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| 1 | 肝癌介入治疗后血清缺氧诱导因子和血管内皮生长因子含量变化对预后的影响显示文摘目的探讨肝癌肝动脉灌注化疗栓塞术(transarterial chemoembolization,TACE)治疗后血清中缺氧诱导因子(HIF)-1a、血管内皮生长因子(VEGF)的含量变化对预后的影响。方法 2007年1月—2012年1月对60例肝癌患者行TACE治疗,另选20名正常人作为对照组,检测患者术前、术后血清HIF-1a VEGF含量。采用Cox回归模型分析KPS评分、Child-Pugh分级、门脉癌栓、血管侵犯及BCLC分期等因素对生存期的影响。采用Kanplan-Meier法分析术后血清中HIF-1a VEGF含量变化对预后的影响。结果 60例患者TACE术前HIF-1a和VEGF含量分别为(175.7±62.2)pg/ml和(346.6±134.6)pg/ml,明显高于对照组的(15.1±5.07)pg/ml和(49.9±11.2)pg/ml,差异有统计学意义(P<0.001)。术后第1天血清HIF-1a含量明显高于术前[(603.1±166.6)pg/ml比(175.7±62.2)pg/ml,P<0.01]。VEGF含量与术前相比差异无统计学意义(P>0.05)。术后1周血清HIF-1a、VEGF含量分别为(210.7±61.5)pg/ml和(300.1±82.6)pg/ml,较术前明显下降(P<0.05);术后1个月下降更明显[分别为(146.8±50.6)pg/ml和(244.8±54.5)pg/ml,P<0.001)]。Cox回归分析证实KPS评分、Child-Pugh分级、门脉癌栓、肝内外转移、血管侵犯等因素中,回归系数对风险度有重要相关性。Kanplan-Meier分析显示,术后血清HIF-1a、VEGF含量高低对评估预后有指导意义。结论肝癌患者行TACE治疗后血清HIF-1a和VEGF含量变化对预后有较大的影响。 | 管清龙 纪卫政 任伟新 顾俊鹏 | 2014 | 介入放射学杂志2014，23，2： | 42 |
| 2 | Meta-analysis of radiofrequency ablation in combination with transarterial chemoembolization for hepatocellular carcinoma显示文摘AIM: To compare radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE) with RFA monotherapy in hepatocellular carcinoma (HCC). METHODS: We searched PubMed, Medline, Embase and Chinese databases (CBMdisc and Wanfang data) for randomized controlled trails comparing RFA plus TACE and RFA alone for treatment of HCC from January 2000 to December 2012. The overall survival rate, re-currence-free survival rate, tumor progression rate, and safety were analyzed and compared. The analysis was conducted on dichotomous outcomes and the standard meta-analytical techniques were used. Pooled odds ratios (ORs) with 95%CIs were calculated using either the fixed-effects or random-effects model. For each meta-analysis, the χ2 and I2 tests were first calculated to assess the heterogeneity of the included trials. For P<0.05 and I 2>50%, the assumption of homogeneity was deemed invalid, and the random-effects model wasused; otherwise, data were assessed using the fixed-effects model. All statistical analysis was conducted us-ing Review manager (version 4.2.2.) from the Cochrane collaboration. RESULTS: Eight randomized controlled trials were identified as eligible for inclusion in this analysis and included 598 patients with 306 treated with RFA plus TACE and 292 with RFA alone. Our data analysis indicated that RFA plus TACE was associated a sig-nificantly higher overall survival rate (OR 1-year=2.96, 95%CI: 1.84-7.74, P<0.001; OR 2-year=3.72, 95%CI: 1.24-11.16, P=0.02; OR 3-year=2.65, 95%CI: 1.81-3.86, P<0.001) and recurrence-free survival rate (OR 3-year=3.00, 95%CI: 1.75-5.13, P<0.001; OR 5-year=2.26, 95%CI: 1.43-3.57, P=0.0004) vs that of RFA alone. The tumor progression rate in patients treated with RFA alone was higher than that of RFA plus TACE (OR=0.60, 95%CI: 0.42-0.88, P=0.008) and there was no significant difference on major complications between two different kinds of treatment (OR=1.20, 95%CI: 0.31-4.62, P=0.79). Additionally, the meta-analysis data of subgroups revealed that the survival rate was significantly higher in patients with intermediate-and large-size HCC underwent RFA plus TACE than in those underwent RFA monotherapy; however, there was no significant difference between RFA plus TACE and RFA on survival rate for small HCC. CONCLUSION: The combination of RFA with TACE has advantages in improving overall survival rate, and pro-vides better prognosis for patients with intermediate-and large-size HCC. | Jia-Yan Ni Shan-Shan Liu Lin-Feng Xu Hong-Liang Sun Yao-Ting Chen | 2013 | World Journal of Gastroenterology2013，19，24： | 34 |
| 3 | Combined TACE and PEI for palliative treatment of unresectable hepatocellular carcinoma显示文摘瞄准:估计是否 transarterial chemoembolization 的联合的有效性(不作声) 并且在 unresectable 肝细胞癌(HCC ) 的治疗的经皮的乙醇注射(PEI ) 是优异的独自不作声使随机化的控制试用是 performed.METHODS:长期的幸存率和住院的持续时间上的联合治疗的效果在 52 以前未经治疗的 HCC 被评估,随机分配了到 TACE-PEI (27 磅) 或独自不作声(25 磅) 。结果:TACE 组的累积幸存率在 6 瞬间是 75.8% , 62.9% 在 12 瞬间,并且 18.0% 分别地在 24 瞬间并且 TACE-PEI 组织 76.9% , 61.5% ,和 38.7% 。在两个组的全面幸存的比较统计上不出现了有效差量。关于有 HCC 的病人, Okuda 上演我(n = 26 ) , TACE-PEI 组的中部的幸存显著地更长(>24 瞬间,还没在学习时期到达的 median ) 与 TACE 组相比(18.4 瞬间[范围 11.6-21.7 瞬间] ;P = 0.04 ) 。TACE-PEI 为死亡把相对风险归结为 0.4 (95%CI 0.15-0.96 ) 独自与接待了的病人相比不作声。在有 HCC Okuda 阶段 II 或 III 的病人的中部的幸存是在 TACE 组的 5.0 瞬间(1.7 瞬间不定义) 与 10.4 相比,在 TACE-PEI 的瞬间组织。结论:联合 TACE-PEI 改进了生存时间与相比独自不作声。我们的学习在 HCC Okuda 舞台揭示了统计上重要的改进幸存我。副作用是次要的,联合治疗没更加延长住院的持续时间。 | Gerhild Becker Tarik Soezgen Manfred Olschewski Joerg Laubenberger Hubert Erich Blum Hans-Peter Allgaier | 2005 | World Journal of Gastroenterology2005，11，39： | 32 |
| 4 | 原发性肝癌TACE术后严重并发症原因及预防显示文摘目的探讨原发性肝癌行经导管肝动脉化疗栓塞术后严重并发症的原因及预防。方法2005年1月-2007年7月,573例原发性肝癌患者行1252次肝动脉化疗栓塞术,术后针对发生的并发症,给予积极治疗,同时结合生化及影像学检查,探讨严重并发症出现的原因及预防措施。结果并发症有上消化道出血3例、急性肝功能衰竭6例(死亡1例)、肺栓塞1例、胆汁瘤2例、胆囊炎4例、胃穿孔并死亡1例。结论经导管肝动脉化疗栓塞术治疗原发性肝癌出现的严重并发症与术前肝功能较差、门静脉高压、化疗栓塞药物剂量过大、药物反流及异位栓塞等有关。重视TACE术时机的选择,采用规范化的介入治疗措施,可以避免或减少严重并发症。 | 赵广生 徐克 梁松年 苏洪英 冯博 杨福玲 | 2008 | 介入放射学杂志2008，17，11： | 34 |
| 5 | Fuzheng Yiliu Granule(扶正抑瘤颗粒)Inhibits the Growth of Hepatocellular Cancer by Regulating Immune Function and Inducing Apoptosis In Vivo and In Vitro显示文摘Objective:To study the inhibitory effect of Fuzheng Yiliu Granule(扶正抑瘤颗粒,FYG) on hepatocellular cancer(HCC) and investigate the mechanism mediating its bioactivity.Methods:H22 tumor-bearing ICR mice were treated with FYG[3.6 g/(kg·d)]for 5 days.Tumor volume and tumor weight,percentages of CD3^+,CD4^+,CD8^+,and natural killer(NK) cells in peripheral blood,tumor apoptosis and serum levels of interleukin-2(IL-2),and tumor necrosis factor-α(TNF-α) were evaluated.FYG-containing serum was prepared from SD rats treated for 7 days[high dose 3.6 g/(kg·d);middle dose 1.8 g/(kg·d);low dose 0.9 g/(kg·d)].Cell cycle,cell viability,and apoptosis were evaluated after HepG2 cell line was cultured in FYG-containing serum for 48 h.The levels of IL-2 and TNF-αin FYG-containing serum were also determined.Results:FYG produced a potent antitumor effect(P<0.01) and induced marked apoptosis of the tumor tissue(P<0.05).Mice treated with FYG had higher percentages of CD3^+ and CD4^+(P<0.05),and more NK cells(P<0.01) in the peripheral blood than those in the animals treated with normal saline.Mice receiving FYG had the highest serum levels of IL-2 and TNF-α(P<0.01).High-dose FYG-containing serum significantly decreased HepG2 cell viability,inhibited cell proliferation(P<0.05),and induced apoptosis(P<0.01).In addition,the levels of IL-2 and TNF-αof highdose -containing serum were higher than the blank serum(P<0.01).Conclusion:FYG could inhibit HCC growth by regulating immune function and inducing apoptosis of tumor cells in vivo and in vitro. | 曹治云 陈旭征 廖联明 彭军 胡海霞 刘志臻 杜建 | 2011 | Chinese Journal of Integrative Medicine2011，17，9： | 20 |
| 6 | Ten-year survival of hepatocellular carcinoma patients undergoing radiofrequency ablation as a first-line treatment显示文摘AIM: To investigate the long-term survival and prognostic factors in hepatocellular carcinoma(HCC) patients undergoing radiofrequency ablation(RFA) as a first-line treatment.METHODS: From 2000 to 2013, 316 consecutivepatients with 404 HCC(1.0-5.0 cm; mean: 3.2 ± 1.1 cm) underwent ultrasonography-guided percutaneous RFA as a first-line treatment. There were 250 males and 66 females with an average age of 60.1 ± 10.8 years(24-87 years). Patients were followed for 1 year to > 10 years after RFA(234, 181, 136, and 71 for 3, 5, 7, and 10 years, respectively). Overall local response rates and long-term survival rates were assessed. Survival results were generated using Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression model. RESULTS: In total, 548 RFA sessions were performed and major complications occurred in 10 sessions(1.8%). Local tumor progression and/or new tumor development were observed in 43.3%(132/305) of the patients during the follow-up period. Overall 5-and 10-year survival rates were 49.7% and 28.4%, respectively. Based on multivariate analysis, three factors were identified as independent prognostic factors for overall survival: Child-Pugh classification(HR = 4.054, P < 0.001), portal vein hypertension(HR = 2.743, P = 0.002), and tumor number(HR = 2.693, P = 0.003). The local progression-free 5- and 10-year survival rates were 42.7% and 19.5%. In addition to the Child-Pugh classification and the number of tumors, the number of RFA sessions(HR = 1.550, P = 0.002) was associated with local progression-free survival.CONCLUSION: RFA can achieve acceptable outcomes for HCC patients as a first-line treatment, especially for patients with Child-Pugh class A, patients with a single tumor and patients without portal vein hypertension. | Wei Yang Kun Yan S Nahum Goldberg Muneeb Ahmed Jung-Chieh Lee Wei Wu Zhong-Yi Zhang Song Wang Min-Hua Chen | 2016 | World Journal of Gastroenterology2016，22，10： | 20 |
| 7 | 肝癌射频消融技术及疗效评价方法显示文摘目的总结肝癌射频消融(RFA)的临床经验并探讨评价RFA疗效的方法。方法对49例肝癌病人进行了统一方案的RFA治疗,其中男43例,女6例;年龄39~72岁,平均(56.4±9.3)岁。肿瘤直径1.5~10cm,其中≤3cm16例,3.1--5cm15例,〉5cm18例。按肝功能Child—Pugh分级,A级41例,B级8例。病理诊断为肝细胞癌44例,胆管细胞性肝癌5例。采用RITA射频消融肿瘤治疗系统(RF-1500)行RFA。在RFA后344周常规行CT及TACE,以评价肝癌RFA的效果及巩固疗效。结果全部病例RFA术后恢复顺利,总体1、2、3年生存率为77.5%、56.5%和44.0%,肝癌RFA后3~4周,AFP阳性(≥25μg/L)者转阴率62.9%(22/35)。改进的肝癌RFA方法可对直径5cm以下的肿瘤进行比较彻底的消融,≤5cm者1、2、3年生存率为100%、79.6%和61.9%。将肝癌消融近期疗效分为3个级别,RFA术后获得根治性消融(19例)、亚根治消融(9例)、姑息性消融(21例)者2年生存率分别为85.7%、60.0%和24.3%。结论肝癌RFA相当于从机能上切除了肿瘤,肝癌消融近期疗效三级分类法可以比较客观地评价RFA的效果,以指导辅助治疗的选择。 | 王悦华 刘家峰 李非 李昂 刘强 刘东斌 刘殿刚 | 2008 | 中华肝胆外科杂志2008，14，12： | 17 |
| 8 | 放射性粒子植入术治疗肝癌显示文摘目的观察放射性粒子植入术治疗肝癌的效果。方法对42例肝癌患者(34例原发性肝癌,8例转移性肝癌,病灶直径3.0~10.5cm)行CT引导下放射性粒子植入术。所有患者术前均经过1次或多次TACE治疗。于粒子植入术前、术后均接受CT、MR等影像学检查,并定期随访。结果术后8例(8/42,19.05%)肿瘤完全缓解,25例(25/42,59.52%)部分缓解,5例(5/42,11.90%)病变稳定,4例(4/42,9.52%)病变进展,甲胎蛋白和癌胚抗原均有不同程度下降。所有病例均未出现严重肝功能损害。结论放射性粒子植入术治疗肝癌安全、有效,配合TACE有助于提高肝癌的治疗效果。 | 申权 杨维竹 江娜 郑曲彬 黄兢姚 黄宁 | 2012 | 中国介入影像与治疗学2012，9，7： | 16 |
| 9 | 射频消融治疗549例肝肿瘤的并发症分析显示文摘目的探讨射频消融(RFA)治疗肝肿瘤的并发症及防治的经验和教训。方法对6年来本所用RFA治疗的549例肝肿瘤患者共904个病灶740次治疗情况进行总结,临床观察治疗后的并发症及防治情况。结果38例次(5.1%)患者出现并发症,包括10例皮肤烧伤、21例胸部并发症、2例肝功能不全;皮下出血、穿刺点皮肤感染、肝脓肿、胆瘘、结肠穿孔各1例。但无1例死亡。结论RFA治疗肝肿瘤的并发症率较低,且多数是可以预防的。 | 马宽生 丁钧 陈敏 欧霞 董家鸿 | 2005 | 第三军医大学学报2005，27，19： | 14 |
| 10 | CT引导下冷循环射频消融联合肝动脉热化疗栓塞治疗中晚期原发性肝癌显示文摘目的探讨CT引导下冷循环射频消融联合肝动脉热化疗栓塞治疗中晚期原发性肝癌的疗效。方法 65例中、晚期原发性肝癌患者按单双日法分为冷循环射频消融联合肝动脉热化疗栓塞组(联合治疗组,A组)31例,单纯肝动脉热化疗栓塞组(单纯组,B组)34例,治疗后通过CT、DSA及血清甲胎蛋白(AFP)测定评价。结果单纯肝动脉热化疗栓塞组(B组)的肿瘤完全坏死率、初次复发率及1年生存率分别为17.6%、38.2%、47.1%,而联合治疗组分别为48.4%、9.7%、80.6%,差异均有统计学意义。结论 CT引导下冷循环射频消融治疗联合肝动脉热化疗栓塞较单纯肝动脉热化疗栓塞治疗中、晚期肝癌效果好。 | 张文兵 王宗华 谢鸿寿 李晓乾 张庆和 | 2010 | 微创医学2010，5，3： | 14 |
| 11 | Clinical significance and risk factors of postembolization fever in patients with hepatocellular carcinoma显示文摘AIM:To investigate tumor response and survival in patients with postembolization fever(PEF) and to determine the risk factors for PEF.METHODS:Four hundred forty-three hepatocellular carcinoma(HCC) patients who underwent the first session of transcatheter arterial chemoembolization(TACE) between January 2005 and December 2009 were analyzed retrospectively.PEF was defined as a body temperature greater than 38.0 ℃ that developed within 3 d of TACE without evidence of infection.The tumor progression-free interval was defined as the interval from the first TACE to the second TACE based on mRECIST criteria.Clinical staging was based on the American Joint Committee on Cancer tumor,node,metastases(TNM) classification of malignant tumors.All patients were admitted before their 1 st TACE treatment,and blood samples were obtained from all patients before and after treatment.Clinicoradiological variables and host-related variables were compared between two groups:patients with PEF vs patients without PEF.Additionally,variables related to 20-mo mortality and tumor progression-free survival were analyzed.RESULTS:The study population comprised 370(85.4%) men and 73(14.6%) women with a mean age of 62.29 ± 10.35 years.A total of 1836 TACE sessions were conducted in 443 patients,and each patient received between 1 and 27(mean:4.14 ± 3.57) TACE sessions.The mean follow-up duration was 22.23 ± 19.6 mo(range:0-81 mo).PEF developed in 117 patients(26.41%) at the time of the first TACE session.PEF was not associated with 20-mo survival(P = 0.524) or computed tomography(CT) response(P = 0.413) in a univariate analysis.A univariate analysis further indicated that diffuse-type HCC(P = 0.021),large tumor size(≥ 5 cm)(P = 0.046),lipiodol dose(≥ 7 mL,P = 0.001),poor blood glucose control(P = 0.034),alanine aminotransferase(ALT) value after TACE(P = 0.004) and C-reactive protein(CRP) value after TACE(P = 0.036) served as possible risk factors correlated with PEF.The ALT value after TACE(P = 0.021) and lipiodol dose over 7 mL(P = 0.011) were independent risk factors for PEF in the multivariate analysis.For the 20-mo survival,poor blood sugar control(P < 0.001),portal vein thrombosis(P = 0.001),favorable CT response after TACE(P < 0.001),initial aspartate aminotransferase(P = 0.02),initial CRP(P = 0.042),tumor size(P < 0.001),TNM stage(P < 0.001) and lipiodol dose(P < 0.001) were possible risk factors in the univariate analysis.Tumor size(P = 0.03),poor blood sugar control(P = 0.043),and portal vein thrombosis(P = 0.031) were significant predictors of survival in the multivariate analysis.Furthermore,the tumor progression-free interval was closely associated with CRP > 1 mg/dL(P = 0.003),tumor size > 5 cm(P < 0.001),tumor type(poorly defined)(P < 0.001),and lipiodol dose(> 7 mL,P < 0.001).CONCLUSION:PEF has no impact on survival at 20 mo or radiologic response.However,the ALT level after TACE and the lipiodol dose represent significant risk factors for PEF. | Chung Hwan Jun Ho Seok Ki Hoon Ki Lee Kang Jin Park Seon Young Park Sung Bum Cho Chang Hwan Park Young Eun Joo Hyun Soo Kim Sung Kyu Choi Jong Sun Rew | 2013 | World Journal of Gastroenterology2013，19，2： | 7 |
| 12 | Efficacy and feasibility of radiofrequency ablation for decompensated cirrhotic patients with hepatocellular carcinoma显示文摘背景有肝功能的补偿不全的大多数 HCC 病人失去了机会外科或 interventional 治疗。这研究的目的是在对待 hepatocellular 评估 radiofrequency 脱离( RFA )的可行性和结果有差的肝的癌( HCC )病人工作(孩子呸类 C ),谁不对外科或肝的动脉 chemo-embolization.Methods 合适 13 个 HCC 病人(肿瘤的数字是 17 )与孩子呸 C 的肝功能(分数:10.2 獳扩敬洠 ' 炭鷽螞h楷拺?慰瑲慩汬? 瑡牴扩瑵摥琠? 桴 ? 潤湷敲畧慬楴湯漠 ? 湥潤桴汥湩? | WU Jin-yu YANG Wei CUI Ming YIN Shan-shan GAO Wen WU Wei YAN Kun CHEN Min-hua | 2010 | Chinese Medical Journal2010，，15： | 7 |
| 13 | 肝癌射频消融后常规行经导管肝动脉化疗栓塞的临床分析显示文摘目的探讨肝癌射频消融(RFA)联合经导管肝动脉化疗栓塞(TACE)的疗效及必要性。方法对65例肝癌患者RFA后进行1次以上的TACE治疗。其中男54例,女11例。肿瘤最大长径1.5~10.0 cm,其中≤3 cm者14例,3.1~5.0 cm者17例,>5.0 cm者34例。按肝功能Child-pugh分级,A级51例,B级14例。病理诊断肝细胞癌58例,胆管细胞性肝癌7例。采用RFA肿瘤治疗系统行RFA,并随后常规行CT以评价RFA的疗效,然后行TACE,术后1月行CT检查,以评价肿瘤消融情况,并观察生存率,以评价治疗效果。结果RFA后完全消融24例,基本消融15例,部分消融26例。RFA+TACE的近期效果为根治性22例、亚根治性13例和姑息性30例。肿瘤消融程度与近期疗效密切相关(r=0.877,P<0.001)。肝癌RFA+TACE治疗后总体1,2,3年生存率为78.2%,65.3%,44.0%。Cox回归模型分析显示消融程度,是最终与生存时间有关的因素,获得完全消融、基本消融或部分消融者3年生存率分别为73.5%,45.0%和0.0%。肿瘤较小的肝癌容易获得完全消融、近期及远期疗效较好;反之预后较差。结论TACE对RFA后残余的癌灶或微小转移病灶可起治疗作用;中大肝癌RFA后联合TACE是必要的。 | 王悦华 刘家峰 李非 李昂 刘强 刘东斌 刘殿刚 王亚军 | 2008 | 中国普通外科杂志2008，17，11： | 7 |
| 14 | KAI1基因对MHCC97-H细胞裸鼠成瘤及转移的影响显示文摘目的:研究肿瘤转移抑制基因KAI1对MHCC97-H细胞裸鼠成瘤及转移的影响. 方法:将已转染KAIl正、反义核苷酸的高转移潜能肝癌细胞MHCC97-H接种裸鼠皮下,观察皮下肿瘤生长情况, 再将皮下肿瘤组织进行裸鼠原位肝接种,观察接种后肿瘤肺转移情况.其中,转染空载体及未转染的MHCC97-H亲本细胞作为实验对照组. 结果:正义组、反义组、空载体组及亲本细胞组裸鼠皮下均成瘤,肿瘤出现的时间、肿瘤块生长的速度无明显差异, 生长方式上反义组表现出明显的侵袭性.原位肝接种6 wk 后裸鼠肺部均出现癌巢,AFP染色可见癌巢中肿瘤细胞质有黄色颗粒沉着,证实为肝癌转移至肺形成的转移灶.与MHCC97-H亲本细胞组比较,反义组转移灶数目明显增加(P=0.00158),正义组转移灶数目明显减少(P=0.00465),差异均有显著性,而载体组传移灶数目无明显变化(P=0.15166). 结论:肿瘤转移抑制基因KAI1对MHCC97-H细胞裸鼠成瘤性及肿瘤生长无明显影响,但上调KAI1蛋白的表达水平能在一定程度上降低肿瘤的侵袭性、抑制转移的发生.这为肝癌的抗转移治疗研究提供了重要线索. | 彭志红 杨建民 唐波 司遂海 房殿春 罗元辉 | 2004 | 世界华人消化杂志2004，12，4： | 3 |
| 15 | Epidemiology, clinical-treatment patterns and outcome in 256 hepatocellular carcinoma cases显示文摘AIM: To analyze the epidemiology, clinical characteristics, treatment patterns and outcome in hepatocellular carcinoma (HCC) patients. METHODS: We analyzed clinical, pathological and therapeutic data from 256 consecutive patients, examined at S. Croce Hospital in Cuneo-Piedmont, with a diagnosis of HCC between 30th June 2000 and 1st July 2010. We analyzed the hospital imaging database and examined all medical records, including the diagnosis code for HCC (155.0 according to the ICD-9M classification system), both for inpatients and outpatients, and discovered 576 relevant clinical records. After the exclusion of reports relating to multiple admissions for the same patient, we identified 282 HCC patients. Moreover, from this HCC series, we excluded 26 patients: 1 patient because of an alternative final diagnosis, 8 patients because of a lack of complete clinical data in the medical record and 17 patients because they were admitted to different health care facilities, leaving 256 HCC patients. To highlight possible changes in HCC patterns over the ten-year period, we split the population into two five-year groups, according to the diagnosis period: 30 th June 2000-30th June 2005 and 1st July 2005-1st July 2010. Patients underwent a 6-mo follow up. RESULTS: Two hundred and fifty-six HCC patients were included (male/female 182/74; mean age 70 years), 133 in the first period and 123 in the second. Hepatitis C virus (HCV) infection was the most common HCC risk factor (54.1% in the first period, 50.4% in the second;P = 0.63); in the first period, 21.8% of patients were alcoholics and 15.5% were alcoholics in the second period (P > 0.05); the non-viral/non-alcoholic etiology rate was 3.7% in the first period and 20.3% in the second period (P < 0.001). Child class A patients increased significantly in the second period (P < 0.001). Adjusting for age, gender and etiology, there was a significant increase in HCC surveillance during the second period (P = 0.01). Differences between the two periods were seen in tumor parameters: there was an increase in the number of unifocal HCC patients, from 53 to 69 (P = 0.01), as well as an increase in the number of cases where the HCC was < 3 cm [from 22 to 37 (P = 0.01)]. The combined incidence of stage Barcelona Clinic Liver Cancer 0 (very-early) and A (early) HCC was 46 (34.6%) between 2000-2005, increasing to 62 (50.4%) between 2005-2010 (P = 0.01). Of the patients, 62.4% underwent specific treatment in the first group, which increased to 90.2% in the second group (P < 0.001). Diagnosis period (P < 0.01), Barcelona-Clinic Liver Cancer stage (P < 0.01) and treatment per se (P < 0.05) were predictors of better prognosis; surveillance was not related to survival (P = 0.20).CONCLUSION: This study showed that, between 2000-2005 and 2005-2010, the number of HCV-related HCC decreased, non-viral/non alcoholic etiologies increased and of surveillance programs were more frequently applied. | Luigi Fenoglio Cristina Serraino Elisabetta Castagna Adele Cardellicchio Fulvio Pomero Maurizio Grosso Carlo Senore | 2013 | World Journal of Gastroenterology2013，19，21： | 1 |
| 16 | Predictive factors of tumor response to trans-catheter treatment in cirrhotic patients with hepatocellular carcinoma:A multivariate analysis of pre-treatment findings显示文摘AIM: To elucidate the pre-treatment clinical and imaging findings affecting the tumor response to the transcatheter treatment of unresectable hepatocellular carcinoma (HCC). METHODS: Two hundred cirrhotic patients with HCC received a total of 425 transcatheter treatments. The tumor response was evaluated by helical CT and a massive necrosis (MN) was def ined as a necrosis > 90%. Twenty-f ive clinical and imaging variables were analyzed: uninodular/multinodular HCC, unilobar/bilobar, tumor capsula, hypervascular lesion, portal vein thrombosis, portal hypertension, ascites, platelets count, aspartate transaminases/alanine transaminases (AST/ALT), alfa- fetoprotein (AFP) > 100, AFP > 400, serum creatinine, virus hepatitis C (VHC) cirrhosis, performance status, age, Okuda stage, Child-Pugg stage, sex, CLIP (Cancer of the Liver Italian Program) score, serum bilirubin, constitutional syndrome, serum albumine, prothrombin activity, BCLC (Barcelona Clinic Liver Cancer) stage. Prognostic factors of response were subjected to univariate analysis and thereafter, when significant, to the multivariate analyses. RESULTS: On imaging analysis, complete response wasobtained in 60 (30%) patients, necrosis > 90% in 38 (19%) patients, necrosis > 50% in 44 (22%) patients, and necrosis < 50% in 58 (29%) patients. Ninety-eight (49%) of the 200 patients were considered to have a MN. In univariate analysis, significant variables (P < 0.01) were: uninodular tumor, unilobar, tumor size 2-6 cm, CLIP score < 2, absence of constitutional syndrome, and BCLC stage < 2. In a multivariate analysis, the variables reaching statistical signifi cance were: presence of tumor capsule (P < 0.0001), tumor size 2-6 cm (P < 0.03), CLIP score < 2 (P < 0.006), and absence of constitutional syndrome (P < 0.03). Kaplan-Mayer cumulative survival at 12 mo was 80% at 24 mo was 56%. MN was associated with a longer survival (P < 0.0001). CONCLUSION: MN after transcatheter treatment is more common in the presence of tumor capsule, maximum diameter of the main lesion between 2 and 6 cm, CLIP score < 2 and absence of constitutional syndrome. The ability to predict which patients will respond to transcatheter treatment may be useful in the clinical decision-making process, and in stratifying the randomization of patients in clinical trials. | Roberto Miraglia Giada Pietrosi Luigi Maruzzelli Ioannis Petridis Settimo Caruso Gianluca Marrone Giuseppe Mamone Giovanni Vizzini Angelo Luca Bruno Gridelli | 2007 | World Journal of Gastroenterology2007，13，45： | 1 |
| 17 | 肝切除联合射频消融治疗中期肝癌显示文摘目的探讨肝切除联合射频消融在中期肝癌治疗中的应用价值。方法回顾性分析2008年i0月-2011年11月,安徽省立医院肝脏外科采用肝切除联合射频消融治疗的中期肝癌患者19例,术前采用肝功能Child评分标准、吲哚菁绿排泄试验等方法对患者肝功能进行评估,术后7d结合肝功能各项指标对近期并发症进行评价,术后4周以血清甲胎蛋白、增强CT、超声造影检查为标准,对近期疗效进行评价,术后半年内每月行血清甲胎蛋白、增强CT、超声造影等检查1次,以后每2-3个月复诊1次。结果术后7d全部病例均有不同程度的肝功能损害,但无肝性脑病及死亡病例的发生;术后4周残留病灶占全部病例的10.1%(2/19),消融不全10.1%(2/19);术后1年、2年生存率分别为83.2%、46.4%,平均生存时间22.23个月,中位生存时间24.87个月。结论肝切除联合射频消融在中期肝癌的治疗中有重要的应用价值,适当的扩大了肝癌特别是中期肝癌手术探查的指征,最大限度的杀灭了肉眼可见的病灶。 | 杨东亮 许戈良 荚卫东 葛勇胜 李建生 马金良 余继海 | 2012 | 国际外科学杂志2012，39，4： | 1 |
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