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Chinese Hepatolgy    2023, 28 (8): 994-996.   Abstract （270）      PDF （564KB）（37）       Knowledge map    Reference | Related Articles | Metrics

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Chinese Hepatolgy    2023, 28 (6): 631-633.   Abstract （225）      PDF （512KB）（119）       Knowledge map    Reference | Related Articles | Metrics

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Chinese Hepatolgy    2023, 28 (8): 885-886.   Abstract （189）      PDF （552KB）（111）       Knowledge map    Reference | Related Articles | Metrics

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An analysis on the influencing factors of liver injury caused by immunotherapy in lung cancer patients WANG Han, PENG Jin, JIN Hui-ru, WANG Xiao, DAI Jing-jing, Li Jun, JIANG Long-feng Chinese Hepatolgy    2023, 28 (6): 688-693.   Abstract （177）      PDF （534KB）（62）       Knowledge map    Objective To explore the characteristics and influencing factors of immunotherapy-mediated liver injury in lung cancer patients. Methods The clinical data of lung cancer patients with complete information who received immunotherapy with Immune checkpoint inhibitors (ICIs) from July 2018 to July 2021 were retrospectively analyzed. The patients were divided into non-liver injury group (n=189) and liver injury group (n=81) according to whether they had liver function abnormalities during immunotherapy. Alternatively, they were divided into immunotherapy group (n=25), immunotherapy combined with anti-angiogenic agents group (n=6), and immunotherapy combined with chemotherapy group (n=50) according to different treatment regimes, and the clinical data among all groups were compared. Results The proportion of female patients in the liver injury group was higher than that in the non-liver injury group (30.86% vs 18.52%,P=0.025). The lymphocyte count [1.52 (1.13, 1.94),P=0.010], erythrocyte level [4.29 (3.96,4.67),P=0.004] and hemoglobin level [131.0 0(121.50, 145.00),P<0.001] before immunotherapy in the liver injury group were higher. However, neutrophil count/lymphocyte count [2.62 (1.86, 3.98),P=0.004] and platelet/lymphocyte count [132.39 (92.60,183.27),P<0.001] were lower. Multiple logistic regression analysis showed that gender (P=0.018, OR=2.142, 95%CI 1.137-4.035) was an independent risk factor. Between different immunotherapy regimens, patients in the immunotherapy combined with chemotherapy group showed earlier elevation of transaminase. Conclusion The clinical symptoms of patients with immune-mediated hepatitis are not typical, which is more common in female patients. There is no obvious correlation between the liver injury with age, pathological type, underlying disease, whereas gender is an independent risk factor. Reference | Related Articles | Metrics

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Effect of microwave ablation on serum levels of Golgi protein 73 and alpha fetoprotein in patients with primary liver cancer XU Zheng-ju, LIU Hui-guo, YAN Yan-yan, YE Qiao-xia, ZHANG Xiao-man, HUANG Jin-fa, LI Yong-fei, WU Jin-piao Chinese Hepatolgy    2023, 28 (5): 554-558.   Abstract （125）      PDF （505KB）（56）       Knowledge map    Objective To observe the efficacy of microwave ablation (MWA) in the treatment of primary liver cancer (PLC) and its effect on serum levels of Golgi protein 73 (GP73) and alpha fetoprotein (AFP).Methods A total of 102 PLC patients with a single small lesion (≤ 3 cm in diameter) and elevated AFP were retrospectively enrolled between January 2016 and October 2018. All of the PLC patients received MWA. Serum GP73, alpha-fetoprotein (AFP), and liver biochemical tests [serum albumin (Alb), total bilirubin (TBil), alanine aminotransferase (ALT), and aspartate aminotransferase (AST)] were compared before MWA and at different time points post the ablation procedure. The efficacy of MWA was evaluated by enhanced MRI or CT follow-up for more than 3 years.Results Complete tumor ablation was achieved in 97 patients (95.10%) with PLC at one month after MWA. The overall survival rates of 1, 2 and 3 years after MWA were 100.00%, 97.06% and 89.22%, respectively. In terms of PLC recurrence, cumulative recurrence occurred in 47 cases (46.08%) at 3 years after MWA, including 9 cases (8.82%) with local tumor progression and 38 cases (37.25%) with new tumors. The disease-free survival rates at 1, 2 and 3 years after MWA were 74.51%, 58.82% and 53.92%, respectively. The serum AFP levels significantly decreased at 1, 2, and 4 weeks after MWA, and returned to the normal range at 12 weeks after MWA. On the contrary, the serum GP73 level increased significantly at 1 and 2 weeks after MWA, and reached the peak at 2 weeks after MWA. After hepato-protective treatment, the serum GP73 declined at 4 weeks after MWA, and returned to the pre-treatment level at 12 weeks after MWA. Liver biochemical indicators of TBil, ALT, and AST were increased significantly at 1 week after MWA. Notably, the changes of serum GP73 in response to MWA were similar to those of liver biochemical indicators (TBil, ALT and AST).Conclusion Serum GP73 increased significantly after MWA treatment for PLC. Therefore, serum GP73 holds potential as a biomarker for monitoring and assessment of MWA-mediated inflammatory injury in patients with PLC. AFP can be used as a monitoring index to evaluate the treatment efficacy of MWA and HCC recurrence after MWA. The normalization of AFP is closely associated with a complete tumor ablation. Reference | Related Articles | Metrics

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Clinical efficacy of DPMAS combined with PE in the treatment of liver failure YANG Hang, LUO Yong-yan, PAN Lu-da, ZHANG Lue-tao, SONG Su-na Chinese Hepatolgy    2023, 28 (6): 707-710.   Abstract （123）      PDF （561KB）（67）       Knowledge map    Objective To study the curative effect of double plasma molecular adsorption system (DPMAS) combined with plasma exchange (PE) on patients with liver failure. Methods A total of 138 patients with liver failure from October 2018 to May 2022 were enrolled. The patients were randomly divided into DPMAS group(Group A), PE group(Group B) and DPMAS+ PEgroup(Group C) with 46 cases in each group. The changes of liver function indexes (AST, ALT, TBil), the serum cytokines (TNF-α, IFN-γ and IL-6) and coagulation function (PT, INR, PTA) in the 3 groups were collected. Results On the 90th day of treatment, managment in Group C was assessed as markedly effective in 22 cases, effective in 14 cases and ineffective in 3 cases. 7 cases died during the treatment. The intervention outcomes for Group C outperformed those of both Group A(which had 12 effective cases, 19 effective cases, 3 ineffective cases and 12 deaths) and Group B(which had 11 effective cases, 18 effective cases, 3 ineffective cases, 14 deaths) (Z=-2.044, -2.408; P=0.041, 0.016). On the 28th and 90th of treatment, the levels of TBil in Group B[(201.1±77.4) μmol/L and (93.6±28.2) μmol/L, respectively] were significantly higher than those in Group A [(157.9±56.2) μmol/L and (80.2±21.7) μmol/L] and Group C [(162.7±50.2) μmol/L and (78.6±24.6) μmol/L, F=6.630、5.004,P=0.002、0.008]. On the 90th day of treatment, the serum levels of TNF-α, IFN-γ and IL-6 in Group C[(20.6±14.4) pg/mL, (32.4±13.8) pg/mL and (31.7±10.1) ng/L, respectively] were significantly lower than those in group A [(34.2±16.2) pg/mL, (43.2±18.4) pg/mL and (48.7±14.4) ng/L] and group B [(35.7±17.3) pg/mL, (40.6±17.6) pg/mL and (50.0±12.8) ng/L]. F=12.417、5.228、30.406,all P<0.05]. On the 90th day of treatment, PT and INR in Group A[(18.3±3.8) s and (1.23±0.11), respectively] were significantly higher than those in Group B [(15.1±3.6) s and (1.10±0.09)] and Group C [(14.6±3.9) s and (1.07±0.27), F=13.052、10.722,P=0.000、0.000]. Conclusion The DPMAS sequential PE therapy for patients with liver failure effectively leverages the strengths of both DPMAS and PE. It is capable of clearing cytokines, improving coagulation disorder, safeguarding liver function and thereby enhancning the overal therapeutic efficacy. Reference | Related Articles | Metrics

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Chinese Hepatolgy    2023, 28 (6): 633-636.   Abstract （122）      PDF （518KB）（159）       Knowledge map    Reference | Related Articles | Metrics

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The diagnostic value of ultrasound E imaging and MR mDixon sequence in non-alcoholic fatty liver disease ZHONG Xian-feng, CHEN Gui'e, CHEN Yan-chan, HUANG Jian-yuan Chinese Hepatolgy    2023, 28 (5): 585-589.   Abstract （121）      PDF （1673KB）（52）       Knowledge map    Objective To investigate the diagnostic value of ultrasound E imaging and MR mDixon sequence examination in nonalcoholic fatty liver disease (NAFLD).Methods 147 NAFLD patients (58 mild cases, 59 moderate cases, 30 severe cases) and 125 healthy subjects were diagnosed and treated in our hospital between January 2020 and June 2022, all patients underwent ultrasound E imaging and MR mDixon sequence examination to obtain liver young's modulus and fat content. Spearman correlation analysis was used to evaluate the correlation between the severity of NAFLD and liver young's modulus and fat content. Area under receiver operating characteristic curve (AUC) was used to evaluate the efficacy of young's modulus and fat content in the diagnosis of severe NAFLD.Results AST, ALT, ALP and TBIL in NAFLD patients were (19.62±5.54) IU/L, (27.82±7.10) IU/L, (70.57±7.90) IU/L and (40.72±11.34) μmol/L, respectively, higher than that in healthy subjects [(17.20±5.30) IU/L, (17.54±5.33) IU/L, (67.95±7.82) IU/L and (11.50±5.45) μmol/L, respectively, P<0.05]. AST, ALT, ALP and TBIL in patients with severe NAFLD were (24.64±5.21) IU/L, (30.24±4.00) IU/L, (75.33±10.60) IU/L and (47.43±11.20) μmol/L, respectively, higher than that of patients with moderate NAFLD [(20.50±5.71) IU/L, (29.00±4.87) IU/L, (70.50±10.61) IU/L and (42.56±9.40) μmol/L, respectively, P<0.05] and patients with mild NAFLD [(16.20±3.42) IU/L, (25.31±4.71) IU/L, (67.10±7.55) IU/L and (35.40±8.24) μmol/L, respectively, P<0.05]. Liver young's modulus and fat content in NAFLD patients were (5.30±1.52) kPa and (5.34±1.20) %, respectively, which were higher than those in healthy subjects [(3.04±1.22) kPa and (3.40±1.11) %, respectively, P<0.05)]. Liver Young's modulus and fat content in patients with severe NAFLD were (7.30±1.30) kPa and (6.80±1.23) %, respectively, which were higher than those in patients with moderate NAFLD [5.21±1.41) kPa and (5.50±1.14) %, respectively, P<0.05] and mild NAFLD patients [(4.30±1.32) kPa and (4.21±0.90) %, respectively, P<0.05]. Spearman correlation analysis showed that the severity of NAFLD was positively correlated with liver Young's modulus and fat content (r=0.680, 0.526, P=0.000, 0.000). ROC curve analysis showed that the AUC of young's modulus and fat content in liver in the diagnosis of severe NAFLD was 0.867 and 0.849 respectively, which was lower than that of 0.946 in the combined diagnosis of young's modulus and fat content (P<0.05).Conclusion Ultrasound E imaging and MR mDixon sequence examination can accurately measure young's modulus and fat content of liver, which has high efficacy in diagnosing the severity of NAFLD patients.     Reference | Related Articles | Metrics

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Chinese Hepatolgy    2023, 28 (5): 505-506.   Abstract （118）      PDF （511KB）（82）       Knowledge map    Reference | Related Articles | Metrics

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Chinese Hepatolgy    2023, 28 (6): 734-737.   Abstract （118）      PDF （536KB）（82）       Knowledge map    Reference | Related Articles | Metrics

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A clinical study for the therapeutic effect of arotinib on patients with stage III primary liver cancer after interventional therapy WANG Chun-hong, FENG Wei-wei, ZHANG Jing, SI Chen-fei Chinese Hepatolgy    2023, 28 (8): 928-931.   Abstract （116）      PDF （424KB）（58）       Knowledge map    Objective To investigate the efficacy of transcatheter arterial chemoembolization (TACE) combined with arotinib on the treatment of stage III primary liver cancer.Methods 205 patients with stage III liver cancer who were treated in Hengshui Third People's Hospital from January 2020 to January 2023 were divided into a control group (n=103) and an observation group (n=102). After TACE therapy, patients in the observation group were administrated with arotinib and evaluated for the clinical efficacy.Results One month after surgery, the Karnofsky score was (79.5±8.0) in the observation group, which was higher than that of (75.3±8.3) in the control group (P<0.05). After treatment, the serum levels of alpha fetoprotein (AFP) and carcinoembryonic antigen (CEA) in the observation group were (558.82±49.87)ng/L and (33.89±5.45)ng/mL, respectively, which were significantly lower than those in the control group (P<0.05). Serum vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and γ-Glutamyle transferase (GGT) in the observation group were significantly lower than those in the control group (P<0.05); The disease control rate in the control group was 69.90%, while the disease control rate in the observation group was 88.23%, which was superior to the control group (χ2=11.959, P=0.008); There was no significant difference in adverse reactions between the control group and the observation group (P>0.05).Conclusion TACE combined with arotinib in the treatment of advanced liver cancer patients significantly improve clinical efficacy without increasing adverse reactions. Reference | Related Articles | Metrics

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Expression and clinical significance of key genes of iron death pathway in liver cancer WANG Xiao, ZHANG Ling-yun Chinese Hepatolgy    2023, 28 (6): 660-664.   Abstract （109）      PDF （4323KB）（72）       Knowledge map    Objective To investigate the expression and prognostic value of key iron death pathway genes in liver cancer and their correlation with the immune microenvironment by bioinformatics. Methods GEPIA online database was used to analyze the expression ferroptosis-related key genes in liver cancer. cBioPortal online database was used to analyze the gene mutation of ferroptosis-related key genes. Kaplan-Meier survival analysis was used to analyze the relationship between ferroptosis-related key genes and prognosis. The TIMER database and the TIDE database were used to analyze the correlation between key genes of the iron death pathway and the immune environment. Results The mRNA expression of ACSL4 was found to be significantly higher in liver cancer tissues than in normal tissues through the GEPIA database (P<0.05). cBioPortal database analysis revealed genetic alterations in key genes of iron death pathway in hepatocellular carcinoma, mainly including gene amplification, deletion mutations, missense mutations and in-frame mutations. Kaplan-Meier survival analysis showed that high GPX4 expression was associated with good prognosis (PFS:HR=0.68, P=0.014) and high expression of SLC7A11 was associated with poor prognosis (OS:HR=2.41, P=5.3e-07; PFS: HR=1.79, P=0.00043). TIMER database analysis showed that SLC7A11 and Nrf2 were positively correlated with infiltration of B cells, CD8+T lymphocytes, CD4+T lymphocytes, neutrophils, macrophages and dendritic cells. Conclusion Iron death pathway key genes are significantly correlated with prognosis and immune cell infiltration in patients with liver cancer, and are potential targets for treatment with important clinical value. Reference | Related Articles | Metrics

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An analysis on the efficacy and prognostic impact factors of postoperative primary suture of laparoscopic common bile duct exploration for the treatment of liver cirrhosis complicated with bile duct stones LIU Shuang, WU Ya-kun, LIU Yuan-jun, TIAN Yin-sheng Chinese Hepatolgy    2023, 28 (5): 544-548.   Abstract （108）      PDF （473KB）（48）       Knowledge map    Objective To investigate the efficacy of primary suture after laparoscopic common bile duct exploration (LCBDE) in the treatment of liver cirrhosis complicated with bile duct stones and the impact factors on postoperative prognosis.Methods One hundred and twenty-four cases of liver cirrhosis complicated with bile duct stones who were operated in hepatobiliary surgery of Suining Central Hospital from March 2020 to March 2022 were analyzed retrospectively. According to the random number table method, all patients were divided into a control group (N=62 cases) and a study group (N=62 cases). LCBDE was performed in both groups. Patients in the control group were treated with T-tube drainage, and patients in the study group were primary sutured after operation. The perioperative indexes and postoperative complications of these two groups were observed. Pain visual analogue scale (VAS) score were obtained at 24 hours after operation. The influencing factors for postoperative prognosis were analyzed by logistic regression.Results When compared the patients in the control group with those in the study group, the intraoperative bleeding volumes were not statistically significant (P>0.05). The drainage times for patients in the study group (4.95±0.22 d) were longer than those of the control group (4.42±0.26 d) (P<0.05). The opertation times (90.16±8.12 min) and hospital stays (5.19±1.16 d) of patients in the study group were shorter than those of 99.2±9.14 min and 7.62±1.26 d, respectively, in the control group (P<0.05); The incidence of postoperative complications was 11.29% in the study group, which had no significant difference than that of 9.68% in the control group (P>0.05); The VAS score of the study group was lower than that of the control group (P<0.05). By univariate analysis it was showed that complicated with basic diseases, diameter of common bile duct, total number of cases operated by the chief surgeon, and T-tube drainage were the influencing factors for a poorer effect of primary suture after LCBDE (P<0.05), while gender, age, ASA score, neutrophil count, CRP and preoperative bilirubin level, bile duct suture mode and bile duct stone number were not the influencing factors (P>0.05). By logistic regression analysis it was showed that the combination of basic diseases, the diameter of common bile duct <1 cm, the number of cases operated by the chief surgeon< 28, and T-tube drainage were independent high-risk factors for poor primary suture effect after LCBDE (P<0.05).Conclusion Compared with T-tube drainage, one-stage suture after LCBDE has the advantages of a shorter operation time, less postoperative pain and a shorter hospital stay, without causing poor postoperative effect. Complicated with basic diseases, common bile duct diameter <1cm, operated cases < 28 by the chief surgeon, T-tube drainage were independent risk factors for a poorer primary suture outcome after LCBDE. Reference | Related Articles | Metrics

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Chinese Hepatolgy    2023, 28 (8): 897-902.   Abstract （107）      PDF （1232KB）（71）       Knowledge map    Reference | Related Articles | Metrics

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Therapeutic effect of entecavir or tenofovir combined with PEG-IFN α-2b on patients with chronic hepatitis B hypoviremia ZHANG Pei-yuan, LEI Xue, WANG Mei-yu Chinese Hepatolgy    2023, 28 (8): 947-949.   Abstract （107）      PDF （311KB）（50）       Knowledge map    Objective To explore the effect of entecavir or tenofovir combined with PEG-IFN α-2b on treating patients with chronic hepatitis B hypoviremia.Methods From September 2017 to October 2021, 52 patients with chronic hepatitis B who had not previously received antiviral therapy were treated with entecavir or tenofovir combined with PEG-IFN α-2b for 48 weeks. The researchers compared the baseline characteristics, blood cell changes and virological changes of patients in entecavir group and tenofovir group.Results There were no significant differences between the two groups at baseline. Red blood cell count, lymphocyte count and neutrophil count showed a downward trend , but there was no significant difference between the two groups. At the 48th week of treatment, the negative conversion rates of HBeAg and HBV DNA in tenofovir group were 46.2% (12/26) and 84.6% (22/26), which were significantly higher than those of entecavir group [11.5% (3/26) and 57.7% (15/26) (P<0.05)].Conclusion In patients with HBeAg-positive chronic hepatitis B, treatment with tenofovir combined with PEG-IFN α-2b was better than treatment with entecavir combined with PEG-IFN α-2b after using PEG-IFN α-2b alone for 12 weeks. Reference | Related Articles | Metrics

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Clinical characteristics and prognosis of patients with primary biliary cholangitis complicated with or without autoimmune diseases WEI Wei, WANG Yu, JIN Hang-bin, ZHENG Yi-nong Chinese Hepatolgy    2023, 28 (8): 965-967.   Abstract （97）      PDF （291KB）（57）       Knowledge map    Objective To evaluate the clinical characteristics and prognostic factors in patients with primary biliary cholangitis (PBC), focusing on those with concurrent autoimmune diseases (ATD) in the PBC patient population.Methods A retrospective analysis was conducted on 152 PBC patients,who were admitted between September 2008 and December 2018. The cohort consisted of 17 males and 135 females, aged 52 (41, 64) years. All patients met the diagnositic criterria for PBC and received treatment with ursodeoxycholic acid(UDCA). Clinical data and prognostic outcomes between PBC patients without concurrent autoimmune diseases and those with concurrent autoimmune hepatitis(PBC-AIH) or Sjogren Syndrome(PBC-SS) were compared.Results Out of 152 evaluated cases of PBC, 104 cases were identified as isolated PBC (68.4%), 11 as PBC-AIH(7.2%), and 24 as PBC-SS (15.8%). Additionally, 3 patients were diagnosed with rheumatoid arthritis (2.0%), 2 with systemic lupus erythematosus, 2 with Graves' disease and 2 with coexisting AIH and SS (1.3%). In comparing isolated PBC with PBC-AIH, the PT was significantly different at 12.0 (11.1, 13.9) s and 12.8 (11.7, 17.3) s, respectively(P<0.05) Similarly, ANA(+) was significantly different between isolated PBC and PBC-AIH, with 55 cases (52.9%) and 9 cases (81.8%), respectively (P<0.05). Furthermore, comparisons of WBC, Hb, Alb and HDL levels were made between isolated PBC and PBC-SS groups. In the isolated PBC group, these values were 4.5 (3.4, 6.2)×109/L, 114.2 (106.1, 128.4) g/L, 34.6 (29.8, 38.7) g/L and 1.1 (1.0, 1.5) mmol/L. 17.0) g/L,respectively. In the PBS-SS group, these values were 3.2 (2.6, 4.2)×109/L, 111.2 (79.8, 117.0) g/L, 33.3 (28.2, 36.5) g/L and 0.9 (0.5, 1.2) mmol/L] respectively, revealing statistically significant differences(P<0.05). Survival data were collected up to January 1st, 2022. The median survival times for patients with isolated PBC, PBC-AIH and PBC-SS were 72.0, 58.5 and 50.0 months, respectively. The median survival time of patients with isolated PBC was significantly longer than those with PBC-AIH and PBC-SS (P<0.05). Similarly, the 5-year survival rate for patients with isolated PBC (80.8%) was significantly higher than for patients with(63.6%) and PBC-SS(58.3%) (P<0.05).Conclusion AIH emerges as the most prevalent hepatic complication among PBC patients, whereas SS stands out as the dominant extrahepatic complication. When PBC becomes complicated with ATD, it poses a detrimental impact on patients' clinical prognosis.     Reference | Related Articles | Metrics

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Effects of endoscopic ultrasound-guided percutaneous aspiration sclerotherapy on serum inflammatory factors in patients with hepatic cysts WU Jian, WANG Lian-cai, WANG Ya-feng, DU Chang-shun, XIAO Jian-an Chinese Hepatolgy    2023, 28 (8): 983-986.   Abstract （97）      PDF （642KB）（45）       Knowledge map    Objective To investigate the effects of endoscopic ultrasound (EUS)-guided aspiration combined with sclerotherapy on serum inflammatory factors in patients with hepatic cysts.Methods From June 2020 to June 2022, 90 patients with hepatic cysts were admitted to our hospital. These patients were randomly divided into control group and observation group, with each group comprising 45 patients, The control group underwent sclerosing agent injection, while the observation group received EUS-guided percutaneous aspiration sclerotherapy, for a duration of 48 weeks. The levels of blood biochemical indexes and inflammatory factors between the two groups pre-treatment and 7 days post-treatment were compared. Further more, the total effective rate and the incidence of adverse reactions 12 weeks post-treatment in both groups were analyzed. Lastly, the recurrence rate of hepatic cysts 48 weeks after treatment in both groups was observed in the two groups.Results At the 12-week post-treatment mark, the observation group showed a higher total effective rate of 95.56% compared to the control group`s 82.22%e (P<0.05). There were no significant differences in ALT, AST, ALP and TBil between the two groups 7 days post-treatment (P>0.05). In the observation group, the serum levels of CRP, TNF-α and IL-1β were significantly lower[(53.83±6.24) mg/L, (260.80±18.40) ng/L and (91.04±5.10) ng/L, respectively] than those in the control group [(56.67±5.96) mg/L, (268.92±16.93) ng/L and (93.22±4.87) ng/L, P<0.05]. The incidence of adverse reactions in the observation group (2.22%) was also lower than that in the control group (17.78% , P<0.05). At the end of the 48-week post-treatment period, the observation group showed a lower recurrence rate of hepatic cysts( 2.27%) compared to the control group(17.95%, P<0.05).Conclusion In comparison to sclerotherapy injection alone, EUS-guided percutaneous aspiration sclerotherapy proves to be more effective for hepatic cysts. This approach can mitigate inflammation, diminish the incidence of complications and recurrence, without significantly impacting liver function. Reference | Related Articles | Metrics

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An evaluation of serum biochemical indexes, pathological characteristics and surgical treatment efficacy of sarcomatoid hepatocellular carcinoma MA Bo-heng, WANG Xia, WU Ying Chinese Hepatolgy    2023, 28 (6): 676-679.   Abstract （95）      PDF （381KB）（51）       Knowledge map    Objective To review the clinicopathological data and surgical treatment efficacy of sarcomatoid and high-grade hepatocellular carcinoma (HCC) cases, so as to provide clinical information for sarcomatoid HCC. Methods The data of sarcomatoid and high-grade HCC patients who underwent surgery from January 2007 to March 2018 were reviewed. Edmondson-Steiner pathological grade III ~ IV cases were defined as high-grade HCC. A total of 21 cases of sarcomatoid HCC and 74 cases of high-grade HCC patients with followed-up data were included in the final analysis. Clinicopathological data, and survival conditions of sarcomatoid and high-grade HCC patients were compared. Results There were significant differences in sex, HBsAg(+) and AFP between sarcoma-like and high-grade HCC patients (P<0.05), but there were no significant differences in age, HCV-Ab, liver cirrhosis, ALT, TBil, Alb and INR (P>0.05). The tumor diameters of sarcomatoid and high-grade HCC patients were 8.3 (1.6, 24.5) cm and 5.4 (1.3, 17.0) cm, the difference was statistically significant (P<0.05). Sarcoma-like HCC had tumor envelope, tumor necrosis, adjacent organ invasion and lymph node metastasis in 5 cases (23.8%), 17 cases (80.9%), 5 cases (23.8%) and 6 cases (28.6%), which were compared with high-grade HCC [37 cases (50.0%), 26 cases (35.1%), 6 cases (8.1%) and 4 cases (5.4%), respectively, the difference was statistically significant (P<0.05). The median OS of sarcomatoid HCC patients was shorter than that of high-grade HCC patients [10.4 months vs 48.0 months, P<0.05]. The 1-year, 3-year and 5-year OS rates of sarcomatoid HCC were 52.4% (11/21), 19.0% (4/21) and 14.3% (3/21), while those of high-grade HCC were 85.1% (63/74), 54.0% (40/74) and 40.5% (30/74), respectively, the difference was statistically significant (P<0.05). The median RFS of sarcomatoid HCC patients was shorter than that of high-grade HCC patients [5.5 months vs 16.5 months, P<0.05]. The half-year, one-year and three-year RFS rates of sarcomatoid HCC were 47.6% (10/21), 23.8% (5/21) and 9.5% (2/21), respectively, which were significantly lower than those of high-grade HCC [82.4% (61/74), 59.4% (44/74) and 33.8% (25/74), respectively], the difference was statistically significant (P<0.05). Conclusion Compared with high-grade HCC, sarcomatoid HCC has a lower AFP level, more frequent tumor invasion and lymph node metastasis, and a poorer prognosis. The high invasiveness of sarcomatoid HCC may be mediated by specific cancerous components. Reference | Related Articles | Metrics

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Chinese Hepatolgy    2023, 28 (9): 1015-1017.   Abstract （94）      PDF （602KB）（61）       Knowledge map    Reference | Related Articles | Metrics

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Chinese Hepatolgy    2023, 28 (9): 1127-1130.   Abstract （89）      PDF （1726KB）（77）       Knowledge map    Reference | Related Articles | Metrics