目的:探讨西南地区雌激素受体α（estrogen receptor α，ERα）基因多态性与原性肝癌关系。方法:选择西南地区100名原发性肝癌患者为实验组，100名非肝病人群作为对照组。应用分子生物学的方法分析PvuⅡ，XbaⅠ限制性片段长度多态性（restriction fragment length polymorphism，RFLP）。同时对人雌激素受体基因上游的短串联重复序列（short tandem repeat，STR）进行纯化、克隆和序列分析，观察ERα基因多态性基因型在实验组与对照组中的基因型分布。结果:PvuⅡ和XbaⅠ限制性片段长度多态性在两组中均呈多态性分布。病例组TA13等位基因频率高于对照组，差异有显著性，TA15等位基因频率低于对照组，差异有显著性。结论:ERα基因多态性与原性肝癌有关，X等位基因可能是其危险因素，P等位基因可能是其保护因素，TA13等位基因可能是其危险因素，TA15等位基因可能是其保护因素。
ObjectiveTo investigate feasibility, safety, and problems to be solved in treatment with programmed death receptor protein-1 (PD-1) monoclonal antibody for patients with recurrent liver cancer after liver transplantation (LT).MethodAll of the domestic and foreign cases reports about the application of PD-1 monoclonal antibody in the patients with recurrent liver cancer after the LT were analyzed and summarized.ResultsIn six patients with recurrent liver cancer after the LT who received the PD-1 monoclonal antibody, the acute graft rejections were observed in 3 patients, 2 patients had the progressive disease but there was no evidence of the graft rejection, 1 patient achieved the complete response and there was no evidence of graft rejection and no side effects.ConclusionsAt present, effect of PD-1 monoclonal antibody therapy is still not sure in patients with recurrent liver cancer after LT. If PD-1 monoclonal antibody is used off-label, close surveillance is needed to discovery possible acute graft rejection.
ObjectiveTo summarize the research progress of hepatocellular carcinoma (HCC) based on tumor microenvironment immunophenotyping.MethodThe related literatures of basic and clinical studies on HCC immunophenotyping in the recent years were reviewed.ResultsHCC could be divided into different immunophenotypes based on tumor microenvironment, and it showed different immune molecular characteristics, immune cell infiltration characteristics, and anti-tumor ability. At the same time, the HCC immunophenotype was significantly associated with patients’ survival and had been proved to be able to better evaluate the prognosis of HCC patients. According to the relevant molecular characteristics in the HCC immune microenvironment, it could provide guidance for the drug regimen of immunotherapy.ConclusionHCC immunophenotyping is still in the early stage of research, and its clinical application value has been preliminarily shown for the evaluation of patients’ prognosis and immunotherapy decision-making, which is a new idea of individualized treatment of HCC in the future.
Objective To investigate the expression of vascular endothelial growth factor-A （VEGF-A） and the phenotypic transition after the activation of fibroblasts by the supernatant of cultured tumor cells．Methods The growth tendency of fibroblasts was tested by the MTT assay．The expressions of alpha-smooth muscle actin （α-SMA） and VEGF-A mRNA were tested by RT-PCR．The expressions of α-SMA and VEGF-A protein were tested by immunohistochemistry and Western blot．Results The MTT assay indicated that the conditional medium which contained tumor cells supernatant could obviously promote the growth of the fibroblasts． RT-PCR and Western blot manifested that α-SMA expressed by the fibroblasts which cultured by normal medium reached its peak on day 5，then decreased to a low level on day 7．When the medium contained 2 ng/ml transforming growth factor-β1 （TGF-β1），the fibroblasts could steadily express more α-SMA．But the above two mediums could not make the fibroblasts express the VEGF-A. When using the conditional medium，the α-SMA peak advanced on the third day and maintained at a high level，so as the expression of the VEGF-A．Conclusions The results suggested that fibroblasts can be activated to be myofibroblasts when using the conditional medium．The best activation time of the fibroblasts is consistent with the time of the VEGF-A expression at the highest level by the activated fibroblasts．The fibroblasts which activated at the best time are expected to become a kind of cells which can be used for promoting revascularization．
ObjectiveTo investigate the clinical effect of “Double R” pancreatojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).MethodsThe clinical data of 20 patients underwent “Double R” pancreaticojejunostomy in the LPD from November 2018 to December 2019 in this hospital were collected retrospectively. The duration of pancreaticojejunostomy, incidence of postoperative pancreatic fistula, incidence of other complications, mortality, length of stay, and other clinical outcomes were analyzed.ResultsThere were 5 males and 6 females. The age was (56±10) years old. The body mass index was (22.6±4.4) kg/m2. The LPDs were successfully performed in all 20 patients, no patient transferred to the laparotomy, and no patient died within 30 d. There were 6 patients with papillary adenocarcinoma of the duodenum, 5 patients with adenocarcinoma of the lower part of the common bile duct, 2 patients with adenocarcinoma of the pancreatic duct, 3 patients with serous cystadenoma of the pancreatic head, 2 patients with intraductal papillary myxoma of the main pancreatic duct of the pancreatic head, 1 patient with duodenal adenoma with high grade intraepithelial neoplasia, 1 patient with metastatic renal clear cell carcinoma of the pancreatic head, 5 patients with soft pancreas, 12 patients with medium texture, 3 patients with hard texture. The diameter of distal pancreatic duct was (2.1±1.7) mm. The operative time was (380±69) min, the duration of pancreaticojejunostomy was (29±15) min, the intraoperative blood loss was (180±150) mL, the postoperative time of anal exhaust (2.2±0.8) d, postoperative time of fluid intake (3.5±1.1) d, postoperative time of half fluid intake (5.5±0.7) d, postoperative time of hospitalization (14±10) d. There were 3 complications in 2 patients, one of which suffered the pulmonary infection, the other suffered the delayed gastric emptying and gastrointestinal anastomosis bleeding, no bile leakage and abdominal hemorrhage happened. There were 2 cases of pancreatic fistula after the operation, all of them were biochemical pancreatic fistula.Conclusions“Double R” pancreaticojejunostomy method has some advantages of convenient operation, short operation time, and low incidence of pancreatic fistula. However, due to the limited sample size, its safety and feasibility still need to be verified by larger samples and more institutions.