检索结果-内蒙古大学图书馆

Projected future increase in aging hepatitis C virus-infected liver transplant candidates: A potential effect of hepatocellular carcinoma

引用

LIVER TRANSPLANTATION 2012年第12期18卷 1471-1478页

作者： Biggins, Scott W. Bambha, Kiran M. Terrault, Norah A. Inadomi, John Shiboski, Stephen Dodge, Jennifer L. Gralla, Jane Rosen, Hugo R. Roberts, John P. Univ Colorado Denver Div Gastroenterol & Hepatol Aurora CO 80045 USA Univ Colorado Denver Dept Pediat Aurora CO 80045 USA Univ Colorado Denver Dept Biostat & Informat Aurora CO 80045 USA Univ Calif San Francisco Div Gastroenterol & Hepatol San Francisco CA 94143 USA Univ Calif San Francisco Dept Epidemiol & Biostat San Francisco CA 94143 USA Univ Calif San Francisco Dept Surg San Francisco CA USA Univ Washington Div Gastroenterol & Hepatol Seattle WA 98195 USA

In the United States, the peak hepatitis C virus (HCV) antibody prevalence of 4% occurred in persons born in the calendar years 1940-1965. The goal of this study was to examine observed and projected age-specific trends in the demand for liver transplantation (LT) among patients with HCV-associated liver disease stratified by concurrent hepatocellular carcinoma (HCC). All new adult LT candidates registered with the Organ Procurement and Transplantation Network for LT between 1995 and 2010 were identified. Patients who had primary, secondary, or text field diagnoses of HCV with or without HCC were identified. There were 126,862 new primary registrants for LT, and 52,540 (41%) had HCV. The number of new registrants with HCV dramatically differed by the age at calendar year, and this suggested a birth cohort effect. When the candidates were stratified by birth year in 5-year intervals, the birth cohorts with the highest frequency of HCV were as follows (in decreasing order): 1951-1955, 1956-1960, 1946-1950, and 1941-1945. These 4 birth cohorts, spanning from 1941 to 1960, accounted for 81% of all new registrants with HCV. A 4-fold increase in new registrants with HCV and HCC occurred between the calendar years 2000 and 2010 in the 1941-1960 birth cohorts. By 2015, we anticipate that an increasing proportion of new registrants with HCV will have HCC and be =60 years old (born in or before 1955). In conclusion, the greatest demand for LT due to HCV-associated liver disease is occurring among individuals born between 1941 and 1960. This demand appears to be driven by the development of HCC in patients with HCV. During the coming decade, the projected increase in the demand for LT from an aging HCV-infected population will challenge the transplant community to reconsider current treatment paradigms. Liver Transpl, 2012. (c) 2012 AASLD.

关键词： Level Trigger Hepatocellular Cancer liver transplant Cohort Effect Parturition Liver Diseases human-centered computing birth Organ Procurement

来源：评论

学校读者我要写书评

暂无评论

Inhibition of human methionine adenosyltransferase 1A transcription by coding region methylation

引用

JOURNAL OF CELLULAR PHYSIOLOGY 2012年第4期227卷 1583-1591页

作者： Tomasi, Maria Lauda Li, Tony W. H. Li, Mei Mato, Jose M. Lu, Shelly C. Keck Sch Med USC So Calif Res Ctr ALPD & Cirrhosis USC Res Ctr Liver Dis Div Gastroenterol & Liver Dis Los Angeles CA 90033 USA Ciberehd CIC BioGUNE Derio Bizkaia Spain

Two genes (MAT1A and MAT2A) encode for the essential enzyme methionine adenosyltransferase (MAT). MAT1A is silenced in hepatocellular carcinoma (HCC), and absence of MAT1A leads to spontaneous development of HCC in mice. Previous report correlated promoter methylation to silencing of MAT1A but definitive proof was lacking. Here we investigated the role of methylation in regulating MAT1A expression. There are three MspI/HpaII sites from -1,913 to +160 of the human MAT1A gene (numbered relative to the translational start site) at position -977, +10, and +88. Bisulfite treatment and DNA sequencing, and Southern blot analysis showed that methylation at +10 and +88, but not -977, correlated with lack of MAT1A expression. MAT1A promoter construct methylated at -977, +10 or +88 position has 0.7-fold, 3-fold, and 1.6-fold lower promoter activity, respectively. Methylation at -977 and +10 did not inhibit the promoter more than methylation at +10 alone;while methylation at +10 and +88 reduced promoter activity by 60%. Mutation of +10 and +88 sites also resulted in 40% reduction of promoter activity. Reactivation of MAT1A correlated with demethylation of +10 and +88. In vitro transcription assay showed that methylation or mutation of +10 and +88 sites reduced transcription. In conclusion, our data support the novel finding that methylation of the MAT1A coding region can inhibit gene transcription. This represents a key mechanism for decreased MAT1A expression in HCC and a target for therapy. To our knowledge, this is the first example of coding region methylation inhibiting transcription of a mammalian gene. J. Cell. Physiol. 227: 1583-1591, 2012. (C) 2011 Wiley Periodicals, Inc.

关键词： Open Reading Frames human-centered computing MAT2A gene Methylation MAT1A gene Genetic Transcription

来源：评论

学校读者我要写书评

暂无评论

Serum DKK1 as a protein biomarker for the diagnosis of hepatocellular carcinoma: a large-scale, multicentre study

引用

LANCET ONCOLOGY 2012年第8期13卷 817-826页

作者： Shen, Qiujin Fan, Jia Yang, Xin-Rong Tan, Yexiong Zhao, Weifeng Xu, Yang Wang, Ning Niu, Yongdong Wu, Zheng Zhou, Jian Qiu, Shuang-Jian Shi, Ying-Hong Yu, Bin Tang, Ning Chu, Wei Wang, Min Wu, Jinhua Zhang, Zhigang Yang, Shengli Gu, Jianren Wang, Hongyang Qin, Wenxin Shanghai Jiao Tong Univ State Key Lab Oncogenes & Related Genes Shanghai Canc Inst Renji HospSch Med Shanghai 200032 Peoples R China Fudan Univ Inst Biomed Sci Shanghai 200433 Peoples R China Second Mil Med Univ Eastern Hepatobiliary Surg Hosp Shanghai Peoples R China Soochow Univ Affiliated Hosp 1 Dept Infect Dis Suzhou Peoples R China

Background Hepatocellular carcinoma (HCC) is prevalent worldwide and improvements in timely and effective diagnosis are needed. We assessed whether measurement of Dickkopf-1 (DKK1) in serum could improve diagnostic accuracy for HCC. Methods We analysed data for patients with HCC, chronic hepatitis B virus (HBV) infection, liver cirrhosis, and healthy controls, recruited from two Chinese centres between December, 2008, and July, 2009. A validation cohort matched for age and sex was recruited from another centre in China between July, 2010, and June, 2011. DKK1 was measured in serum by ELISA by independent researchers who had no access to patients' clinical information. We used receiver operating characteristics (ROC) to calculate diagnostic accuracy. Findings We assessed serum DKK1 in 831 participants: 424 with HCC, 98 with chronic HBV infection, 96 with cirrhosis, and 213 healthy controls. The validation cohort comprised 453 participants: 209 with HCC, 73 with chronic HBV infection, 72 with cirrhosis, and 99 healthy controls. Levels of DKK1 in serum were significantly higher in patients with HCC than in all controls. ROC curves showed the optimum diagnostic cutoff was 2.153 ng/mL (area under curve [AUC] 0.848 [95% CI 0.820-0.875], sensitivity 69.1%, and specificity 90.6% in the test cohort;0.862 [0.825-0.899], 71.3%, and 87.2% in the validation cohort). Similar results were noted for early-stage HCC (0.865 [0.835-0.895], 70.9%, and 90.5% in the test cohort;0.896 [0.846-0.947], 73.8%, and 87.2% in the validation cohort). Furthermore, DKK1 maintained diagnostic accuracy for patients with HCC who were a-fetoprotein (AFP) negative (0.841 [0.801-0.882], 70.4%, and 90.0% in the test cohort;0.869 [0.815-0.923], 66.7%, and 87.2% in the validation cohort), including for patients with early-stage HCC (0.870 [0.829-0.911], 73.1%, and 90.0% in the test cohort;0.893 [0.804-0.983], 72.2%, and 87.2% in the validation cohort), compared with all controls. Raised concentrations of DK

关键词： diagnosis quality/standard cohort DKK1 gene Serum human-centered computing

来源：评论

学校读者我要写书评

暂无评论

EASL-EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma

引用

EUROPEAN JOURNAL OF CANCER 2012年第5期48卷 599-641页

作者： European Assoc Study Liver EASL Off CH-1205 Geneva Switzerland

EASL-EORTC Clinical Practice Guidelines (CPG) on the management of hepatocellular carcinoma (HCC) define the use of surveillance, diagnosis and therapeutic strategies recommended for patients with this type of cancer. This is the first European joint effort by the European Association for the Study of the Liver (EASL) and the European Organisation for Research and Treatment of Cancer (EORTC) to provide common guidelines for the management of hepatocellular carcinoma. These guidelines update the recommendations reported by the EASL panel of experts in HCC published in 2001. Several clinical and scientific advances have occurred during the past decade and, thus, a modern version of the document is urgently needed.

关键词： Hepatocellular Cancer Patient type European organisation Cancer human-centered computing European association

来源：评论

学校读者我要写书评

暂无评论

Contrast-enhanced ultrasound for characterisation of hepatic lesions appearing non-hypervascular on CT in chronic liver diseases

引用

BRITISH JOURNAL OF RADIOLOGY 2012年第1012期85卷 351-357页

作者： Maruyama, H. Takahashi, M. Ishibashi, H. Yoshikawa, M. Yokosuka, O. Chiba Univ Grad Sch Med Dept Med & Clin Oncol Chuou ku Chiba 2608670 Japan

Objectives: The purpose of this prospective study was to elucidate the efficacy of using contrast-enhanced ultrasound to characterise focal hepatic lesions appearing non-hypervascular on contrast-enhanced CT in chronic liver diseases. Methods: The study population included 22 patients with cirrhosis or chronic hepatitis, who between them had 27 focal hepatic lesions smaller than 20 mm (mean 13.9 +/- 3.4) that appeared non-hypervascular on contrast-enhanced CT. Contrast-enhanced ultrasound with perflubutane microbubble agent (Sonazoid, 0.0075 ml kg(-1)) was performed prior to ultrasound-guided needle biopsy, and intensity analysis was done for hepatic lesions in the early phase (-60 s) and late phase (600 s post injection). Results: All seven early-phase hyperenhanced lesions were hepatocellular carcinoma (HCC). 20 lesions iso- or hypoenhanced during the early phase consisted of 11 regenerative nodules (RNs) and 9 HCCs. HCC was more frequent in early-phase hyperenhanced lesions than in iso- or hypoenhanced lesions (p=0.0108). Both late-phase hypoenhanced lesions were HCCs, whereas 25 late-phase isoenhanced lesions consisted of 11 RNs and 14 HCCs. The enhancement patterns of the 11 RNs included isoenhanced appearance in both the early and late phases in 8 lesions, and early-phase hypoenhancement combined with late-phase isoenhancement in the remaining 3. Both of these enhancement patterns (i.e. either iso-iso or hypo-iso) were found in 9 malignant lesions, 9 (75%) of the 12 well-differentiated HCCs. Conclusion: Hypervascularity on contrast-enhanced ultrasound with Sonazoid strongly suggested HCC regardless of non-hypervascularity on CT, and late-phase hypoenhancement was another possible finding of HCC. However, characterisation of hepatic lesions with other enhancement patterns was difficult using our technique.

关键词： Hepatic Organ System X-Ray Computed Tomography chronic liver disease Lesions intensity analysis Liver Diseases perfluorobutane human-centered computing Puncture Biopsy contrast-enhanced ultrasound

来源：评论

学校读者我要写书评

暂无评论

Predictors for Microinvasion of Small Hepatocellular Carcinoma ≤2 cm

引用

ANNALS OF SURGICAL ONCOLOGY 2012年第6期19卷 2027-2034页

作者： Yamashita, Yo-ichi Tsuijita, Eiji Takeishi, Kazuki Fujiwara, Megumu Kira, Shinsuke Mori, Masaki Aishima, Shinichi Taketomi, Akinobu Shirabe, Ken Ishida, Terutoshi Maehara, Yoshihiko Hiroshima Red Cross Hosp Dept Surg Hiroshima Japan Atom Bomb Survivors Hosp Hiroshima Japan Kyushu Univ Grad Sch Med Sci Dept Surg & Sci Fukuoka 812 Japan Hiroshima Red Cross Hosp Dept Pathol Hiroshima Japan Hiroshima Red Cross Hosp Dept Internal Med Liver Hiroshima Japan Hiroshima Red Cross Hosp Dept Radiol Hiroshima Japan Kyushu Univ Grad Sch Med Sci Dept Anat Pathol Fukuoka 812 Japan

Hepatocellular carcinoma (HCC) a parts per thousand currency sign2 cm in diameter is considered to have a low potential for malignancy. A retrospective review was undertaken of 149 patients with primary solitary HCC a parts per thousand currency sign2 cm who underwent initial hepatic resection between 1994 and 2010. The independent predictors of the microinvasion (MI) such as portal venous, hepatic vein, or bile duct infiltration and/or intrahepatic metastasis were identified by multivariate analysis. Prognosis of patients with HCC a parts per thousand currency sign2 cm accompanied by MI was compared to that of patients with HCC a parts per thousand currency sign2 cm without MI. Forty-three patients with HCC a parts per thousand currency sign2 cm had MI in patients (28.9%). Three independent predictors of the MI were revealed: invasive gross type (simple nodular type with extranodular growth or confluent multinodular type), des-gamma-carboxy prothrombin (DCP) > 100 mAU/ml, and poorly differentiated. Disease-free survival rates of patients with HCC a parts per thousand currency sign2 cm with MI (3 year 44%) were significantly worse than those for HCC a parts per thousand currency sign2 cm without MI (3 year 72%). This disadvantage of disease-free survival rate of patients with HCC a parts per thousand currency sign2 cm with MI could be dissolved by hepatic resection with a wide tumor margin of a parts per thousand yen5 mm ( = 0.04). Even in cases of HCC a parts per thousand currency sign2 cm, patients who are suspected of having invasive gross type tumors in preoperative imaging diagnosis or who have a high DCP level (> 100 mAU/ml) are at risk for MI. Therefore, in such patients, hepatic resection with a wide tumor margin should be recommended.

关键词： image diagnosis Hepatic Organ System At-risk ectomy Tumor margin status Data collection platform Tumours Even number human-centered computing

来源：评论

学校读者我要写书评

暂无评论

Clinicopathological Significance of ZEB1 Protein in Patients with Hepatocellular Carcinoma

引用

ANNALS OF SURGICAL ONCOLOGY 2012年第5期19卷 1700-1706页

作者： Zhou, Yan-Ming Cao, Lu Li, Bin Zhang, Rui-Xiu Sui, Cheng-Jun Yin, Zheng-Feng Yang, Jia-Mei Xiamen Univ Affiliated Hosp 1 Dept Hepatobiliary Pancreato Vasc Surg Xiamen Peoples R China Second Mil Med Univ Eastern Hepatobiliary Surg Hosp Dept Special Treatment Shanghai Peoples R China Second Mil Med Univ Eastern Hepatobiliary Surg Hosp Dept Mol Oncol Shanghai Peoples R China

ZEB1, a member of the ZFH family of proteins (zinc-finger E-box binding homeobox), plays a central role in epithelial-mesenchymal transition (EMT) during carcinogenesis. In this study, we investigated the expression of ZEB1 in patients with hepatocellular carcinoma (HCC) and its clinical effects with underlying mechanisms. Expression levels of ZEB1 were assessed by Western blot in 5 HCC cell lines and in paired cancerous and noncancerous tissues from 110 patients with HCC. Short-hairpin RNA (shRNA) interference for ZEB1 was performed in MHCC-97H cell line. ZEB1 protein was detected at a relatively high level in metastatic human HCC cell lines (MHCC-97L and MHCC-97H) when compared with that in nonmetastatic HCC cell lines (Hep3B, PLC and Huh-7). ZEB1 was expressed at high levels in 72 of 110 HCC patients (65.4%) and correlated with advanced TNM stage, tumor size > 5 cm, intrahepatic metastasis, vascular invasion, and frequent early recurrence. The results of multivariate analysis revealed that ZEB1 high expression was a significant prognostic factor for poor overall and disease-free survivals. Silencing ZEB1 resulted in significant suppression of motility of MHCC-97H cell line, which was accompanied with increased expression of the epithelial marker E-cadherin and decreased expression of the mesenchymal markers N-cadherin and vimentin. Furthermore, silencing ZEB1 prevented the spread of intrahepatic metastasis and increased overall survival in mouse orthotopic tumor models. This study shows that ZEB1 high expression was correlated with HCC malignant progression and subsequent poor patient survival by induction of EMT changes.

关键词： Hepatocellular Cancer Zinc Finger E-box-Binding Homeobox 1 Disease-Free Survival human-centered computing Cell Line

来源：评论

学校读者我要写书评

暂无评论

Is Serum Alpha-Fetoprotein Useful for Predicting Recurrence and Mortality Specific to Hepatocellular Carcinoma After Hepatectomy? A Test Based on Propensity Scores and Competing Risks Analysis

引用

ANNALS OF SURGICAL ONCOLOGY 2012年第12期19卷 3687-3696页

作者： Shim, Ju Hyun Yoon, Da-Lim Han, Seungbong Lee, Young-Joo Lee, Sung-Gyu Kim, Kang Mo Lim, Young-Suk Lee, Han Chu Chung, Young-Hwa Lee, Yung Sang Univ Ulsan Coll Med Asan Med Ctr Dept GastroenterolAsan Liver Ctr Seoul South Korea Univ Ulsan Coll Med Asan Med Ctr Dept Biostat Seoul South Korea Univ Ulsan Coll Med Asan Med Ctr Dept SurgAsan Liver Ctr Seoul South Korea

Serum alpha-fetoprotein (AFP) is frequently used to predict posthepatectomy outcomes in patients with hepatocellular carcinoma (HCC), but its predictive value is still not established. Therefore, we assessed the prognostic significance of AFP status. Of 525 patients undergoing curative hepatectomy for HCC, 290 had preoperative AFP levels of a parts per thousand yen20 ng/mL (AFP-positive group) and 235 had AFP levels of < 20 ng/mL (AFP-negative group). We compared the 2 groups with respect to time-to-recurrence, using the inverse probability of treatment weighted (IPTW) for the entire cohort and propensity score matching, and the cumulative incidence of HCC-specific mortality using competing risks regression. During follow-up (median duration 64 months, range 2-137 months), HCC recurred in 54.9 % of the AFP-negative group and 52.4 % of the AFP-positive group;there was no death without recurrence. After IPTW adjustment, time-to-recurrence did not differ in the 2 groups (hazard ratio [HR] 0.86, 95 % confidence interval [95 % CI] 0.66-1.12;P = 0.28). In a propensity-score matched cohort (152 pairs), time-to-recurrence data were similar to those obtained by IPTW adjustment (HR 0.91, 95 % CI 0.65-1.25;P = 0.55). There was no difference in recurrence pattern (site and stage) or treatment between the 2 groups even after propensity-score matching. The adjusted HR evaluating the impact of AFP positivity on the risk of HCC-specific mortality was 0.77 (95 % CI 0.54-1.08;P = 0.13) A multivariable competing risks analysis also failed to reveal a significant correlation between baseline AFP level and HCC-specific mortality in the AFP-positive group. Preoperative AFP levels are not useful for predicting recurrence or survival endpoints following curative hepatectomy for HCC.

关键词： Propensity Score Hepatocellular Cancer Incidence Hepatectomy Relapse Death human-centered computing

来源：评论

学校读者我要写书评

暂无评论

Phase I/II Multicenter Study of Transarterial Chemoembolization with a Cisplatin Fine Powder and Porous Gelatin Particles for Unresectable Hepatocellular Carcinoma: Japan Interventional Radiology in Oncology Study Group Study 0401

引用

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 2012年第10期23卷 1278-1285页

作者： Osuga, Keigo Arai, Yasuaki Anai, Hiroshi Takeuchi, Yoshito Aramaki, Takeshi Sugihara, Eiji Yamamoto, Takanobu Inaba, Yoshitaka Ganaha, Fumikiyo Seki, Hiroshi Sadaoka, Shunichi Sato, Mikio Kobayashi, Takeshi Kodama, Yoshihisa Inoh, Shinichi Yamakado, Koichiro Osaka Univ Grad Sch Med Dept Diagnost & Intervent Radiol Suita Osaka 5650871 Japan Natl Canc Ctr Dept Diagnost Radiol Gyeonggi Do South Korea Jikei Univ Sch Med Dept Radiol Tokyo Japan Univ Tokyo Grad Sch Med Dept Radiol Tokyo Japan Nara Med Univ Dept Radiol Kashihara Nara 634 Japan Shizuoka Canc Ctr Div Diagnost Radiol Shizuoka Japan Osaka Med Ctr Canc & Cardiovasc Dis Dept Diagnost Radiol Osaka Japan Tochigi Canc Ctr Hosp Dept Radiol Utsunomiya Tochigi Japan Aichi Canc Ctr Hosp Dept Diagnost & Intervent Radiol Nagoya Aichi 464 Japan Niigata Canc Ctr Hosp Dept Diagnost Radiol Niigata Japan Ryugasaki Saiseikai Hosp Dept Gastroenterol & Hepatol Ryugasaki Japan Ishikawa Prefectural Cent Hosp Dept Diagnost & Intervent Radiol Kanazawa Ishikawa Japan Teine Keijinkai Hosp Dept Radiol Sapporo Hokkaido Japan Mie Univ Grad Sch Med Dept Diagnost Radiol Tsu Mie 514 Japan

Purpose: A multicenter phase I/II study of transarterial chemoembolization with a fine cisplatin powder and gelatin particles (GPs) for multifocal hepatocellular carcinoma (HCC) was conducted. Primary endpoints were dose-limiting toxicity (DLT) and recommended dose (RD). Secondary endpoints were the incidence and severity of adverse events and tumor response. Materials and Methods: Nonselective transarterial chemoembolization was performed until all tumor enhancement disappeared. Lipiodol was not used. In the phase I study, the cisplatin dose was escalated from 35 mg/m(2) to 65 mg/m(2) in 15-mg/m(2) increments to determine DLT and RD. In the phase II study, 40 patients were treated with the RD. Toxicity was assessed by Common Toxicity Criteria for Adverse Effects (version 3.0), and tumor response was evaluated by Response Evaluation Criteria in Solid Tumors (RECIST;version 1.0) and European Association for the Study of the Liver (EASL) criteria. Results: A total of 46 patients were enrolled. As no DLT occurred at any dose level in the phase I study, RD was determined as 65 mg/m(2). In the phase II study, the treatment was discontinued in one patient as a result of vasovagal response. Toxicities of grade 3 or higher included nausea (2.2%), pancreatitis (2.2%), cholecystitis (2.2%), thrombocytopenia (8.7%), hyperbilirubinemia (2.2%), and increased aspartate aminotransferase (28.3%) and alanine aminotransferase (21.7%) levels. Tumor response rates under RD were 25.6% and 64.1% by RECIST and EASL criteria, respectively. Conclusions: Nonselective transarterial chemoembolization with fine cisplatin powder and GPs was well tolerated and effective in patients with multifocal HCC at the RD of 65 mg/m(2).

关键词： alanine aminotransferase ALT aspartate aminotransferase AST complete response CR DEB DLT dose limiting toxicity drug-eluting bead EASL European Association for the Study of the Liver gelatin particle GP HAIC HCC hepatic arterial infusion chemotherapy hepatocellular carcinoma maximum tolerated dose MTD NE not evaluable partial response PR RD RECIST recommended dose Response Evaluation Criteria in Solid Tumors Partial Remission Alanine Transaminase Response Evaluation Criteria in Solid Tumors REMEDIAL DESIGN Glutamic Oxaloacetic Transaminase fine powders Complete Remission Maximum Tolerated Dose Hepatocellular Cancer chemoembolization human-centered computing AST Cisplatin Aspartate Aminotransferases

来源：评论

学校读者我要写书评

暂无评论

Diffuse Infiltrative Hepatocellular Carcinoma: Assessment of Presentation, Treatment, and Outcomes

引用

ANNALS OF SURGICAL ONCOLOGY 2012年第9期19卷 2897-2907页

作者： Kneuertz, Peter J. Demirjian, Aram Firoozmand, Amin Corona-Villalobos, Celia Bhagat, Nikhil Herman, Joseph Cameron, Andrew Gurakar, Ahmet Cosgrove, David Choti, Michael A. Geschwind, Jean-Francois H. Kamel, Ihab R. Pawlik, Timothy M. Johns Hopkins Univ Sch Med Dept Surg Liver Tumor Ctr Baltimore MD 21205 USA Johns Hopkins Univ Sch Med Dept Radiol Liver Tumor Ctr Baltimore MD 21205 USA Johns Hopkins Univ Sch Med Liver Tumor Ctr Dept Intervent Radiol Baltimore MD 21205 USA Johns Hopkins Univ Sch Med Dept Radiat Oncol Liver Tumor Ctr Baltimore MD 21205 USA Johns Hopkins Univ Sch Med Dept Hepatol Liver Tumor Ctr Baltimore MD 21205 USA Johns Hopkins Univ Sch Med Dept Med Oncol Liver Tumor Ctr Baltimore MD 21205 USA

Data on infiltrating hepatocellular carcinoma (HCC) are limited. We sought to define treatment and outcome of patients treated with infiltrating HCC compared with patients who had advanced multifocal HCC. Between January 2000 and July 2011, a total of 147 patients with advanced HCC were identified from the Johns Hopkins Hospital database (infiltrative, n = 75;multifocal, n = 72). Clinicopathologic data were compared by HCC subtype. Patients with infiltrating HCC had higher alfa-fetoprotein levels (median infiltrative, 326.5 ng/mL vs. multifocal, 27.0 ng/mL) and larger tumors (median size, infiltrating, 9.2 cm vs. multifocal, 5.5 cm) (P < 0.05). Imaging failed to reveal a discrete lesion in 42.7 % of patients with infiltrating HCC. Most infiltrating HCC lesions presented as hypointense on T1-weighted images (55.7 %) and hyperintense on T2-weighted images (80.3 %). Among patients with infiltrating HCC, most (64.0 %) were treated with intra-arterial therapy (IAT), and periprocedural morality was 2.7 %. Patients treated with IAT had longer survival versus patients receiving best support care (median survival, IAT, 12 months vs. best supportive care, 3 months;P = 0.001). Survival after IAT was similar among patients treated with infiltrating HCC versus multifocal HCC (hazard ratio 1.29, 95 % confidence interval 0.82-2.03;P = 0.27). Among infiltrating HCC patients, pretreatment bilirubin > 2 mg/dL and alfa-fetoprotein > 400 ng/mL were associated with worse survival after IAT (P < 0.05). Patients with progressive disease after IAT had higher risk of death versus patients who had stable/responsive disease (hazard ratio 3.53, 95 % confidence interval 1.49-8.37;P = 0.004). Patients with infiltrative HCC often present without a discrete lesion on imaging. IAT for infiltrative HCC was safe and was associated with survival comparable to IAT outcomes for patients with multifocal HCC. Infiltrative HCC morphology is not a contraindication to IAT therapy in select patients.

关键词： Hepatocellular Cancer Progressive Neoplastic Disease human-centered computing risk of death infiltration Patients

来源：评论

学校读者我要写书评

暂无评论

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案：

请选择收藏分类：

通借通还

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：