Objective To Investigate the indications, surgical technique and perioperative management of orthotopic liver transplantation.Methods Orthotopic liver transplantation was successfully performed on a unresectable liver cancer on caudate lobe, 2 cases with Caroli’s disease and 7 cases with advanced liver cirrohosis. A 11 year’s old girl with Caroli’s disease was performed on one reduced size liver transplantation (RSLT). Results The recovery of liver graft function was good after the operation in those patients without perioperative death. The case of liver cancer died of recurrent cancer on the 139th postoperative day, 1 case died of severe fungus infection and one died of gastric stress ulcer perforation, other 7 cases recovered well without complications. Conclusion The results suggest that unresectable central liver cancer, terminal liver cirrohosis or benign liver diseases combined with severe liver disfunction are good indications for liver transplantation. Good surgical technique and perioperative management are key points to succucess of the liver transplantation.
Objective To investigate the variety of telomerase activity in the course of liver cancer development, and the possibility of using telomerase as a marker of HCC. Methods Human liver specimens, comprising 22 HCC and adjacent peritumoral tissues, 12 liver cirrhosistissues, 6 nodulat regenerative hyperplasia (NRH) tissues and 10 normal liver tissues, were examined for telomerase activity by TRAP assay based on PCR. Results Twenty of 22 HCC and 14 of 22 adjacent tissue specimens were positive for telomerase activity with a positive rate of 90.9% and 63.6% respectively. Ten of 12 liver cirrhosis tissues were positive with a positive rate of 83.3%. 5 of 6 NRH were positive with a positive rate of 83.3%. Telomerase activity was negative in 10 normal liver tissues. Conclusion Telomerase may occur in the progress of hepatocarcinogenesis. Telomerase can be used as a tumor marker of HCC.
Objective To study the development of internal radiotherapy for liver cancer and the relationship between effects and radiation doses. Methods Literature about internal radiotherapy of liver cancer were collected and reviewed. Results The rational selection of radioactive microsphere,the appropriate control of radiation dosage and the path of internal radiotherapy are crucial in improving the therapy effects and decreasing the complications. Conclusion The two-stage operation of liver cancer which is on the base of combining chemotherapy, radiotherapy and immunotherapy is the way to go of liver cancer therapy.
Objective To explore the diagnosis and treatment for spontaneous rhexis hemorrhage of liver cancer. Methods Clinical data of thirty patients who suffered from spontaneous rhexis hemorrhage of liver cancer from January 1995 to March 2009 were collected and analyzed retrospectively. Results Twenty-six cases were stanched by surgical therapy, in which 14 cases underwent liver cancer resection, 10 cases underwent bleeding transfixion and hepatic artery ligation (or intubation), and 2 cases underwent omentum stuff transfixion. Four cases died one week after surgery, one died after 15 d, 9 cases died 1 to 3 months after operation, 5 cases survived after 4 to 6 months, 3 cases survived after 7 to 12 months, and in 4 cases survival time was longer than 12 months (in which one patient’s survival time was 16 months, one was 5 years and two patients were still alive with survival time of 3 and 13 years respectively). Four patiens went through the non-surgical therapy and survival time was 3 to 14 d. Conclusion The spontaneous rhexis hemorrhage of the liver cancer is not the telephase of the liver cancer. Early diagnosis and operation can stanch bleeding effectively. The surgical therapy is better than the non-surgical therapy. Resection of liver neoplasms in time can raise long-term survival time.
Objective To evaluate the outcome of liver transplantation in patients with recurrent liver cancer after resection. Methods Data of 23 patients underwent liver transplantation for recurrent liver cancer from April 2001 to March 2008 were retrospectively collected and analyzed. Results Previous history of liver resection had little negative effect in subsequent liver transplantation in technical aspect. Liver function recovered uneventfully after transplantation in all cases. Alpha fetoprotein (AFP) recovered to normal value in 13 of 17 cases with elevated AFP before transplantation within one month after operation. Five cases (21.74%) had postoperative complications. Nineteen cases (82.61%) were followed up, average follow-up duration were 610 days. There were 5 cases (26.32%) of cancer recurrence and 6 deaths during follow-up, survival rate was 68.42%. Conclusion Liver transplantation is a reasonable treatment for recurrent liver cancer after resection.
;ObjectiveUsing human tumor necrosis factoralpha (TNFα) genetransduced human liver cancer cell BEL7404 as tumor vaccine, to study the effect of immune rejection to mice liver cancer implanted tumors. MethodsMice were divided into five groups, and were inoculated with TNFα genetransduced BEL7404 cells which irradiated with 60Co (BEL7404TNFCo group), TNFα genetransduced BEL7404 cells (BEL7404TNF group), BEL7404 cells (BEL7404 group), BEL7404 cell irradiated with 60Co (BEL7404Co group) respectively. Normal saline was injected in control group. Then mice liver cancer H22 cells were implanted to each group, the growth of mice liver cancer implanted tumors was observed. The apoptosis index of implanted tumors was detected by TUNEL method.ResultsCompared to BEL7404 group,BEL7404Co group and control group, the tumor vaccine which did not transduce with TNFα gene and the control group, the tumorigenesis rate of liver cancer implanted tumors was reduced, the growth of implanted tumors was inhibited and the apoptosis of implanted tumors was increased in BEL7404TNFCo group,P＜0.01.There was no difference between BEL7404TNFCo group and BEL7404TNF group,Pgt;0.05. ConclusionHuman tumor necrosis factoralpha genetransduced human liver cancer cell can be used as tumor vaccine, it has quite b effect of immune rejection to mice liver cancer implanted tumors.
Objective To study the mechanism of high intensity focused ultrasound (HIFU) and discuss its clinical significance in the treatment of mid-late stage liver cancer. Methods The patients with mid-late stage liver cancer were treated with HIFU. The changes of photography, pathology and immunology after operation were evaluated. Results It was shown that the results of the photographic, pathologic and immunologic examinations changed during the treatment of the patients with HIFU. Conclusion HIFU is effective and safe for the treatment of mid-late stage liver cancer.
Objective To probe into the significance of tuftsin in patients with liver cancer. MethodsThe serum tuftsin level of 12 patients with liver cancer before and after the resection，20 cirrhostic and 20 normal controls were measured by radioimmunoassay (RIA). ResultsTuftsin level in preoperative group （449±106） ng/ml was much lower than that in postoperative group (588±129) ng/ml，cirrhotics group (580±187) ng/ml and control group (703±128) ng/ml (P＜0.01). The tuftsin level in postoperative group was also quite lower than that in control group (P＜0.01). Conclusion We should try our best to excise the liver cancer so that a higher tuftsin level might be obtained which can activate NK cell and T cell.
Objective To investigate the clinical outlook of hepatic stem cells and its relations with liver cancer. Methods The literatures of recent years on the studies of hepatic stem cells were reviewed. Results Liver cancer may consist of cells of various differentiation grades and it may result from the perodifferentiated hepatic stem cells or abnormal differentiated cells. Conclusion The hypothesis of hepatic stem cells has been identified extensively. Further study maybe helpful for revealing the origin, carcinogenesis of hepatic cancer, and may also be useful for the understanding of the mechanism of metastasis.
Objective To investigate the impact of laparoscopic versus. open hepatic resection for liver cancer on clinical rehabilitation and humoral immune function in patients organism. Methods Forty-four patients of laparoscopic and open left-lateral sectionectomy from January 2010 to June 2012 were selected， including 22 patients of laparoscopy group and 22 patients of conventional laparotomy group. The levels of IgG， IgA， IgM， C3， C4， C reactive protein （CRP）， IL-2， IL-6， and TNF-α in peripheral blood of patients on the last day before operation， first day and 5th day after operation were determinated by using ELISA assay. At the same time， the operative time， intraoperative bleeding， hospitalization time， and complications after operation between two groups were compared. Results The postoperative analgesic using time， first time eating， and hospitalization time in laparoscopic group were （1.9±0.8） days， （2.2±0.5） days， and （6.3±1.3） days， respectively， they were shorter than that in conventional laparotomy group （P＜0.05）. The operative time， intraoperative bleeding， complication rate， and mortality in two groups were not significant differences（P＞0.05） . Compared with before operation， the levels of C3， C4， IgA， IgG， IgM， and IL-2 on the first day after oper-ation in two groups were obviusly reduced， the levels of CRP， IL-6， and TNF-α on the first day after operation in two groups were significantly increased. The levels of C3， C4， lgA， IgG， lgM， and IL-2 on the first day after operation in conventional laparotomy group were significantly decreased than that in laparoscopic group （P＜0.05）. On the 5th day after operation， the levels of C3， C4， lgA， IgG， lgM， and IL-2 of laparoscopy group increased， the levels of CRP， IL-6，and TNF-α were reduced，that were no difference compared with before operation. Compared with before operation，the levels of C3， C4， lgA， IgG， lgM， and IL-2 of conventional laparotomy group were still at a low level state， and the levels of CRP， IL-6， and TNF-α were still at a high level state on the 5th day after operation. Conclusions Laparoscopic resection of liver cancer after operation， the patients’ recovery are quickly， and the impact on humoral immune function of laparoscopic radical resection for liver cancer patients is significantly less than that conventional laparotomy.