Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected pa...Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected patients with initially unresectable HCC to achieve adequate tumor downstaging to undergo surgical resection,a‘conversion therapy’strategy.However,conversion therapy is a new approach to the treatment of HCC and its practice and treatment protocols are still being developed.Review the evidence for conversion therapy in HCC and develop consensus statements to guide clinical practice.Evidence review:Many research centers in China have accumulated significant experience implementing HCC conversion therapy.Preliminary findings and data have shown that conversion therapy represents an important strategy to maximize the survival of selected patients with intermediate stage to advanced HCC;however,there are still many urgent clinical and scientific challenges for this therapeutic strategy and its related fields.In order to summarize and learn from past experience and review current challenges,the Chinese Expert Consensus on Conversion Therapy for Hepatocellular Carcinoma(2021 Edition)was developed based on a review of preliminary experience and clinical data from Chinese and non-Chinese studies in this field and combined with recommendations for clinical practice.Sixteen consensus statements on the implementation of conversion therapy for HCC were developed.The statements generated in this review are based on a review of clinical evidence and real clinical experience and will help guide future progress in conversion therapy for patients with HCC.展开更多
Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness an...Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively studied.Methods: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low MRS.Results: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(P<0.001), with an odds ratio(OR) of high to low MRS of 7.52 [95%confidence interval(95% CI), 3.96-14.28;P<0.001] and an OR of intermediate to low MRS of 3.20(95% CI,1.01-10.14;P=0.041).Conclusions: Molecular alterations were associated with RAI refractoriness, with BRAF and TERT promoter mutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.展开更多
Background and Objective:Hepatocellular carcinoma(HCC)poses a significant global health burden and ranks as the fifth most prevalent cancer on a global scale.Hepatitis C virus(HCV)infection remains one of the major ri...Background and Objective:Hepatocellular carcinoma(HCC)poses a significant global health burden and ranks as the fifth most prevalent cancer on a global scale.Hepatitis C virus(HCV)infection remains one of the major risk factors for HCC development.HCC is a heterogeneous disease,and the development of HCC caused by HCV is intricate and involves various factors,including genetic susceptibility,viral factors,immune response due to chronic inflammation,alcohol abuse,and metabolic dysfunction associated with fatty liver disease.In this review,we provide a comprehensive and updated review of research on the genetics and epigenetic mechanisms implicated in developing HCC associated with HCV infection.We also discuss the potential translational implications,including novel biomarkers and drugs for treatment.Methods:A comprehensive literature search was conducted in June 2023 in PubMed and Embase databases.Key Content and Findings:Recent findings indicate that a variety of genetic and epigenetic processes are involved in the pathogenesis and continue to exist even after the complete elimination of HCV.The deregulation of the epigenome has been identified as a significant factor in the deletrious effects of liver disease,especially during the initial stages when genetic alterations are uncommon.The enduring“epigenetic memory”of gene expression is believed to be regulated by epigenetic mechanisms,indicating that alterations caused by HCV infection continue to exist and are linked to the risk of development of liver cancer even after successful treatment.Systems biology analytical methods will be required to delineate the magnitude and significance of both genetic and epigenomic alterations in tumor evolution.Conclusions:By facilitating a more profound understanding of these aspects,this will ultimately foster the advancement of novel therapies and ultimately improve outcomes for patients.展开更多
Pressure measurement within the body is of pivotal significance in the diagnosis of vascular and organ-related diseases associated with hydrostatic pressure.At present,the most commonly used clinical method is to inse...Pressure measurement within the body is of pivotal significance in the diagnosis of vascular and organ-related diseases associated with hydrostatic pressure.At present,the most commonly used clinical method is to insert a catheter along with a pressure sensor and then guide it to the area of interest through vessels such as central venous pressure(CVP).However,the presence of sensors within the vessel of interest will inevitably cause alterations to the circulation and thus affect blood pressure.Moreover,the use of invasive methods does not allow monitoring of every area inside the body.展开更多
Cancer has remained one of the biggest challenges for human health during the past few decades despite major advances in medicine[1].Poor prognosis of cancer is mainly caused by a lack of effective treatment.Moreover,...Cancer has remained one of the biggest challenges for human health during the past few decades despite major advances in medicine[1].Poor prognosis of cancer is mainly caused by a lack of effective treatment.Moreover,many patients cannot receive appropriate treatment despite early diagnosis.High heterogeneity is a tumor characteristic and different types of cancer usually vary in clinical features and tumorigenic mechanisms,which results in different responses to drugs[2].How to predict accurately the patient’s response to drugs and choose personalized treatment is one of themain concerns of doctors.展开更多
The liver is involved in over 500 biochemical reactions.Over the last couple of decades,liver diseases have become a major cause of morbidity and mortality in the world(1).Unfortunately,treatment options for patients ...The liver is involved in over 500 biochemical reactions.Over the last couple of decades,liver diseases have become a major cause of morbidity and mortality in the world(1).Unfortunately,treatment options for patients with chronic liver disease remain limited.Due to the lack of highly sensitive and effective detection methods,most patients with liver cancer are already in an advanced stage when diagnosed(2).展开更多
Over the past decade,there has been notable progress in the systemic treatment of liver cancer.However,despite the emergence of new therapeutic strategies,they have not universally achieved success,with patients affli...Over the past decade,there has been notable progress in the systemic treatment of liver cancer.However,despite the emergence of new therapeutic strategies,they have not universally achieved success,with patients afflicted by liver diseases frequently displaying resistance to these treatments(1).Consequently,liver cancer remains a global health challenge,and hepatocellular carcinoma(HCC)stands as the fourth most common cause of cancer-related deaths globally,constituting 80-90%of primary liver cancer cases(2,3).This poses a substantial threat to both the survival and overall well-being of individuals.展开更多
Purpose:In recent years,thyroid cancer is a common clinical problem.Since guidelines for the diagnosis and treatment of thyroid nodules and diferentiated thyroid cancer were revised in 2012,signifcant scientifc advanc...Purpose:In recent years,thyroid cancer is a common clinical problem.Since guidelines for the diagnosis and treatment of thyroid nodules and diferentiated thyroid cancer were revised in 2012,signifcant scientifc advances have occurred in the feld.The aim of this guidelines is to inform clinicians,researchers,patients and health policy makers on published evidence and expert consensus relating to the diagnosis and management of thyroid malignancy.Methods:In order to better promote the clinical management of thyroid cancer in China,Chinese Association of Thyroid Oncology(CATO)organized relevant experts to write these guidelines based on latest relevant literatures and clinical experience of multiple centers.The specifc clinical issues and topics addressed in these guidelines were based on published evidence,prior versions of the Chinese guidelines and expert consensus.Results and conclusion:The guidelines provide recommendations for the management of diferent types of thyroid carcinoma,including papillary,follicular,medullary,and anaplastic carcinomas.展开更多
Non-alcoholic fatty liver disease(NAFLD),is a chronic liver disease caused by a build-up of intrahepatic fat.Metabolic comorbidities associated with NAFLD included obesity,type 2 diabetes,hyperlipidemia,hypertension,a...Non-alcoholic fatty liver disease(NAFLD),is a chronic liver disease caused by a build-up of intrahepatic fat.Metabolic comorbidities associated with NAFLD included obesity,type 2 diabetes,hyperlipidemia,hypertension,and metabolic syndrome(1-3).With changes in diet and lifestyle,the incidence of NAFLD is rapidly increasing to an estimated 30%of global population(4).Histologic manifestations of NAFLD range from the mild stage of simple steatosis,to the advanced stage of steatosis accompanied with necroinflammation or fibrosis,so called nonalcoholic non-alcoholic steatohepatitis(NASH).展开更多
Pancreatic cancer(PC)is a prevalent digestive malignancy worldwide and ranks as the fourth leading cause of cancer-related deaths globally.The incidence and mortality rates have been increasing annually,and due to its...Pancreatic cancer(PC)is a prevalent digestive malignancy worldwide and ranks as the fourth leading cause of cancer-related deaths globally.The incidence and mortality rates have been increasing annually,and due to its insidious onset and high malignancy,most patients are diagnosed at an advanced stage,with a 5-year survival rate of less than 8%(1).PC can be classified into endocrine and exocrine tumors,with over 95% of pancreatic malignant tumors originating from the exocrine portion of the pancreas.展开更多
A 40-year-old female presented with progressive abdominal enlargement for 6 months(Panel A),along with severe abdominal distension and amenorrhea.She had not gone to hospital because she assumed herself to be pregnant...A 40-year-old female presented with progressive abdominal enlargement for 6 months(Panel A),along with severe abdominal distension and amenorrhea.She had not gone to hospital because she assumed herself to be pregnant,until the belly grew out of control.A giant lesion in abdomen was detected by computed tomography(Panel B).展开更多
In recent years,transarterial radioembolization(TARE)with Yttrium-90(Y90)has emerged as a technique for treating malignant neoplasms in the liver.Compared with other locoregional therapies,such as transarterial chemoe...In recent years,transarterial radioembolization(TARE)with Yttrium-90(Y90)has emerged as a technique for treating malignant neoplasms in the liver.Compared with other locoregional therapies,such as transarterial chemoembolization(TACE),patients who underwent TARE with Y90 have higher tumor response rates and better outcomes.Moreover,no significant treatment-related complications or treatment-related deaths have been reported[1].We here review the clinical application of TARE and its associated issues.展开更多
Hepatocellular carcinoma(HCC)is one of the most common cancers and is the second leading cause of cancer-related deaths worldwide[1,2].The main therapies for HCC include surgical re-section,local ablation,or liver tra...Hepatocellular carcinoma(HCC)is one of the most common cancers and is the second leading cause of cancer-related deaths worldwide[1,2].The main therapies for HCC include surgical re-section,local ablation,or liver transplantation,which are only applied to early-stage HCC.However,most patients at the time of initial HCC diagnosis have already progressed to an advanced stage,and survival can only be prolonged finitely via palliative therapies,such as transarterial chemoembolization,systemic ther-apy with tyrosine kinase inhibitors,and selective internal radiation therapy[3,4].Moreover,as HCC has a high recurrence rate,the treatment efficacy is not satisfactory[5].Currently,the diagnosis and monitoring of HCC primarily depend on serum biomarker de-tection,pathological examination,and imaging analysis.Common serum markers display poor diagnostic performance,and imaging and pathological examinations have limitations in diagnostic accu-racy and sensitivity[6,7].Therefore,we urgently require better ap-proaches for the diagnosis and monitoring of HCC.展开更多
Hepatocellular carcinoma(HCC)is a highly aggressive cancer that ranks the second leading cause of cancer related death.Hepatitis B virus(HBV)infection is the most prevalent etiological factor,especially in eastern wor...Hepatocellular carcinoma(HCC)is a highly aggressive cancer that ranks the second leading cause of cancer related death.Hepatitis B virus(HBV)infection is the most prevalent etiological factor,especially in eastern world.However,the underlying mechanism of HBV infection-initialed carcinogenic progression remains largely unknown,making it difficult to improve therapeutic strategies for HBV-associated HCC(HBV+HCC).The virus drives multi-omics changes in human liver cells,leading to genomic in stability,epigenomic modifications,and proteomic a lterations.HBV infection also orchestrates the immunosuppressive microenv ironment in HBV+HCC.This review summarized recent research progress with the multimodal methods covering genome,transcriptome,epigenome,and proteome introduced in the mechanistic studies for HBV+HCC.展开更多
Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has become a global pandemic.Several large cohort studies have reported liver injury in COVID-19 patient...Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has become a global pandemic.Several large cohort studies have reported liver injury in COVID-19 patients.Here,we reviewed the manifestations and causes of liver injury in COVID-19 patients and the effects of liver injury on the clinical outcomes based on the published literature.展开更多
Liver plays a central role in various physiological functions,including metabolism,biliary secretion,production of plasma proteins,regulation of hormones as well as detoxication.Because of its multidimensional functio...Liver plays a central role in various physiological functions,including metabolism,biliary secretion,production of plasma proteins,regulation of hormones as well as detoxication.Because of its multidimensional functions,liver diseases such as viral hepatitis,non-alcoholic fatty liver disease,non-alcoholic steato-hepatitis,fibrosis and liver cancer may lead to serious consequences.展开更多
1.Introduction In recent years,investigators have witnessed great progress in understanding the tumor microenvironment(TME)and evolution,which has been accompanied by a substantial number of newly developed targeted t...1.Introduction In recent years,investigators have witnessed great progress in understanding the tumor microenvironment(TME)and evolution,which has been accompanied by a substantial number of newly developed targeted therapies and immunotherapies.Tumors are capable of escaping immune surveillance in the context of both spontaneous immune response and immunotherapies,and these two immune evasion processes share many overlapping mechanisms,such as human leukocyte antigen loss of heterozygosity(HLA-LOH)and immunoediting[1].For hepatocellular carcinoma(HCC),numerous treatment strategies targeting the TME have been proposed in recent years[2,3].Among these strategies,immune-checkpoint inhibitors(ICIs)have been found to be a promising therapeutic choice[4–6].The combination of atezolizumab(anti--programmed death-ligand 1,PD-L1)and bevacizumab(anti-vascular endothelial growth factor,VEGF)antibodies demonstrated significantly better overall and progression-free survival than the kinase inhibitor sorafenib in patients with unresectable HCC in a phase III trial[4],and this combination was established as a first-line treatment for advanced HCC.However,the response rate for ICIs was limited[4–6],and it was reported that nonalcoholic steatohepatitis-related HCC was less responsive to ICIs than other HCCs[7].Given the clinical importance of tolerance to immunotherapy in HCC,tumor-immune co-evolution deserves more attention and may provide novel ideas for developing new combination therapies that target multiple mechanisms of immunotherapy resistance.展开更多
文摘Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected patients with initially unresectable HCC to achieve adequate tumor downstaging to undergo surgical resection,a‘conversion therapy’strategy.However,conversion therapy is a new approach to the treatment of HCC and its practice and treatment protocols are still being developed.Review the evidence for conversion therapy in HCC and develop consensus statements to guide clinical practice.Evidence review:Many research centers in China have accumulated significant experience implementing HCC conversion therapy.Preliminary findings and data have shown that conversion therapy represents an important strategy to maximize the survival of selected patients with intermediate stage to advanced HCC;however,there are still many urgent clinical and scientific challenges for this therapeutic strategy and its related fields.In order to summarize and learn from past experience and review current challenges,the Chinese Expert Consensus on Conversion Therapy for Hepatocellular Carcinoma(2021 Edition)was developed based on a review of preliminary experience and clinical data from Chinese and non-Chinese studies in this field and combined with recommendations for clinical practice.Sixteen consensus statements on the implementation of conversion therapy for HCC were developed.The statements generated in this review are based on a review of clinical evidence and real clinical experience and will help guide future progress in conversion therapy for patients with HCC.
基金supported by the Project on InterGovernmental International Scientific and Technological Innovation Cooperation in National Key Projects of Research and Development Plan (No. 2019YFE0106400)the National Natural Science Foundation of China (No. 81771875)。
文摘Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively studied.Methods: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low MRS.Results: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(P<0.001), with an odds ratio(OR) of high to low MRS of 7.52 [95%confidence interval(95% CI), 3.96-14.28;P<0.001] and an OR of intermediate to low MRS of 3.20(95% CI,1.01-10.14;P=0.041).Conclusions: Molecular alterations were associated with RAI refractoriness, with BRAF and TERT promoter mutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.
基金National Health and Medical Research Council of Australia(NHMRC)Program and Investigator Grants(2008983,1053206,and 1149976,to M.E.)Project and Ideas Grants(1107178 and 1108422,2001692,to M.E.).
文摘Background and Objective:Hepatocellular carcinoma(HCC)poses a significant global health burden and ranks as the fifth most prevalent cancer on a global scale.Hepatitis C virus(HCV)infection remains one of the major risk factors for HCC development.HCC is a heterogeneous disease,and the development of HCC caused by HCV is intricate and involves various factors,including genetic susceptibility,viral factors,immune response due to chronic inflammation,alcohol abuse,and metabolic dysfunction associated with fatty liver disease.In this review,we provide a comprehensive and updated review of research on the genetics and epigenetic mechanisms implicated in developing HCC associated with HCV infection.We also discuss the potential translational implications,including novel biomarkers and drugs for treatment.Methods:A comprehensive literature search was conducted in June 2023 in PubMed and Embase databases.Key Content and Findings:Recent findings indicate that a variety of genetic and epigenetic processes are involved in the pathogenesis and continue to exist even after the complete elimination of HCV.The deregulation of the epigenome has been identified as a significant factor in the deletrious effects of liver disease,especially during the initial stages when genetic alterations are uncommon.The enduring“epigenetic memory”of gene expression is believed to be regulated by epigenetic mechanisms,indicating that alterations caused by HCV infection continue to exist and are linked to the risk of development of liver cancer even after successful treatment.Systems biology analytical methods will be required to delineate the magnitude and significance of both genetic and epigenomic alterations in tumor evolution.Conclusions:By facilitating a more profound understanding of these aspects,this will ultimately foster the advancement of novel therapies and ultimately improve outcomes for patients.
基金National Natural Science Foundation of China(No.82300663)Natural Science Foundation of Sichuan Province(No.2022NSFSC0843)+1 种基金Fundamental Research Funds for the Central Universities(No.2023SCU12055)China Postdoctoral Science Foundation(No.2022M712262).
文摘Pressure measurement within the body is of pivotal significance in the diagnosis of vascular and organ-related diseases associated with hydrostatic pressure.At present,the most commonly used clinical method is to insert a catheter along with a pressure sensor and then guide it to the area of interest through vessels such as central venous pressure(CVP).However,the presence of sensors within the vessel of interest will inevitably cause alterations to the circulation and thus affect blood pressure.Moreover,the use of invasive methods does not allow monitoring of every area inside the body.
基金supported by grants from the CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2016-I2M-1–001)and the National High-tech Research and Development Projects(863)(No.2015AA020303).
文摘Cancer has remained one of the biggest challenges for human health during the past few decades despite major advances in medicine[1].Poor prognosis of cancer is mainly caused by a lack of effective treatment.Moreover,many patients cannot receive appropriate treatment despite early diagnosis.High heterogeneity is a tumor characteristic and different types of cancer usually vary in clinical features and tumorigenic mechanisms,which results in different responses to drugs[2].How to predict accurately the patient’s response to drugs and choose personalized treatment is one of themain concerns of doctors.
基金This work was supported by grants from National Natural Science Foundation of China(32271470)CAMS Innovation Fund for Medical Sciences(CIFMS)2021-I2M-1-058.
文摘The liver is involved in over 500 biochemical reactions.Over the last couple of decades,liver diseases have become a major cause of morbidity and mortality in the world(1).Unfortunately,treatment options for patients with chronic liver disease remain limited.Due to the lack of highly sensitive and effective detection methods,most patients with liver cancer are already in an advanced stage when diagnosed(2).
基金supported by the National Natural Science Foundation of China(No.32271470).
文摘Over the past decade,there has been notable progress in the systemic treatment of liver cancer.However,despite the emergence of new therapeutic strategies,they have not universally achieved success,with patients afflicted by liver diseases frequently displaying resistance to these treatments(1).Consequently,liver cancer remains a global health challenge,and hepatocellular carcinoma(HCC)stands as the fourth most common cause of cancer-related deaths globally,constituting 80-90%of primary liver cancer cases(2,3).This poses a substantial threat to both the survival and overall well-being of individuals.
基金funded by National Natural Science Foundation of China (81872170[Minghua Ge]).
文摘Purpose:In recent years,thyroid cancer is a common clinical problem.Since guidelines for the diagnosis and treatment of thyroid nodules and diferentiated thyroid cancer were revised in 2012,signifcant scientifc advances have occurred in the feld.The aim of this guidelines is to inform clinicians,researchers,patients and health policy makers on published evidence and expert consensus relating to the diagnosis and management of thyroid malignancy.Methods:In order to better promote the clinical management of thyroid cancer in China,Chinese Association of Thyroid Oncology(CATO)organized relevant experts to write these guidelines based on latest relevant literatures and clinical experience of multiple centers.The specifc clinical issues and topics addressed in these guidelines were based on published evidence,prior versions of the Chinese guidelines and expert consensus.Results and conclusion:The guidelines provide recommendations for the management of diferent types of thyroid carcinoma,including papillary,follicular,medullary,and anaplastic carcinomas.
基金supported by the National High Level Hospital Clinical Research Funding(No.2022-PUMCH-B-034).
文摘Non-alcoholic fatty liver disease(NAFLD),is a chronic liver disease caused by a build-up of intrahepatic fat.Metabolic comorbidities associated with NAFLD included obesity,type 2 diabetes,hyperlipidemia,hypertension,and metabolic syndrome(1-3).With changes in diet and lifestyle,the incidence of NAFLD is rapidly increasing to an estimated 30%of global population(4).Histologic manifestations of NAFLD range from the mild stage of simple steatosis,to the advanced stage of steatosis accompanied with necroinflammation or fibrosis,so called nonalcoholic non-alcoholic steatohepatitis(NASH).
基金supported by grants from National Natural Science Foundation of China(No.32271470)CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2021-I2M-1-058).
文摘Pancreatic cancer(PC)is a prevalent digestive malignancy worldwide and ranks as the fourth leading cause of cancer-related deaths globally.The incidence and mortality rates have been increasing annually,and due to its insidious onset and high malignancy,most patients are diagnosed at an advanced stage,with a 5-year survival rate of less than 8%(1).PC can be classified into endocrine and exocrine tumors,with over 95% of pancreatic malignant tumors originating from the exocrine portion of the pancreas.
文摘A 40-year-old female presented with progressive abdominal enlargement for 6 months(Panel A),along with severe abdominal distension and amenorrhea.She had not gone to hospital because she assumed herself to be pregnant,until the belly grew out of control.A giant lesion in abdomen was detected by computed tomography(Panel B).
基金supported by grants from the CAMS Innovation Fund for Medical Sciences(CIFMS)[No.2016-I2M-1–001]the National High-tech Research and Development Projects(863)[No.2015AA020303].
文摘In recent years,transarterial radioembolization(TARE)with Yttrium-90(Y90)has emerged as a technique for treating malignant neoplasms in the liver.Compared with other locoregional therapies,such as transarterial chemoembolization(TACE),patients who underwent TARE with Y90 have higher tumor response rates and better outcomes.Moreover,no significant treatment-related complications or treatment-related deaths have been reported[1].We here review the clinical application of TARE and its associated issues.
文摘Hepatocellular carcinoma(HCC)is one of the most common cancers and is the second leading cause of cancer-related deaths worldwide[1,2].The main therapies for HCC include surgical re-section,local ablation,or liver transplantation,which are only applied to early-stage HCC.However,most patients at the time of initial HCC diagnosis have already progressed to an advanced stage,and survival can only be prolonged finitely via palliative therapies,such as transarterial chemoembolization,systemic ther-apy with tyrosine kinase inhibitors,and selective internal radiation therapy[3,4].Moreover,as HCC has a high recurrence rate,the treatment efficacy is not satisfactory[5].Currently,the diagnosis and monitoring of HCC primarily depend on serum biomarker de-tection,pathological examination,and imaging analysis.Common serum markers display poor diagnostic performance,and imaging and pathological examinations have limitations in diagnostic accu-racy and sensitivity[6,7].Therefore,we urgently require better ap-proaches for the diagnosis and monitoring of HCC.
文摘Hepatocellular carcinoma(HCC)is a highly aggressive cancer that ranks the second leading cause of cancer related death.Hepatitis B virus(HBV)infection is the most prevalent etiological factor,especially in eastern world.However,the underlying mechanism of HBV infection-initialed carcinogenic progression remains largely unknown,making it difficult to improve therapeutic strategies for HBV-associated HCC(HBV+HCC).The virus drives multi-omics changes in human liver cells,leading to genomic in stability,epigenomic modifications,and proteomic a lterations.HBV infection also orchestrates the immunosuppressive microenv ironment in HBV+HCC.This review summarized recent research progress with the multimodal methods covering genome,transcriptome,epigenome,and proteome introduced in the mechanistic studies for HBV+HCC.
基金This study was supported by grants from the CAMS Innovation Fund for Medical Sciences(2016-I2M-1-001)the National High-tech Research and Development Projects(863)(2015AA020303).
文摘Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has become a global pandemic.Several large cohort studies have reported liver injury in COVID-19 patients.Here,we reviewed the manifestations and causes of liver injury in COVID-19 patients and the effects of liver injury on the clinical outcomes based on the published literature.
文摘Liver plays a central role in various physiological functions,including metabolism,biliary secretion,production of plasma proteins,regulation of hormones as well as detoxication.Because of its multidimensional functions,liver diseases such as viral hepatitis,non-alcoholic fatty liver disease,non-alcoholic steato-hepatitis,fibrosis and liver cancer may lead to serious consequences.
文摘1.Introduction In recent years,investigators have witnessed great progress in understanding the tumor microenvironment(TME)and evolution,which has been accompanied by a substantial number of newly developed targeted therapies and immunotherapies.Tumors are capable of escaping immune surveillance in the context of both spontaneous immune response and immunotherapies,and these two immune evasion processes share many overlapping mechanisms,such as human leukocyte antigen loss of heterozygosity(HLA-LOH)and immunoediting[1].For hepatocellular carcinoma(HCC),numerous treatment strategies targeting the TME have been proposed in recent years[2,3].Among these strategies,immune-checkpoint inhibitors(ICIs)have been found to be a promising therapeutic choice[4–6].The combination of atezolizumab(anti--programmed death-ligand 1,PD-L1)and bevacizumab(anti-vascular endothelial growth factor,VEGF)antibodies demonstrated significantly better overall and progression-free survival than the kinase inhibitor sorafenib in patients with unresectable HCC in a phase III trial[4],and this combination was established as a first-line treatment for advanced HCC.However,the response rate for ICIs was limited[4–6],and it was reported that nonalcoholic steatohepatitis-related HCC was less responsive to ICIs than other HCCs[7].Given the clinical importance of tolerance to immunotherapy in HCC,tumor-immune co-evolution deserves more attention and may provide novel ideas for developing new combination therapies that target multiple mechanisms of immunotherapy resistance.
