We have devised a highly sensitive, specific, and quantitative assay for multidrug resistance (mdr1) mRNA expression based on the reverse transcription-polymerase chain reaction (RT-PCR). mdr1 mRNA levels were detected in 30 human primary hepatocellular carcinoma (PHC) tissue and adjacent liver tissue. Five of the patients had received chemotherapy before hepatectomy. The results show that the level of expression of mdr1 gene is higher in tumor tissue than in adjacent liver tissue. mdr1 gene is overexpressed in PHC after chemotherapy. Furthermore, mdr1 gene expression in the treated tumor adjacent liver tissue is higher than that in untreated tumor adjacent liver tissue. Our results indicated that overexpression of mdr1 gene may be responsible for the intrinsic and acquired drug resistance of PHC.
ObjectiveTo study the clinical value of changes of serumα-fetoprotein(AFP) and soluble cell adhesion molecule-1(sICAM-1) levels before and after surgical treatment of primary hepatocellular carcinoma(PHC) as predictors of patient survival. MethodsThe clinical data and followed-up results of 86 patients with hepatocellular carcinoma received hepatectomy or radiofrequency ablation(RFA) in Xijing Hospital and the 451st Hospital of PLA were retrospectivly analyzed. The changes of peripheral blood AFP and sICAM-1 levels in patients before and in 1 month after treatment were observed and all patients were divided into different groups according to the changes in both two markers. Then survival rates of each group were analyzed. ResultsThe patients with AFP < 20μg/L or sICAM-1 < 1 000 U/L before treatment had lower tumor recurrence rate and higher survival rate than patients with elevated serum levels of the both markers(AFP:P=0.018, P < 0.001;sICAM-1:P=0.027, P < 0.001). The larger tumor, late TNM stage, and higher rate of recurrence were associated with elevated serum levels of the both markers(AFP:P=0.016, P=0.026 and P=0.025;sICAM-1:P < 0.001, P=0.024 and P=0.032). The better survival situation was closely related with these cases treated with hepatectomy and their levels of both markers were lower than the above cutoff values both before and after treatment, or leves of both markers above the cut-off values returned to within the normal range after treatment (AFP:P=0.006, P=0.001;sICAM-1:P=0.001, P=0.002). The patients who had simultaneous increase of AFP and sICAM-1 after operation showed the worst tumor-free and overall survivals(P=0.007, P < 0.001). ConclusionTo test the changes of serum AFP and sICAM-1 levels in early stage after treatment for patients who received radical resection of hepatocellular carcinoma has good clinical value for monitoring of tumor recurrence and predict prognosis.
目的:探讨经导管肝动脉灌注化疗栓塞(TACE)与TACE联合三维适形放射治疗(TACE + 3DCRT)原发性肝细胞癌(HCC)的疗效.方法:随机分成两组的HCC患者,均不能手术、门脉无癌栓、无远处脏器转移。50例患者行单纯TACE 2次(TACE组)。40例患者在TACE 2次后第四周再行三维适形放射治疗(TACE + 3DCRT组),放疗采用6MVX射线,4～6 Gy/次,隔日一次,3次/周,总剂量45～60 Gy。TACE采用碘化油、顺铂、5氟尿嘧啶、表阿霉素及明胶海绵。结果:TACE组与TACE+3DCRT组近期疗效有效率(完全缓解+部分缓解)分别为68.0%(34/50)、87.5%(35/40),1年生存率分别为78.0%(39/50)、95.0%(38/40),两组差异均有统计学意义(Plt;0.05)。TACE的治疗反应主要为栓塞综合征,3DCRT有7.5%(3/40)发生急性放射性肝炎,经对症、保肝处理后缓解。两组患者均能耐受。结论:TACE + 3DCRT治疗不能手术、门脉无癌栓、无远处脏器转移的HCC的疗效较单纯TACE治疗HCC的疗效好。
ObjectiveTo evaluate therapeutical effects of Huaier granule combined with transcatheter arterial chemoembolization (TACE) following radical resection of primary hepatocellular carcinoma with microvascular invasion. MethodsThe clinical data of 45 cases of primary hepatocellular carcinoma with microvascular invasion underwent Huaier granule combined with transcatheter arterial chemoembolization (TACE) following radical resection from June 2010 to June 2013 in Liaoning Cancer Hospital were retrospectively analyzed. These patients were divided into Huaier granule plus TACE treatment group (20 cases) and simple TACE treatment group (25 cases) according to the postoperative treatment of the patients. The immune function (CD4+/CD8+ ratio and IL-2 level), 1and 3-year tumor recurrence rates and 3-year cumulative survival rate were compared between two groups after operation. Result① The CD4+/CD8+ ratio and IL-2 level had no significant differences between the 2 groups before operation (P > 0.05), which in the Huaier granule plus TACE treatment group were significantly higher than those in the simple TACE treatment group (P < 0.05) on month 3, 6, and 12 after operation.② 1and 3-year tumor recurrence rates in the Huaier granule plus TACE treatment group were significantly lower than those in the simple TACE treatment group[15% (3/20) versus 48% (12/25), P < 0.05; 45% (9/20) versus 80% (20/25), P < 0.05]. ③ The 3-year cumulative survival rate was 75% and 68% in the Huaier granule plus TACE treatment group and the simple TACE treatment group, respectively. The survival curve analysis showed that the 3-year survival rate had a decreased trend, which in the Huaier granule plus TACE treatment group was slightly higher than that in the simple TACE treatment group, but the difference had no statistical significance between the 2 groups (P > 0.05). ConclusionsAlthough the results of this study fails to confirm that Huaier granule plus TACE treatment for primary hepatocellular carcinoma with microvascular invasion following radical resection could significantly improve the 3-year cumulative survival rate, it could effectively decrease the recurrence rate. It is needed larger sample size to further explore in future research.
Objective To investigate the expressions of CD90, IGF1R, and hTERT protein in hepatocellular carcinoma, and the correlations of each other in the development of carcinoma. Methods The expressions of CD90, IGF1R, and hTERT protein in hepatocellular carcinoma were detected by S-P immunohistochemical staining, 20 cases of normal liver tissues were collected as contrast, and to compare the relations between expression and prognosis or survival rate. Results The positive rate of CD90, IGF1R, and hTERT protein in hepatocellular carcinoma group were obviously higher than that in contrast group（P＜0.05）, which was 63.9% vs. 0, 52.8% vs.5.0%, and 47.2% vs.0, respectively. The positive rate of CD90, IGF1R, and hTERT protein were higher in UICC Ⅲ-Ⅳ stage group than that in UICC stage Ⅰ-Ⅱ group（P＜0.05）, which was 79.2% vs.33.3%, 70.8% vs.16.7%, and 62.5% vs.16.7%, respectively. There was a statistically significant positive correlation observed between the expressions of CD90 and IGF1R protein （Kendall’s tau-b=0.563 1, P＜0.05）, so it was with CD90 and hTERT protein （Kendall’s tau-b=0.363 6, P＜0.05）. The survival rates of positive expressions of CD90, IGF1R, and hTERT protein were lower than negative expressions of CD90, IGF1R, and hTERT（P＜0.05）, which was 21.7% vs.50.0%, 17.6% vs.43.8%, and 20.0% vs.38.9%, respectively. Conclusions The expressions of CD90, IGF1R, and hTERT may have correlations with the progress of HCC, and may serve as a marker for HCC prognosis potentially.
ObjectiveTo observe the changes of peripheral blood lymphocyte subsets of patients with primary hepatocellular carcinoma (PHCC) treated with radiofrequency ablation (RFA). MethodsThe data of 70 cases of hospitalized patients with PHCC that voluntary accepted RFA diagnosed by clinical and pathological in our hospital between July 2011 and December 2014 were collected. According to the numbers of HCC lesions, 70 cases were divided into single focus group (n=41) and multifocal group (n=29). The changes of their immune parameters before and after RFA were analyzed. Results①The ratioes of peripheral blood CD3+/CD19-, CD3+/CD4+, CD4+/CD8+, and NK cells on 7 days and 14 days after RFA treatment of 70 cases were significantly higher than those on 1 day before RFA treatment (P < 0.05). The ratio of CD3+/CD8+ T cells reduced from 1 day before RFA treatment to 14 days after RFA treatment, but the difference was no statistically significant (P > 0.05).②The changing trend of peripheral blood lymphocyte subsets before and after RFA treatment in single focus group and multifocal group were similar to the above.③Compared with single focus group, the ratioes of peripheral blood CD3+/CD19-, CD3+/CD4+, CD4+/CD8+, and NK cells before and after RFA treatment in multifocal group were lower, and the ratio of CD3+/CD8+ T cells was higher, but the difference were not statistically significant (P > 0.05). ConclusionRFA can not only destroy small PHCC foci, but also to significantly improve immune function and enhance the anti-tumor effect.
Objective To explore the differential expressions of seven microRNAs between hepatocellular carcinoma (HCC) and adjacent nontumorous tissues (NT), analyze the correlations between differential expressing microRNAs and the levels of tumor markers in serum, and furnish evidence for novel diagnostic and prognostic tool of HCC. Methods Real-time quantitative PCR technique was used to measure the differential expressions of seven microRNAs in HCC tissues compared with NT. Results Compared with NT, the relative expressions of seven microRNAs in HCC tissues manifested statistical difference (Plt;0.05). MiR-34c, miR-21, miR-16, and miR-10b presented higher expressions in the HCC samples than those in the NT samples, while miR-200a, miR-148b, and miR-Let-7i demonstrated lower expressions in the HCC samples than those in the NT samples. In addition, miR-200a and miR-148b were markedly down-regulated in the HCC tissues than those in the NT. The differential expressions of miR-200a in HCC compared with NT samples was correlated with serum AFP level of the patients (r=0.848 9, Plt;0.01), while the differential expressions of the other six microRNAs had no correlation with the levels of tumor markers in serum (Pgt;0.05). Conclusions There are differential expressions of microRNAs between HCC and NT. MiR-200a may serve as a novel diagnostic and prognostic tool of HCC.
Objective To assess the survival of patients receiving high intensity focused ultrasound (HIFU) and investigate the prognostic factors for primary hepatocellular carcinoma (PHCC) victims with HIFU application. Methods One hundred and eighty-seven patients with PHCC undergoing HIFU treatment in our department were enrolled into this study from June 2004 to June 2007. Among them, 101 patients were males and 86 were females (mean age: 47.7 years old, range: 19-79 years old). The average tumor size was 5.7 cm (range: 0.5-18.0 cm). Of these 187 patients, numbers according to Child-Pugh grade of A, B and C were 104, 52 and 31, respectively. According to TNM system, 45, 111 and 31 patients were in stage Ⅱb, Ⅲa and Ⅲb respectively. Kaplan-Meier model and log-rank test were used in univariate analysis and Cox regression model was used in multivariate analysis to identify prognostic factors for survival. Results Survival period was (17.3±2.5) months after HIFU treatment of PHCC. The overall survival rate of 3-month, 6-month, 1-year and 2-year were 79.1%, 60.1%, 35.7%, and 29.3%， respectively. It was significant that tumor number (P=0.02), size (P=0.04)， AFP (P=0.04)， Child-Pugh grade (P=0.00)， TNM stage (P=0.01)， tumor metastasis (P=0.03) before HIFU， and tumor recurrence after HIFU (P=0.02) and standard treatment (P=0.02) were prognostic factors by single factor analysis. The following factors were identified as independent prognostic factors for overall survival by multivariate model: standard treatment protocol (P=0.000), and TNM stage (P=0.004) and Child-Pugh grade (P=0.009) before HIFU. Conclusion It is used for improving overall survival rate to found PHCC early, protect liver function, examine comprehensively before HIFU treatment, focus on standard treatment and auxiliary treatment.