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中国1990~1992年原发性肝癌死亡调查分析 被引量:124
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作者 张思维 李连弟 +6 位作者 鲁凤珠 牧人 孙秀娣 皇甫小梅 孙杰 周有尚 戴旭东 《中华肿瘤杂志》 CAS CSCD 北大核心 1999年第4期245-249,共5页
目的 通过对中国肝癌死亡流行分布特点分析,探讨肝癌对中国居民健康的危害。方法 对1990~1992 年全国1/10 人口恶性肿瘤死亡抽样调查资料中肝癌死亡情况进行分析。结果肝癌死亡率20.4/10 万( 男性为29.0/... 目的 通过对中国肝癌死亡流行分布特点分析,探讨肝癌对中国居民健康的危害。方法 对1990~1992 年全国1/10 人口恶性肿瘤死亡抽样调查资料中肝癌死亡情况进行分析。结果肝癌死亡率20.4/10 万( 男性为29.0/10 万,女性为11 .2/10 万) ,占全部恶性肿瘤死亡的18 .8 % ,仅次于胃癌居第2 位。肝癌对男性的危害比女性严重,死亡性比例为2 .59。中国肝癌死亡率属于世界高死亡率水平,中国肝癌世界人口调整死亡率男性为33.7/10 万,分别为日本的2 .2 倍,意大利的4.6倍;女性为12 .3/10 万,为日本的3 .1 倍,意大利的5 .1 倍。中国肝癌年龄组死亡率曲线分布有一定特征,肝癌死亡可出现于各年龄组,其中30 ~44 岁组段肝癌死亡位居各肿瘤死亡的第1 位。城乡分布为乡村略高于城市,城市男性累积死亡率为3.5% ,女性为1 .2% ;乡村男性为4.1% ,女性为1 .6% ,均比城市高。肝癌高发区主要在东南沿海一带,呈现一定的地理分布特征。结论 肝癌的防治仍是现在乃至今后我国恶性肿瘤防治研究之重点。 展开更多
关键词 肝肿瘤 原发性 死亡率 流行病学 调查分析
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中国2003-2007年肝癌发病率与死亡率分析 被引量:137
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作者 陈建国 陈万青 +3 位作者 张思维 郑荣寿 朱健 张永辉 《中华流行病学杂志》 CAS CSCD 北大核心 2012年第6期547-553,共7页
目的根据癌症登记报告资料,描述和探讨2003--2007年中国肝癌发病和死亡的特征与趋势。方法采用中国32个癌症登记处2003--2007年肝癌发病与死亡登记年报资料,计算与分析肝癌的发病(死亡)率、中国人口标化率及世界人口标化率;并作年... 目的根据癌症登记报告资料,描述和探讨2003--2007年中国肝癌发病和死亡的特征与趋势。方法采用中国32个癌症登记处2003--2007年肝癌发病与死亡登记年报资料,计算与分析肝癌的发病(死亡)率、中国人口标化率及世界人口标化率;并作年龄别、性别和城乡间发病(死亡)率差异及国际发病(死亡)率的比较分析。结果2003--2007年中国32个癌症登记处观察总数为255430909人年,其中城市197651428人年,农村57779481人年。共登记报告肝癌发病68146例,占全部癌症发病病例的10.03%(居第2位)。年均发病率为26.68/10万(男性39.42/10万,女性13.63/10万),中国和世界人口标化率分别为14.54/10万和20.93/10万;登记报告肝癌死亡63928例,占全部癌症死亡病例的14.56%(居第2位)。年均死亡率为25.03/10万(男性36.41/10万,女性13.37/10万),中国和世界人口标化率分别为13.29/10万和17.45/10万。肝癌发病率和死亡率性别比分别为2.89:1和2.72:1。城市和农村地区肝癌发病率分别为23.91/10万和36.15/10万,死亡率分别为22.39/10万和34.05/10万。肝癌发病和死亡有较大的地区差异:城市发病率10.15/10万至33.85/10万,而农村为11.83/10万至78.59/10万;城市死亡率在13.99/10万至28.45/10万,农村为11.02/10万至71.99/10万。在同期全球184个国家或地区中,中国肝癌发病率水平男性居第5位,女性居第6位;死亡率水平男性居第2位,女性居第5位。结论肝癌是中国目前仅次于肺癌的最主要恶性肿瘤,每年发病和死亡人数分别约在36万和35万,并有继续增高的趋势。府当加强全国性的肝痛峪测和防治。 展开更多
关键词 肝肿瘤 发病率 死亡率 癌症登记 流行病学
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Establishment of cell clones with different metastatic potential from the metastatic hepatocellular carcinoma cell line MHCC97 被引量:111
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作者 Yan Li Zhao-You Tang Sheng-Long Ye Yin-Kun Liu Jie Chen Qiong Xue Jun Chen Dong-Mei Gao Wei-Hua Bao Liver Cancer Institute and Zhongshan Hospital of Fudan University (Former Liver Cancer Institute of Shanghai Medical University),Shanghai 200032,China 《World Journal of Gastroenterology》 SCIE CAS CSCD 2001年第5期630-636,共7页
AIM: To establish clone cells with different metastatic potential for the study of metastasis-related mechanisms. METHODS: Cloning procedure was performed on parental hepatocellular carcinoma (HCC) cell line MHCC97, a... AIM: To establish clone cells with different metastatic potential for the study of metastasis-related mechanisms. METHODS: Cloning procedure was performed on parental hepatocellular carcinoma (HCC) cell line MHCC97, and biological characteristics of the target clones selected by in vivo screening were studied. RESULTS: Two clones with high (MHCC97-H) and low (MHCC97-L) metastatic potential were isolated from the parent cell line. Compared with MHCC97-L, MHCC97-H had smaller cell size (average cell diameter 43 microm vs 50 microm) and faster in vitro and in vivo growth rate (tumor cell doubling time was 34.2h vs 60.0h). The main ranges of chromosomes were 55-58 in MHCC97-H and 57-62 in MHCC97-L. Boyden chamber in vitro invasion assay demonstrated that the number of penetrating cells through the artificial basement membrane was (37.5 +/- 11.0) cells/field for MHCC97-H vs (17.7 +/- 6.3)/field for MHCC97-L. The proportions of cells in G0-G1 phase, S phase, and G2-M phase for MHCC97-H/MHCC97-L were 0.56/0.65, 0.28/0.25 and 0.16/0.10, respectively, as measured by flow cytometry. The serum AFP levels in nude mice 5wk after orthotopic implantation of tumor tissue were (246 +/- 66) microg.L(-1) for MHCC97-H and (91 +/- 66) microg.L(-1) for MHCC97-L. The pulmonary metastatic rate was 100% (10/10) vs 40% (4/10). CONCLUSION: Two clones of the same genetic background but with different biological behaviors were established, which could be valuable models for investigation on HCC metastasis. 展开更多
关键词 ALBUMINS Animals Carcinoma Hepatocellular Cell Division Chromosomes Clone Cells Flow Cytometry Hepatitis B Hepatitis B Surface Antigens Hepatitis B virus purification Humans Keratin liver liver neoplasms Experimental Male MICE Mice Inbred BALB C Mice Nude neoplasm Invasiveness Research Support Non-U.S. Gov't Tumor Cells Cultured Virus Integration ALPHA-FETOPROTEINS
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Antitumor activities of human autologous cytokineinduced killer(CIK)cells against hepatocellular carcinoma cells in vitro and in vivo 被引量:107
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作者 Fu-Sheng Wang Ming-Xu Liu Bing Zhang Ming Shi Zhou-Yun Lei Wen-Bing Sun Qing-You Du Ju-Mei Chen,Division of Biological Engineering,Beijing Institute of Infectious Diseases,Beijing 100039,China Wen-Bing Sun,Department of Surgery,Beijing Hospital of Infectious Diseases,Beijing 100039,China 《World Journal of Gastroenterology》 SCIE CAS CSCD 2002年第3期464-468,共5页
AIM: To characterize the anticancer function of cytokine-induced killer cells (CIK) and develop an adoptive immunotherapy for the patients with primary hepatocellular carcinoma (HCC), we evaluated the proliferation ra... AIM: To characterize the anticancer function of cytokine-induced killer cells (CIK) and develop an adoptive immunotherapy for the patients with primary hepatocellular carcinoma (HCC), we evaluated the proliferation rate, phenotype and the antitumor activity of human CIK cells from healthy donors and HCC patients in vitro and in vivo. METHODS: Peripheral blood mononuclear cells (PBMC) from healthy donors and patients with primary HCC were incubated in vitro and induced into CIK cells in the presence of various cytokines such as interferon-gamma (IFN-gamma), interleukin-1 (IL-1), IL-2 and monoclonal antibody (mAb) against CD3. The phenotype and characterization of CIK cells were identified by flow cytometric analysis. The cytotoxicity of CIK cells was determined by (51)Cr release assay. RESULTS: The CIK cells were shown to be a heterogeneous population with different cellular phenotypes. The percentage of CD3+/CD56+ positive cells, the dominant effector cells, in total CIK cells from healthy donors and HCC patients, significantly increased from 0.1-0.13% at day 0 to 19.0-20.5% at day 21 incubation, which suggested that the CD3+ CD56+ positive cells proliferated faster than other cell populations of CIK cells in the protocol used in this study. After 28 day in vitro incubation, the CIK cells from patients with HCC and healthy donors increased by more than 300-fold and 500-fold in proliferation cell number, respectively. CIK cells originated from HCC patients possessed a higher in vitro antitumor cytotoxic activity on autologous HCC cells than the autologous lymphokine-activated killer (LAK) cells and PBMC cells. In in vivo animal experiment, CIK cells had stronger effects on the inhibition of tumor growth in Balb/c nude mice bearing BEL-7402-producing tumor than LAK cells (mean inhibitory rate, 84.7% vs 52.8%, P【0.05) or PBMC (mean inhibitory rate, 84.7% vs 37.1%, P【0.01). CONCLUSION: Autologous CIK cells are of highly efficient cytotoxic effector cells against primary hepatocellular carcinoma cells and might 展开更多
关键词 Animals Carcinoma Hepatocellular Cell Division Cytokines Cytotoxicity Immunologic Humans IMMUNOPHENOTYPING Immunotherapy Adoptive Killer Cells liver neoplasms MICE Mice Nude neoplasm Transplantation Research Support Non-U.S. Gov't Transplantation Heterologous Tumor Cells Cultured
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Multimodality treatment in hepatocellular carcinoma patients with tumor thrombi in portal vein 被引量:80
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作者 Jia Fan Zhi Quan Wu +5 位作者 Zhao You Tang Jian Zhou Shuang Jian Qiu Zeng Chen Ma Xin Da Zhou Sheng Long Ye Liver Cancer Institute, Zhongshan Hospital, Fudan University Medical Center (Former Shanghai University), 136 Yixueyuan Road, Shanghai 200032, China 《World Journal of Gastroenterology》 SCIE CAS CSCD 2001年第1期28-32,共5页
AIM: To compare the therapeutic effect and significances of multimodality treatment for hepatocellular carcinoma (HCC) with tumor thrombi in portal vein (PVTT). METHODS: HCC patients (n=147) with tumor thrombi in the ... AIM: To compare the therapeutic effect and significances of multimodality treatment for hepatocellular carcinoma (HCC) with tumor thrombi in portal vein (PVTT). METHODS: HCC patients (n=147) with tumor thrombi in the main portal vein or the first branch of portal vein were divided into four groups by the several therapeutic methods. There were conservative treatment group in 18 out of patients (group A); and hepatic artery ligation(HAL) and/or hepatic artery infusion (HAI) group in 18 patients (group B), in whom postoperative chemoembolization was done periodically; group of removal of HCC with PVTT in 79 (group C) and group of transcatheter hepatic arterial chemoembolization (TACE) or HAI and/or portal vein infusion (PVI) after operation in 32 (group D). RESULTS: The median survival period was 12 months in our series and the 1-,3-, and 5-year survival rates were 44.3%, 24.5% and 15.2%, respectively. The median survival times were 2, 5, 12 and 16 months in group A, B, C and D, respectively. The 1-, 3- and 5-year survival rates were 5.6%, 0% and 0% in group A; 22.2%, 5.6% and 0% in group B; 53.9%, 26.9% and 16.6% in group C; 79.3%, 38.9% and 26.8% in group D, respectively. Significant difference appeared in the survival rates among the groups (P 【 0.05). CONCLUSION: Hepatic resection with removal of tumor thrombi and HCC should increase the curative effects and be encouraged for the prolongation of life span and quality of life for HCC patients with PVTT, whereas the best therapeutic method for HCC with PVTT is with regional hepatic chemotherapy or chemoembolization after hepatic resection with removal of tumor thrombi. 展开更多
关键词 Chemoembolization Therapeutic neoplasm Circulating Cells Adult Aged Antineoplastic Agents Carcinoma Hepatocellular Combined Modality Therapy Comparative Study Female Hepatic Artery Humans LIGATION liver neoplasms Male Middle Aged Portal Vein Prognosis Research Support Non-U.S. Gov't Survival Rate
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The prognostic significance of clinical and pathological features in hepatocellular carcinoma 被引量:77
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作者 Lun-Xiu Qin Zhao-You Tang,Liver Cancer Institute and Zhongshan Hospital,Fudan University,Shanghai,China 《World Journal of Gastroenterology》 SCIE CAS CSCD 2002年第2期193-199,共7页
The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, such as patient's general ... The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, such as patient's general conditions, macroscopic tumor morphology, as well as tumor histopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are worse than the older ones. Co-existing hepatitis status and hepatic functional reserve have been confirmed as risk factors for recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features, such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and advanced pTNM stage, are the best-established risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. Extratumor spreading and lymph nodal metastasis are independent predictors for poor outcome. Some new predictive systems have recently been proposed. Different strategies of treatment might have significant different effects on the patients' prognosis. To date, surgical resection is still the only potentially curative treatment for HCC, including localized postoperative recurrences. Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of HCC patients who have no opportunity to rece 展开更多
关键词 Age Factors Carcinoma Hepatocellular HEPATITIS Humans liver Cirrhosis liver neoplasms neoplasm Staging Prognosis RECURRENCE Sex Factors ALPHA-FETOPROTEINS
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Current and future treatments for hepatocellular carcinoma 被引量:78
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作者 Alexander Schlachterman Willie W Craft Jr +2 位作者 Eric Hilgenfeldt Avir Mitra Roniel Cabrera 《World Journal of Gastroenterology》 SCIE CAS 2015年第28期8478-8491,共14页
Hepatocellular carcinoma(HCC) represents a unique challenge for physicians and patients.There is no definitively curative treatment.Rather,many treatment and management modalities exist with differing advantages and d... Hepatocellular carcinoma(HCC) represents a unique challenge for physicians and patients.There is no definitively curative treatment.Rather,many treatment and management modalities exist with differing advantages and disadvantages.Both current guidelines and individual patient concerns must be taken into account in order to properly manage HCC.In addition,quality of life issues are particularly complex in patients with HCC and these concerns must also be factored into treatment strategies.Thus,considering all the options and their various pros and cons can quickly become complex for both clinicians and patients.In this review,we systematically discuss the current treatment modalities available for HCC,detailing relevant clinical data,risks and rewards and overall outcomes for each approach.Surgical options discussed include resection,transplantation and ablation.We also discuss the radiation modalities:conformal radiotherapy,yttrium 90 microspheres and proton and heavy ion radiotherapy.The biologic agent Sorafenib is discussed as a promising new approach,and recent clinical trials are reviewed.We then detail currently described molecular pathways implicated in the initiation and progression of HCC,and we explore the potential of each pathway as an avenue for drug exploitation.We hope this comprehensive and forward-looking review enables both clinicians and patients to understand various options and thereby make more informed decisions regarding this disease. 展开更多
关键词 Hepatocellular carcinoma HEPATOMA Hepatocellular cancer liver cancer Adult liver cell carcinoma liver neoplasm Hepatic neoplasm
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肝癌发生发展机制的研究进展及其治疗现状 被引量:81
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作者 陈世发 赵礼金 《中国普通外科杂志》 CAS CSCD 北大核心 2018年第7期910-923,共14页
肝癌是预后较差的恶性肿瘤,发病率及病死率高。迄今为止,肝癌的发生发展机制尚未完全明确。多学科综合治疗是治疗肝癌的主要手段。笔者综述肝癌发病机制及治疗的研究进展,以期望为肝癌提供更好诊断及治疗的策略。
关键词 肝肿瘤 肿瘤形成过程 肿瘤分期 综述文献
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超声造影对肝转移癌的诊断价值 被引量:65
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作者 尹珊珊 陈敏华 +5 位作者 严昆 吴薇 杨薇 范智慧 王艳滨 戴莹 《中华超声影像学杂志》 CSCD 2005年第5期354-358,共5页
目的观察超声造影对肝转移癌的灌注过程及回声变化规律,探讨超声造影对肝转移癌的诊断应用价值。方法应用超声造影剂SonoVue及CnTI实时灰阶造影匹配成像技术,对53例被确诊患有恶性肿瘤并经超声检查检出或疑有肝占位者行超声造影检查,增... 目的观察超声造影对肝转移癌的灌注过程及回声变化规律,探讨超声造影对肝转移癌的诊断应用价值。方法应用超声造影剂SonoVue及CnTI实时灰阶造影匹配成像技术,对53例被确诊患有恶性肿瘤并经超声检查检出或疑有肝占位者行超声造影检查,增强CT检查其中49例发现肝占位。超声造影记录所观察病灶的造影剂灌注过程,转移灶的大小、数目,并与常规超声及增强CT结果进行比较。结果常规超声检查53例发现131个病灶,超声造影确认51例193个病灶,22例发现新病灶62个,其中<1.0cm占41.9%(26灶);CT发现新病灶46个;常规超声、CT、超声造影3种方法显示的最小病灶分别为0.8cm,0.9cm,0.6cm。51例肝转移癌109个重点观察病灶超声造影的灌注特征呈4种形式:第一种为肿瘤周边呈快速环状强化,本组占72.5%(79个灶);第二种为动脉期快速团状强化,快速廓清,占15.6%(17个灶);第三种为动脉期至实质期病灶内均无增强,占8.2%(9个灶);第四种动脉期或门脉期延迟增强或与肝同步,实质后期轻度退出,占3.7%(4个灶)。结论肝转移癌超声造影灌注特征的研究以及对转移癌数目、部位的确认,尤在实质期对小转移灶及临床前期微小癌灶的早期检出,对临床分期诊断及治疗方法的选择提供了重要的依据,有较高的临床应用价值。 展开更多
关键词 肝转移癌 诊断价值 SONOVUE 增强CT检查 临床应用价值 灌注过程 超声检查 超声造影剂 动脉期 变化规律 成像技术 灰阶造影 造影检查 恶性肿瘤 延迟增强 早期检出 临床前期 小转移灶 治疗方法 分期诊断 肝占位 实质期 小病灶
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灰阶超声造影新技术对肝肿瘤诊断及射频治疗的应用价值 被引量:49
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作者 陈敏华 严昆 +3 位作者 戴莹 沈理 姜晓龙 尹珊珊 《中国医学影像技术》 CSCD 2004年第3期326-330,共5页
目的 观察新型超声造影剂SonoVue及实时灰阶造影成像技术 (CnTI)对肝脏肿瘤的灌注过程及回声变化规律 ,探讨其对肝脏恶性肿瘤诊断及射频消融治疗的应用价值。方法  3 5例超声不能完全明确诊断或漏诊的肝脏占位患者 ,2 6例经手术或穿... 目的 观察新型超声造影剂SonoVue及实时灰阶造影成像技术 (CnTI)对肝脏肿瘤的灌注过程及回声变化规律 ,探讨其对肝脏恶性肿瘤诊断及射频消融治疗的应用价值。方法  3 5例超声不能完全明确诊断或漏诊的肝脏占位患者 ,2 6例经手术或穿刺病理确诊 ,9例为增强CT、核磁共振等临床资料证实 ;原发性肝癌 2 3例 ,肝转移癌 5例 ,良性病变 7例。原发性肝癌中 14例为射频治疗前检查。结果 原发性肝癌 2 3例均发生动脉早期强化 ,2 1例 (91.3 %)实质期呈快速消退 ,即“快进快出”型 ;另 2例 <2cm的高分化小肝癌则消退缓慢。肝转移性肿瘤 5例表现多样 ,呈动脉期或门脉期环状强化或不同程度强化 ,消退快慢不一。肝血管瘤 3例动脉期瘤内无强化 ,门静脉期呈向心性填充增强 ,持续数分钟后消退 ;余 4例良性病灶变化不典型。射频组 14例 2 6个HCC瘤灶中 9个肿瘤 (3 4.6%)可显示荷瘤血管 ;12个灶 (4 6.1%)造影后显示原病灶范围增大 ,其中边界不清晰及无晕征的肿瘤增大明显 ,此结果有助于确定射频消融范围。结论 新型超声造影技术对肝脏占位病变的定性诊断灵敏而有效 ,显示肿瘤实际大小、数目和发现微小病灶等可极大地提高超声对肝脏占位病变的诊断价值 ,并为射频适应征的选择和治疗方案的制定提供了依据。 展开更多
关键词 超声检查 造影剂 肝肿瘤 射频消融
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Recurrence or metastasis of HCC:predictors,early detection and experimental antiangiogenic therapy 被引量:57
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作者 Jiang YF Yang ZH Hu JQ 《World Journal of Gastroenterology》 SCIE CAS CSCD 2000年第1期61-65,共5页
AIM To investigate the predictors forrecurrence or metastasis of HCC,and toevaluate the effect of antiangiogenic therapy onthe growth of transplantable human HCC in nudemice.METHODS RT-PCR was used to measure theexpre... AIM To investigate the predictors forrecurrence or metastasis of HCC,and toevaluate the effect of antiangiogenic therapy onthe growth of transplantable human HCC in nudemice.METHODS RT-PCR was used to measure theexpression of matrix metalloproteinase-9(MMP-9)and vascular endothelial growth factor(VEGF)in 56 pairs of nontumorous liver andtumor samples.Sixty blood samples from humanHCC were examined by nested RT-PCR to find outAFP mRNA.Recombinant human endostatin andpolyclonal antibody against VEGF wereadministered to treat human HCC transplanted innude mice.RESULTS Thirty of 56 HCC samples showedstronger expression of MMP-9 in tumoroustissues than in nontumorous tissues.Fifteen ofthe 26 patients with relative expression level ofMMP-9 more than 0.34 developed tumorrecurrence or metastasis,whereas only 7 of 30patients with relative expression level less than0.34 developed tumor recurrence(P【0.05).There was no significant difference in therelative expression level of VEGF betweenpatients with postoperative recurrence ormetastasis and those without recurrence.AFPmRNA was detectable in 53.3% of patients withHCC.The sensitivity and specificity of AFPmRNA as a marker to detect hematogenousdissemination of HCC cells was 81.8% and84.4%,respectively.Recombinant human endostatin and polyclonal antibody against VEGFinhibited the growth of transplantable HCC innude mice by 52.2% and 45.7%,respectively.CONCLUSION MMP-9 expression in HCCcorrelates with the postoperative recurrence ormetastasis of HCC.Patients with high level ofMMP-9 expression in HCC are susceptible tometastasis.AFP mRNA could serve as anindicator of hematogenous spreading of HCCcells in circulation and a predictor of recurrenceor metastasis of HCC.Antiangiogenesis may bean adjuvant therapy for HCC. 展开更多
关键词 Subject headings carcinoma HEPATOCELLULAR neoplasm METASTASIS angiogenesis liver neoplasmS
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原发性肝癌的外科治疗:20年7566例的临床经验 被引量:58
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作者 樊嘉 周俭 +5 位作者 吴志全 汤钊猷 周信达 马曾辰 钦伦秀 王征 《中华消化外科杂志》 CAS CSCD 2009年第2期99-102,共4页
目的总结原发性肝癌外科治疗的临床经验。方法回顾性分析复旦大学附属中山医院肝癌研究所1988年1月至2007年12月7566例原发性肝癌外科治疗的临床资料。采用Kaplan—Meier法计算术后生存率和无复发生存率,Log—rank检验比较组间差异,... 目的总结原发性肝癌外科治疗的临床经验。方法回顾性分析复旦大学附属中山医院肝癌研究所1988年1月至2007年12月7566例原发性肝癌外科治疗的临床资料。采用Kaplan—Meier法计算术后生存率和无复发生存率,Log—rank检验比较组间差异,多因素分析采用Cox回归模型。结果7164例肝癌肝切除患者术后3、5、10年生存率分别为56.29%、41.76%、26.70%,无复发生存率分别为63.92%、56.12%、42.97%,围手术期死亡率为1.54%。肿瘤直径45cm的小肝癌患者术后5、10年生存率分别为58.20%、38.47%,肿瘤直径〉5cm的大肝癌患者术后5、10年生存率分别为31.42%、20.43%,两者比较差异有统计学意义(Χ^2=535.568,P〈0.01)。110例肿瘤降期后切除患者、515例术后复发再次切除患者、168例肝癌合并门静脉主干癌栓患者的5年生存率分别为51.26%、67.28%、26.81%,5年无复发生存率分别为77.44%、13.01%(统计始于第1次手术)、34.90%。402例肝癌肝移植患者术后3、5年生存率及无复发生存率分别为60.81%、55.63%及64.47%、58.52%。肿瘤直径、数目、分化程度及大血管侵犯是影响肝癌肝切除患者生存率及无复发生存率的独立预后因素()(。=200.539,27.536,96.964,216.156,P〈0.01)。结论肝癌早期筛查和治疗,手术安全性的提高,综合治疗模式的开展,预防转移、复发研究的突破,显著地提高了肝癌外科治疗的效果。 展开更多
关键词 肝肿瘤 肝切除术 肝移植 预后 肿瘤转移 复发
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Experimental study on antitumor effect of arsenic trioxide in combination with cisplatin or doxorubicin on hepatocellular carcinoma 被引量:50
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作者 Wei Wang~1 Shu-Kui Qin~1 Bao-An Chen~2 Hui-Ying Chen~1 1 Chinese PLA Cancer Center,Chinese PLA 81 Hospital,Nanjing 210002,Jiangshu Province,China2 Affliliated Zhongda Hospital of Southeast University Medical College,Nanjing 210087,Jiangsu Province,China 《World Journal of Gastroenterology》 SCIE CAS CSCD 2001年第5期702-705,共4页
INTRODUCTIONThe main component of a traditional Chinese drug 'Pishuang'. arsenic trioxide (As2O3), has obviously selective anti-tumor effect on human hepatocellular carcinoma (HCC)in both in vitro and in vivo ... INTRODUCTIONThe main component of a traditional Chinese drug 'Pishuang'. arsenic trioxide (As2O3), has obviously selective anti-tumor effect on human hepatocellular carcinoma (HCC)in both in vitro and in vivo studies[1-5]. Due to limited effectiveness when any anti-carcinogen is used alone and obviously increased toxicity when the dose is raised, there is no exception for As2O3. Furthermore, combined chemotherapy contributes to improve therapeutic effectiveness, disperse toxicity and surmount drug-resistance,in which the combination of traditional Chinese and modern medicine has more advantages and characteristics. As a result,we made an experimental study on anti-tumor effect of As2O3in combination with cisplantin (PDD) or doxorubicin (ADM)on HCC. to investigate the possibility of AS2O3 in combination with PDD or ADM and nature of interaction between them,and to provide experimental basis for clinical application. 展开更多
关键词 Animals Antineoplastic Agents Antineoplastic Combined Chemotherapy Protocols ARSENICALS Carcinoma Hepatocellular CISPLATIN DOXORUBICIN Female Humans liver neoplasms Experimental Male MICE Mice Inbred Strains neoplasm Transplantation Oxides Research Support Non-U.S. Gov't Tumor Cells Cultured
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中国2008年肝癌发病、死亡和患病情况的估计与预测 被引量:52
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作者 李倩 杜佳 +3 位作者 关鹏 杜君 曲春枫 代敏 《中华流行病学杂志》 CAS CSCD 北大核心 2012年第6期554-557,共4页
目的估计中国2008年肝癌发病、死亡和患病情况,并预测未来20年发病数和死亡数。方法根据中国36个肿瘤登记点的数据以及全国第三次死因调查(2004--2005年)的结果,估计中国2008年肝癌发病、死亡和患病情况,并预测2010、2015、2020、2... 目的估计中国2008年肝癌发病、死亡和患病情况,并预测未来20年发病数和死亡数。方法根据中国36个肿瘤登记点的数据以及全国第三次死因调查(2004--2005年)的结果,估计中国2008年肝癌发病、死亡和患病情况,并预测2010、2015、2020、2025和2030年肝癌的发病数和死亡数。结果2008年中国肝癌新发病例数约为40.2万(占所有恶性肿瘤发病例数的14.3%),死亡病例数约为37.2万(占所有恶性肿瘤死亡例数的19.0%)。世界人口标化发病率和标化死亡率分别为25.7/10万(居所有恶性肿瘤第3位)和23.7/10万(居所有恶性肿瘤第2位)。2008年中国15岁以上人群肝癌5年患病数约为29.6万,占所有恶性肿瘤5年患病数的6.4%,5年患病率为27.7/10万,排在所有恶性肿瘤的第6位。在肝癌新发病例中72.8%为男性,男女性别比为2.7:1;死亡病例中74.3%为男性,男女性别比为2.9:1。在任何年龄段,男性肝癌的发病率和死亡率均高于女性。40岁以上人群,尤其是男性,是肝癌的高发人群;未来20年,中国肝癌的发病数和死亡数均将呈现上升趋势。结论肝癌是中国主要癌症之一,其死亡率仅次于肺癌,发病和死亡情况在未来20年将越来越严峻,40岁以上男性是肝癌重点防控人群。 展开更多
关键词 肝肿瘤 发病率 死亡率 患病数
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经皮肝穿刺射频热凝治疗肝脏恶性肿瘤 被引量:49
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作者 张智坚 吴孟超 +2 位作者 陈汉 陈夷 郭佳 《中华外科杂志》 CAS CSCD 北大核心 2001年第10期749-752,T001,共5页
目的 探讨经皮肝穿刺射频热凝治疗肝癌的意义、适应证和疗效评价标准。 方法1999年 10月~ 2 0 0 0年 10月 ,10 0例肝脏恶性肿瘤患者进行了B超引导经皮肝穿刺射频热凝治疗。患者治疗后每个月进行血清肿瘤标记物检测、B超检查 ,治疗后 ... 目的 探讨经皮肝穿刺射频热凝治疗肝癌的意义、适应证和疗效评价标准。 方法1999年 10月~ 2 0 0 0年 10月 ,10 0例肝脏恶性肿瘤患者进行了B超引导经皮肝穿刺射频热凝治疗。患者治疗后每个月进行血清肿瘤标记物检测、B超检查 ,治疗后 1个月复查MRI。 结果 患者肝功能ChildA级 6 7例 ,ChildB级 2 9例 ,ChildC级 4例。原发性肝癌 76例 ,转移性肝癌 2 4例。小肝癌 (未手术 ,肿瘤直径≤ 5cm)甲胎蛋白阳性者治疗后甲胎蛋白转阴占 75 0 % (2 1 2 8) ,明显下降占 2 1 4% (6 2 8)。B超复查肿瘤缩小、MRI或CT提示≤ 5cm肿瘤完全凝固性坏死率 85 9% (6 1 71)。 结论 经皮肝穿刺射频热凝 (PRFA)作为肿瘤透热治疗的一种方法 ,对于小肝癌尤其是无手术指征 ,或有手术指征但位于肝中央区、临近腔静脉或肝门区的小肝癌 ,是一种微创、时间短、安全方便、疗效可靠的新方法。对于大肝癌 ,PRFA可与肝动脉介入化疗栓塞联合应用 ,提高疗效。 展开更多
关键词 肝肿瘤 电外科手术 射频治疗 电凝法 适应证 PRFA
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基于CT图像的纹理分析鉴别肝脏实性局灶性病变 被引量:51
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作者 黄燕琪 马泽兰 +3 位作者 何兰 梁翠珊 梁长虹 刘再毅 《中国医学影像学杂志》 CSCD 北大核心 2016年第4期289-292,297,共5页
目的 CT是鉴别肝脏实性局灶性病灶的常用检查方法,但其对不典型病灶的鉴别诊断仍有较大的经验依赖性,而纹理分析可以提供客观、定量的图像描述特征。本研究旨在探讨基于CT图像的纹理分析在肝脏实性局灶性病变鉴别诊断中的价值。资料与... 目的 CT是鉴别肝脏实性局灶性病灶的常用检查方法,但其对不典型病灶的鉴别诊断仍有较大的经验依赖性,而纹理分析可以提供客观、定量的图像描述特征。本研究旨在探讨基于CT图像的纹理分析在肝脏实性局灶性病变鉴别诊断中的价值。资料与方法回顾性分析258例经病理证实或临床确诊的肝脏局灶性病变患者的CT图像,其中肝脏局灶性结节增生(FNH)34例,血管瘤(HEM)60例,肝细胞肝癌(HCC)60例,肝内胆管细胞癌(ICC)44例,转移瘤(MET)60例。所有患者均行腹部CT平扫与三期增强扫描。以Ma Zda软件生成CT图像的纹理特征并进行特征筛选,进行各组病灶的判别。结果 258例患者中,基于增强CT图像的纹理分析对于肝脏实性局灶性病变的鉴别诊断错判率(4.26%~37.80%)低于基于平扫图像的纹理分析(9.57%~39.02%)。对于良恶性病变的鉴别,门静脉期图像纹理分析错判率最低(13.57%);对于FNH与HEM的鉴别,动脉期及门静脉期图像纹理分析效果相当(错判率为4.26%);对于恶性肿瘤间的鉴别纹理分析错判率相对较高,若于恶性肿瘤间两两鉴别则错判率可降低(错判率最低为HCC与MET,约11.67%)。结论基于CT图像的纹理分析可以作为肝脏实性局灶性病灶鉴别诊断的辅助手段,尤其是FNH与HEM、良性病灶与恶性病灶、恶性病灶间的两两鉴别;其中基于三期增强扫描的纹理分析较基于平扫图像者效果更优。 展开更多
关键词 肝疾病 结节病 肝肿瘤 血管瘤 肝细胞 胆管肿瘤 肿瘤转移 体层摄影术 螺旋计算机 图像增强 诊断 鉴别
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Alterations in metastatic properties of hepatocellular carcinoma cell following H-ras oncogene transfection 被引量:48
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作者 Qing Wang~1 Zhi Ying Lin~2 Xiao Li Feng~3 ~1Department of Microbiology,Medical Center of Fudan University.the former Shanghai Medical University,Shanghai 200032,China ~2Liver Cancer Institute,Zhongshan Hospital,Shanghai 200032,China ~3Shanghai Institute of Biochemistry,Academy Sinica,Shanghai 200031,ChinaQing Wang earned master degree from Shanghai Medical University in 1996,now a senior lecturer of microbiology,specialized in the role of oncogcncs on tumor metastasis,having 8 papers published. 《World Journal of Gastroenterology》 SCIE CAS CSCD 2001年第3期335-339,共5页
AIM: To demonstrate the relationship between H-ras oncogene and hepatocellular carcinoma (HCC) metastasis. METHODS: Activated H-ras oncogene was transfected into SMMC 7721, a cell line derived from human HCC, by calci... AIM: To demonstrate the relationship between H-ras oncogene and hepatocellular carcinoma (HCC) metastasis. METHODS: Activated H-ras oncogene was transfected into SMMC 7721, a cell line derived from human HCC, by calcium phosphate transfection method. Some metastasis-related parameters were detected in vitro, including adhesion assay, migration assay, expression of collagenase IV(c IV ase) and epidermal growth factor receptor (EGFR). RESULTS: The abilities of H-ras-transfected cell clones in adhesion to laminin (LN) or fibronectin (FN), migration, c IV ase secretion increased markedly, and the expression of EGFR elevated moderately. More importantly, these alterations were consistent positively with the expression of p21, the protein product of H-ras oncogene. CONCLUSION: H-ras oncogene could induce the metastatic phenotype of HCC cell in vitro to raise its metastatic potential. 展开更多
关键词 Carcinoma Hepatocellular Cell Adhesion Cell Movement Gelatinase A Gelatinase B Gene Expression Regulation Neoplastic Genes ras Humans In Vitro liver neoplasms PHENOTYPE Predictive Value of Tests Receptor Epidermal Growth Factor TRANSFECTION
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乙型肝炎病毒表面抗原携带者队列前瞻性研究在肝癌发生发展中的意义 被引量:42
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作者 陆培新 王金兵 +6 位作者 吴一迁 张启南 吴燕 万曙光 旷双远 王能进 钱耕荪 《中华医学杂志》 CAS CSCD 北大核心 2001年第14期856-859,共4页
目的 研究定期随访乙型肝炎病毒表面抗原 (HBsAg)携带者队列在肝癌发生中的病因学和临床意义。方法 在肝癌高发区 ,对HBsAg携带的 744人和相应的HBsAg阴性的 895人进行了 8年 3个月的前瞻性随访观察 ,同时建立血清库和进行详细的个人... 目的 研究定期随访乙型肝炎病毒表面抗原 (HBsAg)携带者队列在肝癌发生中的病因学和临床意义。方法 在肝癌高发区 ,对HBsAg携带的 744人和相应的HBsAg阴性的 895人进行了 8年 3个月的前瞻性随访观察 ,同时建立血清库和进行详细的个人史调查。结果  (1)HBsAg阳性组年平均肝癌发生率为 177 2 9/10万 ,高于HBsAg阴性组的 6 9 5 3/10万 ,相对危险度为 16 93,两组差异有非常显著意义 (P <0 .0 1)。其他肿瘤两组间差异无显著意义 (P >0 0 5 )。 (2 )个人史调查结果提示 ,发生肝炎到诊断肝癌的平均时间为 14 5年 ,中位时间 13年 ;肝硬化到诊断肝癌的平均时间为 6 4年 ,中位时间 5 5年。 (3)肝癌患者较差的经济状况 ,长期饮酒、吸烟 ,曾患肝病与慢性胃肠道疾病以及肝癌家属史均高于非肝癌组 (P <0 0 0 1) ,其他的个人嗜好、生活史、疾病史及家属史两组间差异无显著意义 (P >0 0 5 )。 (4)前瞻队列中发现的肝癌患者手术切除率 (16 44 % )及 1年生存率 (31 5 1% )均明显高于当地就诊肝癌患者 (分别为 8 7%、9 7% ,P <0 0 0 1)。结论 乙型肝炎病毒与肝癌发生密切相关 ;男性、年龄在 2 0~ 6 0岁之间、HBsAg携带及 /或有肝病史、家属肝癌史者 ,是肝癌的高危险人群。 展开更多
关键词 肝肿瘤 乙型肝炎病毒 前瞻性研究 肝癌 表面抗原携带者
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人参皂甙-Rh_2诱导人肝癌Bel-7404细胞凋亡的作用 被引量:37
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作者 樊光华 姜浩 欧文胜 《实用癌症杂志》 2003年第1期16-18,共3页
目的 研究人参皂甙 -Rh2 (GS -Rh2 )诱导肝癌Bel -740 4细胞凋亡的作用。方法 应用流式细胞术检测GS -Rh2对肝癌Bel -740 4细胞凋亡的诱导作用以及对细胞周期的影响。结果 流式细胞术证实GS -Rh2 具有诱导凋亡作用 ,细胞凋亡率(AR )... 目的 研究人参皂甙 -Rh2 (GS -Rh2 )诱导肝癌Bel -740 4细胞凋亡的作用。方法 应用流式细胞术检测GS -Rh2对肝癌Bel -740 4细胞凋亡的诱导作用以及对细胞周期的影响。结果 流式细胞术证实GS -Rh2 具有诱导凋亡作用 ,细胞凋亡率(AR )随GS -Rh2 浓度增高和作用时间延长而升高 ,当GS -Rh2 浓度由 12 .5 μg/ml增至 5 0 .0 μg/ml时 ,AR由 16.2 %升高至2 7.5 % ,但GS -Rh2 浓度由 5 0 .0 μg/ml进一步增至 10 0 .0 μg/ml后 ,AR未见相应升高 ;GS -Rh 2 可将细胞周期阻滞于G1期。结论 GS -Rh2 能诱导体外培养的Bel -740 4细胞凋亡 ;GS -Rh2 诱导Bel -740 展开更多
关键词 人参皂甙-Rh2 肝肿瘤 凋亡
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乙型肝炎病毒感染与肝癌发生的31年随访研究 被引量:48
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作者 陈建国 陆建华 +2 位作者 朱源荣 朱健 张永辉 《中华流行病学杂志》 CAS CSCD 北大核心 2010年第7期721-726,共6页
目的 研究乙型肝炎病毒(HBV)与肝癌发生的关系,评价HBsAg长期携带者发生肝癌的结局.方法 利用1976年建立的启东某社区15岁以上自然人群队列[血清筛检确定HBsAg、抗-HBs及丙氨酸转氨酶(ALT),并进行前瞻随访],该数据库与人群癌症登记... 目的 研究乙型肝炎病毒(HBV)与肝癌发生的关系,评价HBsAg长期携带者发生肝癌的结局.方法 利用1976年建立的启东某社区15岁以上自然人群队列[血清筛检确定HBsAg、抗-HBs及丙氨酸转氨酶(ALT),并进行前瞻随访],该数据库与人群癌症登记资料、居民病伤死因资料链接核实,分析1977年1月至2007年12月12351名人群中肝癌等肿瘤的发生情况.结果 队列观察总人年数为355 305.0.HBsAg携带者中发生肝癌173例,发生率为361.55/10万;HBsAg非携带者发生肝癌95例,发生率为30.90/10万,两组比较RR=11.70(95%CI:9.06~15.19);其中男性和女性HBsAg携带者的RR值分别为12.30和10.46.两性各年龄组HBsAg携带者的肝癌发生率均高于非携带者.若以女性非携带者肝癌的发生率为1,则男性非携带者、女性携带者、男性携带者的RR值分别为3.07、10.46和37.76;该四组人群在31年中肝癌发生的累积率分别为0.86%、2.73%、10.22%和34.19%.非条件logistic回归模型分析显示性别(男性)、年龄、HBsAg、ALT为肝癌发生的显著影响因素,抗-HBs为保护因素.HBsAg携带与其他部位癌的发生未见有联系.结论 证实启东自然人群中HBsAg携带与肝癌发生的因果联系;针对HBV感染而采取干预措施是现场肝癌防治的重点. 展开更多
关键词 乙型肝炎病毒 肝肿瘤 相对危险度 前瞻研究
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