Microvascular invasion (MVI), also known as microvascular tumor embolism, refers to the cancer cell nest in vessels lined with endothelial cells. MVI may be found in the small branches of the portal vein and hepatic v...Microvascular invasion (MVI), also known as microvascular tumor embolism, refers to the cancer cell nest in vessels lined with endothelial cells. MVI may be found in the small branches of the portal vein and hepatic vein. Occasionally, MVI may also exist in the hepatic artery, bile duct and lymphatic vessels.展开更多
Proximal point algorithms （PPA） are attractive methods for solving monotone variational inequalities （MVI）. Since solving the sub-problem exactly in each iteration is costly or sometimes impossible, various approx...Proximal point algorithms （PPA） are attractive methods for solving monotone variational inequalities （MVI）. Since solving the sub-problem exactly in each iteration is costly or sometimes impossible, various approximate versions ofPPA （APPA） are developed for practical applications. In this paper, we compare two APPA methods, both of which can be viewed as prediction-correction methods. The only difference is that they use different search directions in the correction-step. By extending the general forward-backward splitting methods, we obtain Algorithm Ⅰ; in the same way, Algorithm Ⅱ is proposed by spreading the general extra-gradient methods. Our analysis explains theoretically why Algorithm Ⅱ usually outperforms Algorithm Ⅰ. For computation practice, we consider a class of MVI with a special structure, and choose the extending Algorithm Ⅱ to implement, which is inspired by the idea of Gauss-Seidel iteration method making full use of information about the latest iteration. And in particular, self-adaptive techniques are adopted to adjust relevant parameters for faster convergence. Finally, some numerical experiments are reported on the separated MVI. Numerical results showed that the extending Algorithm II is feasible and easy to implement with relatively low computation load.展开更多
Background:The survival benefit of postoperative adjuvant transcatheter arterial chemoembolization(PA-TACE)remained controversial.We aimed to investigate the prognosis effect of PA-TACE on the Barcelona Clinic Liver C...Background:The survival benefit of postoperative adjuvant transcatheter arterial chemoembolization(PA-TACE)remained controversial.We aimed to investigate the prognosis effect of PA-TACE on the Barcelona Clinic Liver Cancer(BCLC)early stage multinodular hepatocellular carcinoma(MHCC)patients with/without microvascular invasion(MVI).Methods:Two hundred and seventy-one patients from January 2010 to December 2014 undergoing curative hepatectomy were included in this study.Disease-free survival(DFS)rates and overall survival(OS)rates as well as prognostic factors were analyzed by the Kaplan-Meier method,the log-rank test and the Cox proportional hazard model.Results:Thirty-four point four percent(44/128)MVI positive and 55.2%(79/143)MVI negative patients underwent PA-TACE.Multivariate analysis revealed that HBV DNA load>103 copy/Ml,>three tumors,MVI,and without PA-TACE were independent risk factors for poor DFS.Higher alkaline phosphatase(ALP),three tumors,MVI,and without PA-TACE were independent risk factors for poor OS.Both DFS and OS were significantly improved in patients with MVI who received PA-TACE as compared to those who underwent hepatic resection alone(5-year DFS,26.3%vs.20.7%,P=0.038;5-year OS,73.6%vs.47.7%,P=0.005).No differences were noted in DFS and OS among MVI negative patients with or without PA-TACE(5-year DFS,33.7%vs.33.0%,P=0.471;5-year OS,84.1%vs.80.3%,P=0.523).Early recurrence was more likely to occur in patients without PA-TACE(P=0.001).Conclusions:PA-TACE was a safe intervention and could effectively prevent tumor recurrence and improve the survival of the BCLC early stage MHCC patients with MVI.展开更多
Background:To study the influence of pathological responses(PR)after transcatheter arterial chemoembolization(TACE)on incidences of microvascular invasion(MVI)and early recurrence in hepatocellular carcinoma(HCC)patie...Background:To study the influence of pathological responses(PR)after transcatheter arterial chemoembolization(TACE)on incidences of microvascular invasion(MVI)and early recurrence in hepatocellular carcinoma(HCC)patients.Methods:Between 2013 to 2015,consecutive HCC patients who underwent liver resection with“curative”intent at three hospitals were enrolled in this study.Patients with different areas of PR after preoperative TACE were compared with those without preoperative TACE on the incidences of MVI,early recurrence rates and patterns of recurrence before and after propensity score matching(PSM).Results:Of 1,970 patients,737 patients who received preoperative TACE were divided into three groups according to the areas of PR:≥90%(n=226),60-90%(n=447),and<60%(n=64).PR≥90%was an independent protective factor of incidences of MVI[odds ratio(OR),0.144;95%confidence interval(CI),0.082-0.245,P<0.001)and early recurrence(HR,0.742;95%CI,0.561-0.963,P=0.032);while PR<60%was an independent risk factor of incidences of MVI(OR,6.076;95%CI,3.004-11.728,P<0.001)and early recurrence(HR,1.428;95%CI,1.095-1.929;P=0.009).Furthermore,patients with PR<60%were significantly more likely to develop multiple intrahepatic recurrences involving multiple hepatic segments when compared with patients without preoperative TACE.Conclusions:This study indicated the area of PR after TACE was closely associated with the incidences of MVI and early tumor recurrence.Patients with PR<60%were at significantly higher risks of having more MVI,early and multiple tumor recurrences.展开更多
文摘Microvascular invasion (MVI), also known as microvascular tumor embolism, refers to the cancer cell nest in vessels lined with endothelial cells. MVI may be found in the small branches of the portal vein and hepatic vein. Occasionally, MVI may also exist in the hepatic artery, bile duct and lymphatic vessels.
基金Project (No. 1027054) supported by the National Natural Science Foundation of China
文摘Proximal point algorithms （PPA） are attractive methods for solving monotone variational inequalities （MVI）. Since solving the sub-problem exactly in each iteration is costly or sometimes impossible, various approximate versions ofPPA （APPA） are developed for practical applications. In this paper, we compare two APPA methods, both of which can be viewed as prediction-correction methods. The only difference is that they use different search directions in the correction-step. By extending the general forward-backward splitting methods, we obtain Algorithm Ⅰ; in the same way, Algorithm Ⅱ is proposed by spreading the general extra-gradient methods. Our analysis explains theoretically why Algorithm Ⅱ usually outperforms Algorithm Ⅰ. For computation practice, we consider a class of MVI with a special structure, and choose the extending Algorithm Ⅱ to implement, which is inspired by the idea of Gauss-Seidel iteration method making full use of information about the latest iteration. And in particular, self-adaptive techniques are adopted to adjust relevant parameters for faster convergence. Finally, some numerical experiments are reported on the separated MVI. Numerical results showed that the extending Algorithm II is feasible and easy to implement with relatively low computation load.
基金National Natural Science Foundation of China(grant No.81472278)Funds for Creative Research Groups of National Natural Science Foundation of China(grant No.81521091).
文摘Background:The survival benefit of postoperative adjuvant transcatheter arterial chemoembolization(PA-TACE)remained controversial.We aimed to investigate the prognosis effect of PA-TACE on the Barcelona Clinic Liver Cancer(BCLC)early stage multinodular hepatocellular carcinoma(MHCC)patients with/without microvascular invasion(MVI).Methods:Two hundred and seventy-one patients from January 2010 to December 2014 undergoing curative hepatectomy were included in this study.Disease-free survival(DFS)rates and overall survival(OS)rates as well as prognostic factors were analyzed by the Kaplan-Meier method,the log-rank test and the Cox proportional hazard model.Results:Thirty-four point four percent(44/128)MVI positive and 55.2%(79/143)MVI negative patients underwent PA-TACE.Multivariate analysis revealed that HBV DNA load>103 copy/Ml,>three tumors,MVI,and without PA-TACE were independent risk factors for poor DFS.Higher alkaline phosphatase(ALP),three tumors,MVI,and without PA-TACE were independent risk factors for poor OS.Both DFS and OS were significantly improved in patients with MVI who received PA-TACE as compared to those who underwent hepatic resection alone(5-year DFS,26.3%vs.20.7%,P=0.038;5-year OS,73.6%vs.47.7%,P=0.005).No differences were noted in DFS and OS among MVI negative patients with or without PA-TACE(5-year DFS,33.7%vs.33.0%,P=0.471;5-year OS,84.1%vs.80.3%,P=0.523).Early recurrence was more likely to occur in patients without PA-TACE(P=0.001).Conclusions:PA-TACE was a safe intervention and could effectively prevent tumor recurrence and improve the survival of the BCLC early stage MHCC patients with MVI.
基金the Institutional Ethics Committees of the Eastern Hepatobiliary Surgery Hospital,940 Hospital of PLA Joint Logistic Support Force,and Hai Nan Hospital of Chinese PLA General Hospital(No.EHBHKY2020-K-056)。
文摘Background:To study the influence of pathological responses(PR)after transcatheter arterial chemoembolization(TACE)on incidences of microvascular invasion(MVI)and early recurrence in hepatocellular carcinoma(HCC)patients.Methods:Between 2013 to 2015,consecutive HCC patients who underwent liver resection with“curative”intent at three hospitals were enrolled in this study.Patients with different areas of PR after preoperative TACE were compared with those without preoperative TACE on the incidences of MVI,early recurrence rates and patterns of recurrence before and after propensity score matching(PSM).Results:Of 1,970 patients,737 patients who received preoperative TACE were divided into three groups according to the areas of PR:≥90%(n=226),60-90%(n=447),and<60%(n=64).PR≥90%was an independent protective factor of incidences of MVI[odds ratio(OR),0.144;95%confidence interval(CI),0.082-0.245,P<0.001)and early recurrence(HR,0.742;95%CI,0.561-0.963,P=0.032);while PR<60%was an independent risk factor of incidences of MVI(OR,6.076;95%CI,3.004-11.728,P<0.001)and early recurrence(HR,1.428;95%CI,1.095-1.929;P=0.009).Furthermore,patients with PR<60%were significantly more likely to develop multiple intrahepatic recurrences involving multiple hepatic segments when compared with patients without preoperative TACE.Conclusions:This study indicated the area of PR after TACE was closely associated with the incidences of MVI and early tumor recurrence.Patients with PR<60%were at significantly higher risks of having more MVI,early and multiple tumor recurrences.
