibilities of many hepatobiliary diseases. The donor procedure can be done safely with low morbidity. The recipie
文摘目的系统评价含斑蝥素中药制剂对肝癌患者免疫功能的影响。方法检索PubMed、Cochrane Library、EMBASE、Web of Science、中国期刊全文数据库(CNKI)、万方、维普和中国生物医学文献数据库(CBM),检索时间为2014年9月至2019年9月。纳入含斑蝥素中药制剂治疗肝癌并结局指标包含免疫功能指标的临床随机对照试验文献,对其进行方法学质量评价,并采用Revman5.3进行Meta分析。结果共纳入14项临床研究,1298例肝癌患者。Meta分析结果显示:斑蝥组与对照组比较,CD3^+[MD=8.45,95%CI(3.12,13.79),P=0.002];CD4^+[MD=6.81,95%CI(3.14,10.48),P=0.003];CD4^+/CD8^+[MD=0.32,95%CI(0.23,0.41),P=0.000];NK细胞[MD=5.54,95%CI(4.28,6.80),P=0.000],差异均有统计学意义;CD8^+[MD=-2.37,95%CI(-9.57,4.82),P=0.520],差异无统计学意义。结论含斑蝥素中药制剂能提高肝癌患者CD3^+、CD4^+、NK细胞水平及CD4^+/CD8^+比值,增强肝癌患者的免疫功能。
基金Supported by An unrestricted research grant from Astellas BelgiumSM and CM are Ph D fellows with grants from the Académie de Recherche et d’Enseignement Supérieur(ARES)of the Wallonia-Brussels Federation
文摘AIM:To evaluate the prognostic value of pretreatment F D G p o s i t r o n e m i s s i o n t o m o g ra p h y c o m p u t e d tomography(PET-CT) in patients with hepatocarcinoma treated by liver transplantation(LT).METHODS:The authors retrospectively analyzed the data of 27 patients(mean age 58 ± 9 years) who underwent FDG PET-CT before LT for hepatocarcinoma.Mean follow-up was 26 ± 18 mo.The FDG PET/CT was performed according to a standard clinical protocol:4 MBq FDG/kg body weight,uptake 60 min,low-dose non-enhanced CT.The authors measured the SUVmax and SUVmean of the tumor and the normal liver.The tumor/liver activity ratios(RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors:MILAN,CLIP,OKUDA,TNM stage,alphafoetoprotein level,portal thrombosis,size of the largest nodule,tumor differentiation,microvascular invasion,underlying cirrhosis and liver function.RESULTS:Overall and recurrence free survivals were80.7%and 67.4%at 3 years,and 70.6%and 67.4%at 5 years,respectively.According to a multivariate Cox model,only FDG PET/CT RSUVmax predicted recurrence free survival.Even though the MILAN criteria alone were not predictive,it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax<1.15 relapsed.CONCLUSION:FDG PET/CT with an RSUVmax cutoff value of 1.15 is a strong prognostic factor for recurrence and death in patients with HCC treated by LT in this retrospective series.Further prospectivestudies should test whether this metabolic index should be systematically included in the preoperative assessment.
