ObjectiveTo understand advances in diagnostic value of long non-coding RNA (LncRNA) in hepatocellular carcinoma (HCC) and to find a useful tumor marker for early diagnosis of HCC.MethodThe recent literatures relevant the LncRNA in the HCC were reviewed and summarized.ResultsThe LncRNA could be detected in the blood and urine of the patients by the RNA immunoprecipitation, sequencing technology, gene chip, real-time quantitative PCR, and other techniques. With the rise of RNA sequencing technology, the number of identified LncRNAs had increased rapidly, and the remarkable progress had been made in the field of liver diseases. At present, the LncRNA related to HCC mainly included the urothelial cancer associated 1, highly up-regulated in liver cancer, metastasis-associated lung adenocarcinoma transcript 1, HOXA transcript at the distal tip, H19, SPRY4 intronic transcript 1, plasma-cytoma variant translocation gene 1, uc002mbe.2, uc007biz.1, etc., which were stable in the blood or urine and abnormally expressed in the HCC, alone or as a supplement to alpha-fetoprotein could obviously improve the sensitivity and specificity of diagnosis of HCC, even increased the sensitivity to 100%.ConclusionsLncRNA is specifically expressed in HCC and is expected to be a novel biomarker for early diagnosis of HCC. However, LncRNA has many types, diverse structures, and complex molecular regulation mechanisms. It is very difficult to find a strong combination or combinations to replace or supplement traditional biomarkers and to be clinically useful further efforts. It is believed that with deepening of LncRNA research in HCC, it will have a broader prospect in early screening, diagnosis, and prognosis of HCC.
Indocyanine green fluorescence imaging has been widely used in hepatobiliary surgery, which can guide accurate hepatectomy and improve the prognosis of patients. Lipiodol–indocyanine green emulsion as a pure physical way to prepare lipiodol-drug mixed solvent can be used for primary interventional embolization and subsequent fluorescence-guided hepatectomy. In this paper, the application of iodized oil-indocyanine green emulsion in hepatectomy was summarized by reviewing relevant research progress at home and abroad, and further discussion and prospect were made.
ObjectiveTo summarize the research progress of risk factors related to early recurrence and late recurrence of hepatocellular carcinoma (HCC) after radical resection.MethodsReviewed and summarized recent literatures on factors related to early and late recurrence of HCC after radical resection.ResultsRadical resection was the most effective treatment for HCC, but the postoperative recurrence rate was high, which seriously affected the treatment effect. Current research divided the recurrence after radical resection of HCC into early recurrence (≤2 years) and late recurrence (>2 years). Early recurrence was considered to be mainly caused by intrahepatic metastasis (IM), which was related to the tumor itself, while late recurrence was mainly caused by multicentric occurrence (MO) and was related to background liver factors. Factors of the tumor itself, including tumor diameter and number, invasion of tumor large vessels and microvessels, anatomical and non-anatomical resection, tumor margin, residual liver ischemia (RLI), intermittent total entry hepatic blood flow interruption method (IPM), the expression level of circulating microRNA in serum and long-chain non-coding RNA, circulating tumor cells, and circulating tumor DNA were related to early recurrence; background liver factors, including liver cirrhosis, high viral load, and liver inflammatory activity, were associated with late recurrence.ConclusionsBoth the tumor factors associated with early recurrence and the background liver factors associated with late recurrence can affect the recurrence after radical resection of HCC.
ObjectiveTo summarize the research progress of long non-coding RNA (lncRNA) in the regulation of malignant biological behavior of gallbladder cancer so as to provide references for its related research.MethodThe relevant literatures about studies of lncRNA in gallbladder cancer in recent years were reviewed.ResultsThe recent studies had shown that 19 lncRNAs associated with gallbladder cancer had played the important roles in regulating tumor cell proliferation, migration, invasion, apoptosis, “sponge” miRNAs, chemoresistance, and tumor metastasis. Among them, most lncRNAs tended to have carcinogenic properties, only a few had anticarcinogenic effect. Although the research suggested the mechanism and role of lncRNA to promote or inhibit the occurrence and development of gallbladder cancer, the current research on its mechanism was still limited. In addition, some lncRNAs were found to be specifically expressed in the serum of patients with gallbladder cancer, so which were expected to become biomarkers for tumor diagnosis and prognosis.ConclusionslncRNAs associated with gallbladder cancer have carcinogenic or anticarcinogenic effect, or chemoresistance. They play potential roles in diagnosis, prognosis, and (or) treatment of tumors, but molecular mechanisms of their effects are still limited.
ObjectiveTo understand the clinical value of centromere proteins (CENPs) in hepatocellular carcinoma and their influence on the malignant biological behavior of hepatocellular carcinoma, and to provide theoretical references for related research in this field. MethodDomestic and international databases were searched for relevant literatures on the study of CENPs in hepatocellular carcinoma in recent years to be analyzed and reviewed. ResultsA total of 11 CENPs closely related to hepatocellular carcinoma had been summarized, which were differentially expressed in hepatocellular carcinoma and correlated with prognosis. CENPs might regulate various malignant biological behaviors such as hepatocellular carcinoma proliferation, metastasis, apoptosis, and resistance to radiotherapy and thus participate in the development of hepatocellular carcinoma via multiple mechanisms. The roles and mechanisms of some CENPs in hepatocellular carcinoma remained unclear. ConclusionsCENPs play an essential role in the diagnosis, treatment, and prognosis of hepatocellular carcinoma. They are involved in multiple malignant biological behaviors of hepatocellular carcinoma and are expected to be potential therapeutic targets for hepatocellular carcinoma. However, their roles and mechanisms in hepatocellular carcinoma remain to be investigated.
Objective To systematically evaluate the diagnostic efficacy of circulating tumor DNA (ctDNA) in hepatitis B viral hepatocellular carcinoma (HBV-HCC), and to study the clinical value of ctDNA. Methods The databases of PubMed, Embase, Web of Science, and Cochrane Library database were retrieved systematically from the establishment of the database to April 26, 2021. The characteristic information of literatures and the original data such as the sensitivity, specificity, and area under curve (AUC) of the receiver operating characteristic (ROC) curve were extracted. A meta-analysis was conducted by applying RevMan 5.3 and Stata 15.0 software. The combined sensitivity, combined specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (OR) were calculated, ROC curve was plotted and the AUC was calculated, Deck’s funnel chart to assess publication bias, the Fagan diagram to test the diagnostic efficiency. Results Finally, 16 studies involving 3 744 patients were enrolled in this study, of which 1 852 were HBV-HCC patients, and 1 892 were HBV-infected patients without HCC. The meta-analysis results showed that ctDNA had a pooled sensitivity of 0.85 [95%CI (0.78, 0.90)], a specificity of 0.74 [95%CI (0.63, 0.83)], a diagnostic OR of 15.98 [95%CI (10.65, 23.99)], and the AUC of ROC was 0.87 [95%CI (0.84, 0.90)] in the diagnosis of HBV-HCC. The pooled sensitivity, specificity, diagnostic OR, and the AUC of ROC for ctDNA combined with AFP in the diagnosis of HBV-HCC were 0.86 [95%CI (0.80, 0.90)], 0.79 [95%CI (0.68, 0.87)], 22.69 [95%CI (13.64, 37.76)], and 0.90 [95%CI (0.87, 0.92)]. Meta-regression analysis found that the heterogeneity came from other non-covariate factors. The Fagan chart showed that while HBV-HCC was diagnosed by liquid biopsy-based on ctDNA, the probability of being diagnosed with hepatocellular carcinoma was 77%, if HBV-HCC was excluded, the probability of having the corresponding disease was 17%. Deek’s test showed no obvious publication bias (P>0.05). ConclusionsThe ctDNA can diagnose HBV-HCC with high sensitivity, specificity and accuracy, and can be used as a promising circulating biomarker in the early diagnosis of HBV-related HCC. The combination of ctDNA in serum and AFP is beneficial to improve the diagnostic accuracy of HBV-HCC.
Objective To assess the effectiveness of bariatric surgery for obese type 2 diabetes mellitus (T2DM) in Mainland China. Methods Such databases as the Cochrane Central Register of Controlled Trials (Issue 2, 2012), MEDLINE (1990 to February 2012), EMbase (1990 to February 2012), CBM (1990 to February 2012), CNKI (1990 to February 2012), WanFang Data (1999 to February 2012) and VIP (1996 to February 2012) were searched, and the references of the included literature were also retrieved. The studies were screened according to the predefined inclusion and exclusion criteria, the data were extracted, the quality was evaluated, and then the meta-analysis was performed using RevMan 5.2 software. Results A total of 6 controlled before-and-after studies involving 100 patients were included. The overall quality of all literature was as low as grade C. The results of meta-analysis showed that the following indexes after operation obviously decreased than before: 1-month postoperative fasting plasma glucose (MD= –2.27, 95%CI ?4.12 to ?0.42, P=0.02), 6-month postoperative fasting plasma glucose (MD= ?2.73, 95%CI ?2.91 to 2.56, Plt;0.000 01), and 6-month postoperative glycated hemoglobin (SMD= ?1.97, 95%CI ?2.98 to ?0.96, P=0.000 1), and the differences were statistically significant. The sensitivity analysis indicated the results of meta-analysis were credible and stable, but the funnel-plot analysis displayed publication bias might exist in the included studies. Conclusion Current studies show that bariatric surgery is effective for obese T2DM patients in mainland China. However, due to small sample size and low methodological quality of the included studies, its effect has to be proved by high quality, large sample, and long follow-up studies.
Objective To explore risk factors and treatment strategies of liver resection surface infection following laparoscopic hepatolithiectomy for patient with complicated intrahepatic bile duct stones. Methods The clinical data of 45 patients with complicated intrahepatic bile duct stone underwent laparoscopic hepatectomy from January 2014 to April 2017 in this hospital were analyzed. The liver resection surface infection rate, pathogenic bacteria distribution, factors of operation, antibiotic use time, volume of drainage, and drainage tube placement time were analyzed. Results A total of 13 cases of liver resection surface infection occurred following the laparoscopic hepatolithiectomy in the 45 cases, the infection rate was 28.89%. Totally 24 strains of pathogens were isolated from the infected patients, including 9 strains of gram-positive bacteria and 15 strains of gram-negative bacteria. The mainly postoperative complications included 16 cases of the biliary leakage, 5 cases of the effusion and empyema, the average drainage volume was about 200 mL after the surgery. The double pipes were placed in the 10 patients in the operation. The drainage tubes were placed in the 23 patients under the ultrasound or CT intervention after the surgery, the average time of drainage tube placement was 8 d. The results of univariate analysis showed that the past biliary surgery history, combined with liver cirrhosis, double pipe drainage, operation time, and postoperative biliary leakage were associated with the liver section surface infection following the laparoscopic hepatolithiectomy (P<0.050). The results of multivariate analysis identified that the past biliary surgery history and postoperative biliary leakage were the risk factors (P<0.050), while the double pipe drainage was the protective factor (P<0.050) for liver resection surface infection following the laparoscopic hepatolithiectomy. Conclusions Prophylactic treatment such as perfect preoperative management and careful intraoperation should be taken for risk factors of liver section surface infection following laparoscopic hepatolithiectomy. Actively effective treatment strategies should be given if postoperative liver section surface infection existence.
ObjectiveTo systematically evaluate efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with Huaier granules in treatment of primary liver cancer (PLC).MethodsThe databases including the PubMed, Embase, Cochrane Library, Wanfang Data, CNKI, VIP were searched to obtain the relevant literatures of Huaier granule combined with TACE therapy (Huaier+TACE group) and alone TACE therapy (TACE group) in the treatment of PLC. The short-term curative effects (objective response rate and disease control rate), 6 and 12-month survival rates, immune function change, and adverse reactions were extracted. The RevMan 5.3 software was applied to carry out the meta analysis.ResultsFifteen studies involving 1 781 cases were enrolled in this study, of which 876 cases underwent the Huaier+TACE, 905 underwent the TACE. The meta analysis results showed that the objective response rate and disease control rate, 6 and 12-month survival rates of the Huaier+TACE group were significantly more superior as compared with of the TACE group (P<0.05), the adverse reaction incidence had no significant difference (P>0.05). Compared with the TACE group, the CD4 +/CD8 + of the Huaier+TACE group was significantly improved (P<0.05).ConclusionFrom results of meta analysis, Huaier granule combined with TACE could improve therapeutic effect, increase survival rate, and improve life quality of PLC.
ObjectiveTo summarize the key technical points, applicability, feasibility, and safety of laparoscopic spleen-preserving distal pancreatectomy (LSPDP).MethodA retrospective analysis was performed for the clinical data of 22 patients who were admitted to the Affiliated Hospital of North Sichuan Medical College from September 2016 to November 2019, all patients planned to receive LSPDP.ResultsTwenty of the 22 patients successfully completed LSPDP, and 2 patients converted to laparotomy. One patient was transferred to laparotomy to suture the damaged splenic artery. The spleen was observed to have no ischemia and the spleen preservation operation was continued. One patient was converted to laparotomy due to the difficulty of dissecting the tail of the pancreas which caused by severe abdominal adhesion. The operation time of LSPDP patients was (191±86) minutes (170–480 min), intraoperative blood loss was (365±50) mL (200–1 000 mL), and postoperative hospital stay was (9.9±2.6) days (7–16 d). Six patients of pancreatic fistula occurred after operation, including 3 cases of biochemical fistula, which were cured and discharged after symptomatic treatment, 3 cases of grade B pancreatic fistula, who all improved after anti-inflammatory, acid suppression, enzyme suppression, and double catheter drainage. Twenty patients were interviewed after the operation, and the follow-up time was 3–24 months (median of 15 months). During the follow-up period, no patient had recurrence or metastasis.ConclusionsUnder the conditions of strict screening of suitable cases, adequate preoperative imaging evaluation, intraoperative fine manipulation, and the application of appropriate operating instruments and cutting closure devices, LSPDP is safe and feasible to treat benign tumors of the pancreatic body and tail and some borderline tumors. During the operation, attention should be paid to the reasonable treatment and protection of splenic arteries and veins.