ObjectiveTo summarize current treatment methods and research advances of liver metastasis in patients with gastrointestinal stromal tumor (GIST).MethodThe related literatures about treatment of liver metastasis in patients with GIST were collected and reviewed.ResultsGIST often occurred liver metastasis, which seriously affected the prognosis of patients. In the era of tyrosine kinase inhibitors (TKI) treatment, radical resection combined with TKI was the first choice. In addition, radiofrequency ablation and interventional therapy could be selected according to the patient’s condition.ConclusionsComplete resection of tumor and TKI treatment can improve the prognosis and survival rate of GIST patients with liver metastasis. GIST patients with liver metastasis need multi-disciplinary and multi-mode combined treatment.
ObjectiveTo summarize the research progress and clinical efficacy of hepatic artery infusion chemotherapy in the treatment of colorectal cancer liver metastasis.MethodThe literatures of hepatic artery infusion chemotherapy for colorectal cancer liver metastasis were collected and reviewed.ResultsThe incidence of colorectal cancer liver metastasis was high, which affected the prognosis of patients. Surgical treatment was the preferred treatment for colorectal cancer liver metastasis. Hepatic arterial infusion chemotherapy could be used for preoperative neoadjuvant therapy and postoperative adjuvant therapy.ConclusionsHepatic arterial infusion chemotherapy is an effective local treatment for colorectal cancer liver metastasis and can be used as a supplement to surgical treatment. Compared with systemic chemotherapy, hepatic arterial infusion chemotherapy combined with systemic chemotherapy can improve the overall survival and disease-free survival, reduce the risk of intrahepatic recurrence, and improve the prognosis of patients.
ObjectiveTo introduce the basic principles of commonly used assessment methods for liver function reserve, and compare the advantages and disadvantages of various assessment methods, so as to provide a reference for hepatectomy of patients with hepatocellular carcinoma (HCC). MethodThe literature on evaluation methods of liver reserve function in patients with HCC at home and abroad in recent years was searched and summarized. ResultsFrom the results of literature review, the Child‐Pugh score and indocyanine green discharge test were the most commonly used to assess preoperative liver function reserve for patients with HCC. The application value of other examinations such as albumin-bilirubin score, gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI), nuclear medical imaging in predicting post-hepatectomy liver failure was gradually being explored. ConclusionsThe combination of clinical parameters and volumetric studies is used to assess preoperative liver function reserve for patients with HCC. The clinical applications of nuclear medical imaging and Gd-EOB-DTPA-enhanced MRI make up for the deficiency of local liver function reserve evaluation, which are important examinations to assess liver function reserve after conversion therapy in the future. However, more domestic studies are still needed to confirm their values.
Objective To summarize the research progress in the diagnosis and treatment of pancreatic cystic neoplasms (PCNs). Method The guidelines and literatures related to the diagnosis and treatment of PCNs were collected and reviewed. Results At present, there was still no clear method to distinguish the types of PCNs and their benign and malignant, and there was still a dispute between domestic and foreign guidelines on the diagnosis and treatment of PCNs. Conclusion Clinical researchers still need to carry out more research, provide higher quality evidence, resolve the disputes existing in different guidelines, standardize the diagnosis and treatment process of PCNs, thus, PCNs can be identified early, diagnosed accurately and intervened in time.
ObjectiveTo study the mechanisms of spontaneous rupture of hepatocellular carcinoma and the treatments in the acute phase and the second phase after hemostasis. MethodsRelated domestic and foreign literatures were reviewed. ResultsThe mechanism of spontaneous rupture of hepatocellular carcinoma was still not quite clear. In China, spontaneous rupture of hepatocellular carcinoma was closely related with hepatitis B virus infection. Immune complex deposition in vessel wall led to the injuries of small arteries and bleeding. Treatments included conservative therapy, surgical intervention （lobectomy of liver, hepatic artery ligation, packing, and suturing), transarteial embolization, other medications (percutaneous ethanol injection, radiofrequency ablation, bio-immunotherapy). ConclusionTransarterial embolization has been shown to be highly effective in achieving immediate hemostasis, and can be used as the basis of phase two comprehensive treatment.
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．