检索结果-内蒙古大学图书馆

Priority of Candidates With Hepatocellular Carcinoma Awaiting Liver Transplantation Can Be Reduced After Successful Bridge Therapy

引用

LIVER TRANSPLANTATION 2011年第11期17卷 1344-1354页

作者： Cucchetti, Alessandro Cescon, Matteo Bigonzi, Eleonora Piscaglia, Fabio Golfieri, Rita Ercolani, Giorgio Morelli, Maria Cristina Ravaioli, Matteo Pinna, Antonio Daniele Univ Bologna St Orsola Malpighi Hosp Dept Gen Surg Liver & Multiorgan Transplant Unit I-40138 Bologna Italy Univ Bologna St Orsola Malpighi Hosp Dept Internal Med & Gastroenterol I-40138 Bologna Italy Univ Bologna St Orsola Malpighi Hosp Radiol Unit I-40138 Bologna Italy

The allocation rules for patients with hepatocellular carcinoma (HCC) who are awaiting liver transplantation (LT) are a difficult issue and are continually evolving. To reduce tumor progression or down-stage advanced disease, most transplant centers have adopted the practice of treating HCC candidates with resection or locoregional therapies. This study was designed to assess the effectiveness of bridge therapy in preventing removal from the waiting list for death/sickness severity or tumor progression beyond the Milan criteria and in determining posttransplant outcomes. The removal rates for 315 adult patients with HCC who were listed for LT were analyzed and were correlated to responses to bridge therapy with a competing risk analysis. The 3-, 6-, and 12-month dropout rates were 3.5%, 6.5%, and 19.9%, respectively, and they were significantly affected by the Model for End-Stage Liver Disease score (P = 0.032), the tumor stage at diagnosis (P = 0.041), and the response to bridge therapy (P < 0.001). The stratification of candidates by the tumor stage and the response to bridge therapy showed that patients with T2 tumors who achieved only a partial response or no response to bridge therapy had the highest dropout rates, and they were followed by patients with successfully down-staged T3-T4a tumors (P = 0.037). Patients with T2 tumors who had a complete response and patients with T1 tumors had similar dropout rates (P = 0.964). The response to bridge therapy significantly affected both the recurrence rate of 176 transplant patients (P = 0.017) and the overall intention-to-treat survival rate (P = 0.001). In conclusion, the response to therapy is a potentially effective tool for prioritizing HCC patients for LT as well as select cases with different risks of tumor recurrence after transplantation. Liver Transpl 17:1344-1354, 2011. (C) 2011 AASLD.

关键词： Partial Remission Medicine Patients Neoplasm Staging precedence Tumours Tumor Progression human-centered computing Level Trigger Liver Transplantation Repetition rate

来源：评论

学校读者我要写书评

暂无评论

Growth of Hepatocellular Carcinoma in the Regenerating Liver

引用

LIVER TRANSPLANTATION 2011年第7期17卷 866-874页

作者： Shi, Ji-Hua Huitfeldt, Henrik S. Suo, Zhen-He Line, Pal-Dag Oslo Univ Hosp Dept Organ Transplantat Gastroenterol & Nephrol Rikshosp N-0424 Oslo Norway Oslo Univ Hosp Dept Pathol Rikshosp N-0424 Oslo Norway Oslo Univ Hosp Inst Surg Res Rikshosp N-0424 Oslo Norway Zhengzhou Univ Affiliated Hosp 1 Dept Surg Zhengzhou Peoples R China

Liver resection and liver transplantation are the treatment modalities with the greatest potential for curing hepatocellular carcinoma (HCC). Tumor recurrence after resection for HCC is, however, a major problem, and an increased rate of recurrence after living donor transplantation versus cadaveric whole liver transplantation has been suggested. Factors involved in liver regeneration may stimulate the growth of occult tumors. The aim of this project was to test the hypothesis that a microscopic HCC tumor in the setting of partial hepatectomy would show enhanced growth and signs of increased invasiveness corresponding to the size of the liver resection. Hepatectomy was performed to various degrees in groups of Buffalo rats with the concomitant implantation of a fixed number of hepatoma cells in the remnant liver;a control group underwent only resection. After 21 days, the sizes and numbers of the tumors and the expression of alpha-fetoprotein (AFP), cyclin D1, calpain small subunit 1 (CAPNS1), CD34 (a microvessel density marker), vascular endothelial growth factor (VEGF), and vascular endothelial growth factor receptor 2 (VEGFR2) were evaluated and compared between the groups. The tumor volume and number increased significantly with the size of the partial hepatectomy (P < 0.05). The largest resections were also associated with increased hepatoma cell infiltration in the lungs and significant up-regulation of cyclin D1, AFP, CAPNS1, CD34, VEGF, and VEGFR2. The results suggest that liver regeneration after partial hepatectomy facilitates the growth and malignant transformation of microscopic HCC, and this could be significant for liver resection and partial liver transplantation strategies for HCC. Liver Transpl 17:866-874, 2011. (C) 2011 AASLD.

关键词： Hepatectomy Liver Transplantation Tumours Liver Regeneration Hepatocellular Cancer Vascular Endothelial Growth Factor A ectomy partial hepatectomy Vascular Endothelial Growth Factor Receptor-2 hepatoma cell Tumor Volume human-centered computing biologic regeneration Living Donors

来源：评论

学校读者我要写书评

暂无评论

Lens Culinaris Agglutinin-Reactive Fraction of Alpha-Fetoprotein as a Marker of Prognosis and a Monitor of Recurrence of Hepatocellular Carcinoma After Curative Liver Resection

引用

ANNALS OF SURGICAL ONCOLOGY 2011年第8期18卷 2218-2223页

作者： Zhang, Xiao-Feng Lai, Eric C. H. Kang, Xiao-Yan Qian, Hai-Hua Zhou, Yan-Ming Shi, Le-Hua Shen, Feng Yang, Ye-Fa Zhang, Yu Lau, Wan Yee Wu, Meng-Chao Yin, Zheng-Feng Second Mil Med Univ Eastern Hepatobiliary Surg Hosp Mol Oncol Lab Shanghai Peoples R China Second Mil Med Univ Eastern Hepatobiliary Surg Hosp Dept Comprehens Treatment Shanghai Peoples R China Chinese Univ Hong Kong Fac Med Shatin Hong Kong Peoples R China Xiamen Univ Affiliated Hosp 1 Dept Hepatobiliary Pancreatovasc Surg Xiamen Peoples R China

The aim of this study was to determine the role of Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) as a prognostic marker and a monitor marker of recurrence after curative resection of hepatocellular carcinoma (HCC). From December 2002 to May 2004, 395 consecutive patients with HCC who underwent curative partial hepatectomy were included in the study. The tumor characteristics and clinical outcomes of patients with positive preoperative and postoperative AFP-L3 were compared with those with negative results. A high ratio of AFP-L3 to total AFP was an indicator of pathologic aggressiveness. Patients with positive preoperative AFP-L3 had significantly earlier recurrence (median time to recurrence 22.0 +/- A 2.4 months vs 45.0 +/- A 6.9 months, P < .001) when compared with those with negative preoperative results. Significantly more patients with continuously positive or negative-turn-positive AFP-L3 results after surgery developed recurrence, particularly distant metastases, when compared with patients with continuously negative AFP-L3 results. The overall and disease-free survivals were significantly shorter in the positive than the negative preoperative AFP-L3 group. The overall and disease-free survivals were significantly shorter in the continuously positive and the negative-turn-positive than the continuously negative postoperative AFP-L3 group. Positive preoperative AFP-L3 and continuously positive or negative-turn-positive AFP-L3 results after surgery predicted a more aggressive tumor behavior, higher tumor recurrence, and poorer clinical outcomes. HCC patients with an increased proportion of AFP-L3 to total AFP should be more aggressively treated and closely followed-up.

关键词： Positive Lens culinaris partial hepatectomy Hepatocellular Cancer Hepatectomy Relapse Disease-Free Survival lentil lectin human-centered computing Prognosis Negative MONITOR

来源：评论

学校读者我要写书评

暂无评论

The combination of sorafenib with transarterial chemoembolisation for hepatocellular carcinoma

引用

ALIMENTARY PHARMACOLOGY & THERAPEUTICS 2011年第2期34卷 205-213页

作者： Cabrera, R. Pannu, D. S. Caridi, J. Firpi, R. J. Soldevila-Pico, C. Morelli, G. Clark, V. Suman, A. George, T. J., Jr. Nelson, D. R. Univ Florida Dept Med Div Gastroenterol Hepatol & Nutr Sect Hepatobiliary Dis Gainesville FL 32610 USA Univ Florida Dept Med Div Internal Med Gainesville FL 32610 USA Univ Florida Dept Radiol Div Intervent Radiol Gainesville FL 32610 USA Univ Florida Dept Med Div Oncol Gainesville FL 32610 USA

Background Standard of practice involves using transarterial therapy for multifocal hepatocellular carcinoma (HCC) alone and sorafenib only for more advanced HCC, but the sorafenib and transarterial therapy combination may provide greater efficacy. Aim To evaluate the safety and efficacy of concurrent sorafenib and transarterial therapy in HCC. Methods Consecutive cases of HCC were treated with sorafenib and transarterial therapy, receiving sorafenib 2 to 4 weeks before transarterial therapy. Baseline clinical parameters, adverse events (AEs) and survival were collected. Results A total of 47 patients received sorafenib and transarterial therapy. The majority of the patients were male (70%) with HCV (60%), median age of 60 years, good performance status (0-1), stable cirrhosis (Child: A 72%;B 28%), unresectable tumour (stage: B 81%;C 19%) and median AFP of 24 ng/mL. Median follow-up was 12 months and median time on sorafenib was 6 months. LC Bead TACE was used with a median frequency of 3. The majority of the patients (89%) experienced AEs. The most common AEs were fatigue (51%), hand-foot skin reaction (51%) and diarrhoea (43%). Grade 3 and 4 AEs included fatigue (13%) and hand-foot skin reaction (26%). Most patients required a dose reduction (66%). The main AE related to transarterial therapy was post-TACE syndrome (23%). The disease control rate was 68% at 6 months. Overall median survival rate was 18.5 months (95% CI 16.1-20.9 months). Conclusion Concurrent sorafenib and transarterial therapy is overall safe with no unexpected side effects and encouraging efficacy that warrants further study.

关键词： sorafenib Medicine Side Effect Hepatocellular Cancer Median human-centered computing

来源：评论

学校读者我要写书评

暂无评论

Importance of Low Preoperative Platelet Count in Selecting Patients for Resection of Hepatocellular Carcinoma: A Multi-Institutional Analysis

引用

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS 2011年第4期212卷 638-648页

作者： Maithel, Shishir K. Kneuertz, Peter J. Kooby, David A. Scoggins, Charles R. Weber, Sharon M. Martin, Robert C. G., II McMasters, Kelly M. Cho, Clifford S. Winslow, Emily R. Wood, William C. Staley, Charles A., III Emory Univ Winship Canc Inst Dept Surg Div Surg OncolSch Med Atlanta GA 30322 USA Univ Louisville Sch Med Dept Surg Div Surg Oncol Louisville KY 40292 USA Univ Wisconsin Dept Surg Div Surg Oncol Sch Med & Publ Hlth Madison WI USA

BACKGROUND: Low platelet count is a marker of portal hypertension but is not routinely included in the standard preoperative evaluation of patients with hepatocellular carcinoma (HCC) because it pertains to liver function (Child/model for end-stage liver disease [MELD] score) and tumor burden (Milan criteria). We hypothesized that low platelet count would be independently associated with increased perioperative morbidity and mortality after resection. STUDY DESIGN: Patients treated with liver resection for HCC between January 2000 and January 2010 at 3 institutions were eligible. Preoperative platelet count, Child/MELD score, and tumor extent were recorded. Low preoperative platelet count (LPPC) was defined as < 150 x 10(3)/mu L. Postoperative liver insufficiency (PLI) was defined as peak bilirubin > 7 mg/dL or development of ascites. Univariate and multivariate regression was performed for predictors of major complications, PLI, and 60-day mortality. RESULTS: A total of 231 patients underwent resection, of whom 196 (85%) were classified as Child A and 35 (15%) as Child B;median MELD score was 8. Overall, 168 (71%) had tumors that exceeded Milan criteria and 134 (58%) had major hepatectomy (>= 3 Couinaud segments). Overall and major complication rates were 55% and 17%, respectively. PLI occurred in 25 patients (11%), and 21 (9%) died within 60 days of surgery. Patients with LPPC (n = 50) had a significantly increased number of major complications (28% versus 14%, p = 0.031), PLI (30% versus 6%, p = 0.001), and 60-day mortality (22% versus 6%, p = 0.001). When adjusted for Child/MELD score and tumor burden, LPPC remained independently associated with increased number of major complications (odds ratio [OR] 2.8, 95% confidence intervals [CI] 1.1 to 6.8, p = 0.026), PLI (OR 4.0, 95% CI 1.4 to 11.1, p = 0.008), and 60-day mortality (OR 4.6, 95% CI 1.5 to 14.6, p = 0.009). CONCLUSIONS: LPPC is independently associated with increased major complications, PLI, and mortalit

关键词： Hepatocellular Cancer Death Platelet Count ectomy Mortality Portal Hypertension Hepatectomy Tumor Burden Tumours human-centered computing Complication Patients

来源：评论

学校读者我要写书评

暂无评论

Identification of miRNomes in human Liver and Hepatocellular Carcinoma Reveals miR-199a/b-3p as Therapeutic Target for Hepatocellular Carcinoma

引用

CANCER CELL 2011年第2期19卷 232-243页

作者： Hou, Jin Lin, Li Zhou, Weiping Wang, Zhengxin Ding, Guoshan Dong, Qiongzhu Qin, Lunxiu Wu, Xiaobing Zheng, Yuanyuan Yang, Yun Tian, Wei Zhang, Qian Wang, Chunmei Zhang, Qinghua Zhuang, Shi-Mei Zheng, Limin Liang, Anmin Tao, Wenzhao Cao, Xuetao Second Mil Med Univ Natl Key Lab Med Immunol Shanghai 200433 Peoples R China Second Mil Med Univ Inst Immunol Shanghai 200433 Peoples R China Tsinghua Univ Sch Med Inst Immunol Beijing 100084 Peoples R China Zhejiang Univ Sch Med Inst Immunol Hangzhou 310058 Zhejiang Peoples R China Eastern Hepatobiliary Surg Hosp Dept Hepat Surg 3 Shanghai 200438 Peoples R China Shanghai Changzheng Hosp Dept Organ Transplantat Shanghai 200003 Peoples R China Fudan Univ Liver Canc Inst Shanghai 200032 Peoples R China Fudan Univ Zhongshan Hosp Inst Biomed Sci Shanghai 200032 Peoples R China Natl Lab Mol Virol & Genet Engn Beijing 100052 Peoples R China Beijing Genom Inst Shenzhen 518083 Peoples R China Sun Yat Sen Univ Sch Life Sci Guangzhou 510275 Guangdong Peoples R China Guangxi Med Univ Affiliated Tumor Hosp Nanning 530021 Peoples R China

The full scale of human miRNome in specific cell or tissue, especially in cancers, remains to be determined. An in-depth analysis of miRNomes in human normal liver, hepatitis liver, and hepatocellular carcinoma (HCC) was carried out in this study. We found nine miRNAs accounted for similar to 88.2% of the miRNome in human liver. The third most highly expressed miR-199a/b-3p is consistently decreased in HCC, and its decrement significantly correlates with poor survival of HCC patients. Moreover, miR-199a/b-3p can target tumor-promoting PAK4 to suppress HCC growth through inhibiting PAK4/Raf/MEK/ERK pathway both in vitro and in vivo. Our study provides miRNomes of human liver and HCC and contributes to better understanding of the important deregulated miRNAs in HCC and liver diseases.

关键词： Hepatocellular Cancer FULL-SCALE MicroRNAs Liver Diseases Liver human-centered computing

来源：评论

学校读者我要写书评

暂无评论

Toward Optimizing the Indications for Orthotopic Liver Transplantation in Hepatocellular Carcinoma

引用

LIVER TRANSPLANTATION 2011年第S2期17卷 S6-S13页

作者： Samuel, Didier Colombo, Massimo El-Serag, Hachem Sobesky, Rodolphe Heaton, Nigel Hop Paul Brousse AP HP Ctr Hepato Biliaire F-94800 Villejuif France INSERM U785 Villejuif France Univ Paris Sud UMR S785 Villejuif France Mangiagalli & Regina Elena Hosp Div Gastroenterol 1 Fdn Sci Inst Res Hosp & Hlth Care Milan Italy Michael E DeBakey VA Med Ctr Houston TX USA Baylor Coll Med Houston TX 77030 USA Kings Coll Hosp Inst Liver Studies London England

Key Points

关键词： Patients Survival Rate human-centered computing Waiting Lists patient history of liver transplantation Indications Liver Transplantation

来源：评论

学校读者我要写书评

暂无评论

Mutant Thyroid Hormone Receptors (TRs) Isolated from Distinct Cancer Types Display Distinct Target Gene Specificities: A Unique Regulatory Repertoire Associated with Two Renal Clear Cell Carcinomas

引用

MOLECULAR ENDOCRINOLOGY 2011年第8期25卷 1311-1325页

作者： Rosen, Meghan D. Chan, Ivan H. Privalsky, Martin L. Univ Calif Davis Dept Microbiol Coll Biol Sci Davis CA 95616 USA

Thyroid hormone receptors (TRs) are hormone-regulated transcription factors that regulate a diverse array of biological activities, including metabolism, homeostasis, and development. TRs also serve as tumor suppressors, and aberrant TR function (via mutation, deletion, or altered expression) is associated with a spectrum of both neoplastic and endocrine diseases. A particularly high frequency of TR mutations has been reported in renal clear cell carcinoma (RCCC) and in hepatocellular carcinoma (HCC). We have shown that HCC-TR mutants regulate only a fraction of the genes targeted by wild-type TRs but have gained the ability to regulate other, unique, targets. We have suggested that this altered gene recognition may contribute to the neoplastic phenotype. Here, to determine the generality of this phenomenon, we examined a distinct set of TR mutants associated with RCCC. We report that two different TR mutants, isolated from independent RCCC tumors, possess greatly expanded target gene specificities that extensively overlap one another, but only minimally overlap that of the wild-type TRs, or those of two HCC-TR mutants. Many of the genes targeted by either or both RCCC-TR mutants have been previously implicated in RCCC and include a series of metallothioneins, solute carriers, and genes involved in glycolysis and energy metabolism. We propose as a hypothesis that TR mutations from RCCC and HCC may play tissue-specific roles in carcinogenesis, and that the divergent target gene recognition patterns of TR mutants isolated from the two different types of tumors may arise from different selective pressures during development of RCCC vs. HCC. (Molecular Endocrinology 25: 1311-1325, 2011)

关键词： Mutants Distinct F2R gene Tumor Suppressor Genes TMEFF2 gene Thyroid hormone receptors Clear Cell Renal Cell Carcinoma TRANSFORMER ROOM human-centered computing

来源：评论

学校读者我要写书评

暂无评论

Does antiviral therapy prevent hepatocellular carcinoma?

引用

ANTIVIRAL THERAPY 2011年第6期16卷 787-795页

作者： Kwon, Hellan Lok, Anna S. Univ Michigan Div Gastroenterol & Hepatol Ann Arbor MI 48109 USA

Chronic infection with HBV or HCV can lead to the development of hepatocellular carcinoma (HCC). The major risk factors for HBV-related HCC are persistent presence of hepatitis B e antigen (HBeAg) and/or high serum HBV DNA levels, and cirrhosis. The major risk factor for HCV-related HCC is cirrhosis. One randomized double blind controlled trial of lamivudine in patients with HBeAg and/or high serum HBV DNA levels showed that antiviral therapy prevented disease progression and reduced the incidence of HCC. A beneficial effect of antiviral therapy on the risk of HCC has also been shown in cohort studies and meta-analyses, particularly among responders. Several randomized controlled trials of interferon in patients with HCV-related cirrhosis showed that treated patients had a lower incidence of HCC. A greater effect was observed in patients who achieved sustained virological response, while the benefit in non-responders is unclear. Antiviral therapies for hepatitis B and hepatitis C can prevent but not completely eliminate HCC. Improvement in identification of infected persons, accessibility of care and affordability of treatment is needed for antiviral therapy to have a major impact on the global incidence of HCC.

关键词： antiviral therapy Hepatitis B e Antigens Hepatocellular Cancer Hepatitis B virus human-centered computing Risk Factors Hepatitis B and hepatitis C chronic infection

来源：评论

学校读者我要写书评

暂无评论

Comparative Analysis of the Safety and Efficacy of Transcatheter Arterial Chemoembolization and Yttrium-90 Radioembolization in Patients with Unresectable Hepatocellular Carcinoma

引用

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 2011年第12期22卷 1697-1705页

作者： Lance, Craig McLennan, Gordon Obuchowski, Nancy Cheah, Grace Levitin, Abraham Sands, Mark Spain, James Srinivas, Shyam Shrikanthan, Sankaran Aucejo, Federico N. Kim, Richard Menon, K. V. Narayanan Cleveland Clin Fdn Inst Digest Dis Imaging Inst Cleveland OH 44195 USA Cleveland Clin Fdn Inst Digest Dis Dept Transplant Surg Cleveland OH 44195 USA Case Western Reserve Univ Sch Med Cleveland OH USA Cleveland Clin Fdn Inst Digest Dis Div Vasc & Intervent Radiol Cleveland OH 44195 USA Cleveland Clin Fdn Inst Digest Dis Dept Quantitat Hlth Sci Cleveland OH 44195 USA

Purpose: To compare retrospectively the safety and efficacy of yttrium-90 ((90)Y) radioembolization with the safety and efficacy of chemoembolization in patients with unresectable hepatocellular carcinoma (HCC). Materials and Methods: Survival and complication rates were evaluated for patients with HCC who underwent chemoembolization or radioembolization at a single institution between August 2007 and April 2010. Complications were graded according to a standardized grading system for embolization procedures. Survival was determined via the Kaplan-Meier method, and multivariable analysis for factors affecting survival was performed. Results: This study included 73 patients with HCC who underwent index embolization with radioembolization (n = 38;52.1%) or chemoembolization (n = 35;47.9%). The two patient populations were similar in terms of demographics, etiology of cirrhosis, functional status, tumor characteristics, Child-Pugh class, previous liver-directed therapy, and number of patients with bilirubin > 2.0 mg/dL. There was no significant difference in survival between the radioembolization (median 8.0 months) and chemoembolization (median 10.3 months) cohorts (P = .33). Postembolization syndrome was significantly more severe in patients who underwent chemoembolization, which led to increased total hospitalization rates in these patients. The rates of other complications and rehospitalization were similar between groups. Increased age, Child-Pugh class B, hepatitis seropositivity, bilobar tumor distribution, tumor vascular invasion, and presence of extrahepatic metastases were associated with reduced patient survival. Conclusions: Patients treated with radioembolization did not show a survival advantage over patients treated with chemoembolization. However, patients who underwent chemoembolization had significantly higher rates of hospitalization as a result of postembolization syndrome.

关键词： 90Y AFP alpha-fetoprotein CI confidence interval Eastern Cooperative Oncology Group ECOG HCC hepatocellular carcinoma yttrium-90 chemoembolization Hepatocellular Cancer Yttrium 90 human-centered computing Electrocorticography 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

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

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：