Khai Viet Ninh;Dang Hai Do;Trung Duc Nguyen;Phuong Ha Tran;Tuan Hoang;Dung Thanh Le;Nghia Quang Nguyen
한국간담췌외과학회지
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제28권1호
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pp.34-41
/
2024
Backgrounds/Aims: Liver transplantation (LT) provides a favorable outcome for patients with hepatocellular carcinoma (HCC) and was launched in Vietnam in 2004. In this study, we evaluated the short-term and long-term outcomes of LT and its risk factors. Methods: This retrospective study analyzed HCC patients who underwent LT at Viet Duc University hospital, Vietnam, from 01/2012-03/2022. The following data were gathered: demographics, virus infection, tumor characteristics, alpha-fetoprotein (AFP) level, Child-Pugh and MELD scores, selection criteria, type of LT, complications, 30-day mortality, and disease-free and overall survival (DFS and OS). Results: Fifty four patients were included, the mean age was 55.39 ± 8.46 years. Nearly 90% had hepatitis B virus-related HCC. The median (interquartile range) AFP level was 16.2 (88.7) ng/mL. The average MELD score was 10.57 ± 5.95; the rate of Child-Pugh A and B were 70.4% and 18.5%, respectively. Nearly 40% of the patients were within Milan criteria, brain-dead donor was 83.3%. Hepatic and portal vein thrombosis occurred in 0% and 1.9%, respectively; hepatic artery thrombosis 1.9%, biliary leakage 5.6%, and postoperative hemorrhage 3.7%. Ninety-day mortality was 5.6%. Five-year DFS and OS were 79.3% and 81.4%, respectively. MELD score and ChildPugh score were predictive factors for DFS and OS (p < 0.05). In multivariate analysis, Child-Pugh score was the only significant factor (p < 0.05). Conclusions: In Vietnam, LT is an effective therapy for HCC with an acceptable complication rate, mortality rate, and good survival outcomes, and should be further encouraged.
Background: Recently, peroxiredoxin3 (PRDX3) was identified as a novel molecular marker for the progression of hepatocellular carcinoma (HCC). However, its potential clinical application as a serum marker for the early diagnosis and prognosis of HCC has not been investigated. Methods: PRDX3, alpha-fetaprotein (AFP), and other biochemical parameters were measured in serum samples from 297 Chinese patients, including 96 with HCC, 98 with liver cirrhosis (LC), and 103 healthy controls (HCs). Correlations between serum PRDX3 expression and clinicopathological variables and the relationship between serum PRDX3 expression and prognosis were analyzed. Results: Serum PRDX3 was significantly higher in HCC patients than in the LC and HC groups. The sensitivity and specificity of serum PRDX3 for the diagnosis of HCC were 85.9% and 75.3%, respectively, at a cutoff of 153.26 ng/mL, and the area under the curve was 0.865. Moreover, serum PRDX3 expression was strongly associated with AFP level, tumor diameter, TNM stage, and portal vein invasion. Kaplan-Meier curve analysis revealed that HCC patients with high serum PRDX3 expression had a shorter median survival time than those with low PRDX3 expression. Moreover, serum PRDX3 expression was an independent risk factor for overall survival. The inverse correlation between serum PRDX3 and patient survival remained significant in patients with early-stage HCC and in those with normal serum AFP levels. Conclusions: Serum PRDX3 can be used as a noninvasive biomarker for the diagnosis and/or prognosis of HCC.
Objective: This study aimed to investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma (HB) and the factors affecting prognosis. Methods: A total of 35 children underwent multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. The patients were followed up every month. Results: Serum AFP levels in 33 out of 35 patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the values of serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the 35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases with locally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventional treatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33 patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission (PR), 1 became disease progressive (DP), and 10 died. The remission and overall survival rates were 66.7% (22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than the epithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P < 0.001). Conclusion: Multimodality treatment can effectively improve remission rate and prolong the survival of children with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors, HB pathological classification, and staging are highly useful in predicting prognosis.
This study was carried out to evaluate the effects of all-trans retinoic acid(RA) on the development of cholangiocarcinoma in hamsters. Eighty six female Syrian golden hamsters were divided into four groups. Group I was for the induction of the cholangiocarcinoma, which was infected orally with C sinensis and given dimethylnitrosamine(DMN, 15ppm) in drinking water for 4 weeks. Group II was for evaluating the effect of all-trans RA treatment on the cholangiocarcinogenesis, which was treated the same as group I and orally given RA(1mg/kg, 5 times per week) for 15 weeks. Group III was given only RA hr 15 weeks. Control group IV was given only soybean oil which was solvent for RA treatment. More than 5 heads of hamsters in each group were sacrificed at 4, 7, 11 and 15 weeks after the begining of the experiment. The livers were examined grossly, histopathologically, and immunohistochemically. The results obtained were as follows : 1. Death of animals started from the 11 weeks after the begining of the experiment. One of the total 22 animals(5%) and 7 of the total 24 animals(29%) died in group I and group II, respectively. 2. Proliferation of oval cell was peaked at 11 weeks in group I and at 7 weeks in group II, and decreased gradually after those periods of the time. 3. Cholangiocarcinomas were found in 1 of 6 animals(17%) at 11 weeks and in 4 of 6 animals(67%) at 15 weeks in group I, respectively. But in group II, the cholangiocarcinomas occured in 1 of 5 animals(20%) at 7 weeks, in 7 of 12 animals(58%) at 11 weeks and in 2 of the rest animals(100%) at 15 weeks, respectively. 4. Expression of $\alpha$-fetoprotein(AFP) of the oval cells in the group II showed the same degree of positive reaction at that of group I at 4 weeks. But AFP postive oval cells decreased gradually and AFP negative oval cells(ductlike oval cells) increased gradually. 5. Expression of cytokeratin of the oval cells in group II was shown slightly at 4 weeks and the degree of expression increased moderately from the 7 weeks. But the expression of the oval cells in group I was shown slightly after the 7 weeks. These results suggested that all-trans RA promoted the occurrence and the rate of cholangiocarcinoma by inducing differentiation of small cells and oval cells in the liver of hamsters infected with C sinensis and treated with DMN.
Objectives The objective of present study was to investigate the effect of Ojeoksangamibang ($W\check{u}j\bar{i}s\check{a}nji\bar{a}w\grave{e}if\bar{a}ng$) extract on recovery of liver function in carbontetrachloride ($CCl_4$)-exposed rat. Methods Male rats weighing $230{\pm}7.21g$ fed experimental diet for 1 week and 28 rats were divided into 4 groups. Each of 7 rats was devided into a control group and experimental groups. We fed a control group of rats a basal diet and administered normal saline (100 mg/kg, 1 time/1 day) for 3 weeks. And we fed each experimental group of rats basal diet and administered an extract of Ojeoksangamibang extracts (100 mg/kg, 200 mg/kg, 300 mg/kg, 1 time/1 day) for 3 weeks. We measured lipid of plasma and liver, concentration of proinflammatory cytokines ($IL-1{\beta}$, IL-6 and IL-10). Statistical analysis was done by one-way analysis of variance (ANOVA) and Duncan's multiple range test with significance level at p<0.05. Results Plasma a-fetoprotein (AFP) and total protein concentration showed a tendency to decrease in Ojeoksangamibang extract-treated groups. However, plasma albumin concentration showed no significant differences in all treatment groups. Activity of plasma Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) in the Ojeoksangamibang extract-treated groups, increased addition amount of Ojeoksangamibang extracts tended to decline. Alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and ${\gamma}$-glutamyl transferase (${\gamma}$-GT) activities showed a tendency to decrease in Ojeoksangamibang extract-treated groups, increased addition amount of Ojeoksangamibang extracts tended to decline. Concentration of plasma triglyceride and total cholesterol showed a lower value than that of control group. The liver $IL-1{\beta}$, IL-6 and $TNF-{\alpha}$ concentration were decreased, and IL-10 was increased in Ojeoksangamibang extract groups, compared to control group. Plasma $IL-1{\beta}$, IL-6 and $TNF-{\alpha}$ concentration were decreased, and IL-10 was increased in Ojeoksangamibang extract groups, compared to control group. Conclusions This study suggested that Ojeoksangamibang may alleviate liver inflammatory reaction induced by liver toxicity.
Elsayed, Engy Yousry;Mosalam, Nesreen Ahmed;Mohamed, Noha Refaat
Asian Pacific Journal of Cancer Prevention
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제16권16호
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pp.7139-7142
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2015
Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer related death overall. The role of insulin resistance in the development of HCC associated with chronic HCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family which could contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistance as risk factors for HCC in HCV cirrhotic patients. Materials and Methods: This prospective case controlled study included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related liver cirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologic markers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA) were examined along with resistin. Results: HCC patients had higher mean values of HOMA-IR and resistin than cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent risk factors in development of HCC, those patients with resistin > 12 ng/ml and HOMA > 4 being 1.6 times more likely to have HCC. Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswho are at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novel markers to identify HCV cirrhotic patients at greater risk of development of HCC.
Park, Ji-Sook;Cha, Dong-Hyun;Jung, Jin-Woo;Kim, Young-Hwan;Lee, Sook-Hwan;Kim, Young-Jun;Kim, Kwang-Pyo
Journal of Microbiology and Biotechnology
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제20권6호
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pp.959-967
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2010
Down syndrome (DS) is an abnormality of the 21st chromosome that commonly occurs in children born to older women. Thus, amniotic fluid (AF) is usually collected from such women for prenatal diagnosis. This study analyzed human AF supernatants (AFS) using a mass spectrometric (MS) approach to search for candidate biomarkers of a DS pregnancy. The AFS were collected from older pregnant women at weeks 16-18 of their gestation by amniocentesis for cytogenetic analysis. The AFS from the pregnancies carrying DS (n=4) or chromosomally normal (n=6) fetuses, as revealed by the cytogenetic analysis, were then subjected to global protein profiling based on liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS). Affinity chromatography was also applied prior to the LC-ESI-MS/MS to minimize the masking effect of highly abundant albumin and immunoglobulin and thereby increase the diversity of the identified proteins. As a result, at least 30 new AFS proteins were identified and 44 AFS proteins were found to be differentially expressed between the DS and normal cases, where 6 of the proteins were unique to the DS cases and 11 were unique to the chromosomally normal cases. In addition, in the DS cases, 19 AFS proteins were downregulated and 8 were upregulated to varying degrees. A Western blot analysis confirmed the LC-ESI-MS/MS data, indicating that the combined detection of apolipoprotein A-II (apoA-II) and alpha-fetoprotein (AFP) could be a potential tool for diagnosing DS cases.
Munaf, Alvina;Memon, Muhammad Sadik;Kumar, Prem;Ahmed, Sultan;Kumar, Maheshwari Bhunesh
Asian Pacific Journal of Cancer Prevention
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제15권18호
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pp.7563-7567
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2014
Background: Hepatocellular carcinoma (HCC) is the first cause of death in cirrhotic patients, mostly due to viral hepatitis with HCV or HBV infection. This study was performed to estimate the true prevalence of viral hepatitis-related HCC and the demographic and clinical-pathological associations with the two virus types. Materials and Methods: This cross sectional observational study enrolled clinical data base of 188 HCC patients and variables included from baseline were age, sex, area of residence, clinical-pathological features such as underlying co-morbidity, presence or absence of liver cirrhosis, macrovascular involvement, tumor extension and metastasis, liver lobes involved, serum alpha-fetoprotein level, and hepatitis serologies. Results: Overall prevalence of HCV- and HBV-related HCC was 66.0% and 34.0%, respectively. Patients with HCV were more likely to develop HCC at advanced age ($52.4{\pm}11.9$ vs. $40.7{\pm}12.09$ years), with highly raised serum AFP levels (${\geq}400ng/ml$) 78.2% (HBV 67.1%), large tumor size (HCV-66% >5 cm, HBV-59.3%), and presence of portal vein thrombosis (8.06%, HBV 1.56%). A binominal multivariate analysis showed that HCV-HCC group were more likely to be cirrhotic (OR=0.245, 95%CI: 0.117, 0.516) and had more than two times higher rate of solitary macrovascular involvement (OR=2.533, 95%CI: 1.162, 5.521) as compared with HBV associated HCC. Conclusions: Statistically significant variations were observed from baseline to clinical-pathological characteristics in HCV vs HBV associated HCC. Our study suggests prompt and early screening for high risk patients so that the rate of progression of these chronic viral diseases to cirrhosis and cancer can be decreased.
Background: The prognostic significance of the circulating absolute monocyte count (AMC) in patients with locally advanced hepatocellular carcinoma (HCC) is uncertain. This study was designed to assess the association of circulating AMC with survival outcomes in patients diagnosed with locally advanced or metastatic HCC receiving systemic chemotherapy. Materials and Methods: Between January 1, 2005 and December 30, 2012, locally advanced or metastatic HCC patients who had Child-Pugh stage A or B disease and received systemic chemotherapy were retrospectively enrolled. Patient features including gender, age, extrahepatic metastasis, Child-Pugh stage, serum alpha-fetoprotein(AFP) level and AMC were collected to investigate their prognostic impact on overall survival(OS). Results: A total of 216 patients were eligible for the study. The optimal cut-off value of AMC for OS analysis was $0.38{\times}10^9/L$. Median OS was 5.84 months in low-AMC group (95% confidence interval [CI], 5.23 to 6.45), and 5.21 months in high-AMC group (95% CI, 4.37 to 6.04; p=0.003). In COX multivariate analysis, elevated AMC remained as an independent prognostic factor for worse OS (HR, 1.578; 95% CI, 1.120 to 2.223, p=0.009). Conclusions: Our results indiicate that circulating AMC is confirmed to be an independent prognostic factor for OS in patients with locally advanced or metastatic HCC receiving systemic chemotherapy.
The findings of serum biochemical tests in the inhabitants residing in some riverside areas of kyongsangnam-do were analized to know the correlation with the Clonorchis sinensis infection. A total of 2,722 fecal samples of inhabitants was examined by Kato's cellophane thick smear and formalin-ether sedimentation methods, and their serums were analized biochemically. Three hundred and thirty-three inhabitants (12.2%) were positive with C. sinensis eggs (egg-positive group), and remaining 2,389 were negative (egg-negative group). In the egg-positive group, the positive .ate of aspartate aminotransferase (AST) was 6.9% (male: 10.3%; female: 3.2%), that of alanine aminotransferase (ALT) was 6.3% (male: 9.1%; female: 3.2%), of $\gamma$-glutamy1 transpeptidase ($\gamma$-GIP) was 9.0% (male: 13.1%; female: 4.4%), and that of $\alpha$-fetoprotein (AEP) was 3.0% (male: 2.9%; female: 3.2%). In the egg-negative group, the positive rate of AST was 5.2% (male: 8.9%; female: 3.2%), that of ALT was 5.1% (male: 8.6%; female: 3.2%), of $\gamma$-GTP was 7.5% (male: 13.0%; female: 4.5%), and that of AFP was 0.3% (male: 0.5%; female: 0.1%). In the egg-positive group, 127 cases (38.1%) were light infection, 108 (32.4%) were moderate infection,64 (19.2%) were heavy infection, and 34 (10.2%) were very heavy infection. The positive rates of all tests were high according to the intensity of infection. From the above results, It was confirmed that prevalence of clonorchiasis is still high in some riverside areas of Kyongsangnam-do, and findings of serum biochemical tests are not different between the egg-positive group and egg-negative group. However, there were some difference in the positive rates of serum AST, ALT, $\gamma$-GTP and AEP by the age, sex and the intensity of infection.
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