Liver cancer is one of the world’s most prevalent malignancies, and is also the third leading cause of cancer death in China. Hepatitis and cirrhosis background is a major feature of liver cancer patients in China, which makes specific requirements that suits the national conditions in many aspects of prevention and control like screening diagnosis, treatment options, and prognosis follow-up. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition), which is based on China’s practice, proposes liver cancer staging in line with China’s national conditions and forms a multi-disciplinary joint diagnosis and treatment model based on surgical treatment. Liver transplantation is included in liver cancer as one of the surgical treatments option. It also emphasizes the support of evidence-based medicine. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition) may have laid a solid foundation for future diagnosis and treatment of liver cancer in China.
Objective To analyze the trend of changes in the burden of liver cancer diseases attributed to alcohol consumption in China from 1990 to 2019. Methods Data on liver cancer burden attributed to drinking in China from 1990 to 2019 were obtained from the global burden of disease 2019. Joinpoint regression model was used to analyze the temporal trend of disease burden, and age-period-cohort model was used to evaluate age, period, and cohort effects. Results From 1990 to 2019, the standardized incidence rate of liver cancer attributable to drinking among the total population, men and women showed a downward trend. The AAPC was −2.52% (95%CI −2.83% to −2.21%), 3.26% (95%CI −3.62% to −2.89%) and −2.24% (95%CI −2.61% to −1.86%), respectively; The standardized mortality rates showed a decreasing trend, with AAPC values of −2.86% (95%CI −3.46% to −2.26%), −3.48% (95%CI −4.20% to −2.76%), and −2.67% (95%CI −2.99% to −2.34%), respectively; The standardized DALY rates showed a downward trend, with AAPC values of −3.09% (95%CI −3.65% to −2.53%), −2.92% (95%CI −3.25% to −2.58%), and −3.77 (95%CI −4.21% to −3.31%), respectively. The trend changes were statistically significant (P<0.05). From 1990 to 2019, the overall risk of liver cancer incidence and death attributed to drinking in China, both in males and females, showed a trend of first increasing and then decreasing with age; As the period increased, both the overall population and the male population showed a downward trend, followed by an upward trend, while the female population remained relatively stable; The lower the risk of liver cancer incidence and death attributed to drinking as the queue progressed. Conclusion The standardized incidence rate, mortality and DALY rates of liver cancer attributable to drinking in China are generally declining, we should strengthen health education and early diagnosis and treatment for both male and elderly people to reduce the burden of liver cancer.
Objective To review the advances of target gene therapy of liver cancer. MethodsWe analyze and compare the tissuespecific carrier system or cellspecific gene expressing system from current researches of liver cancer gene therapy. ResultsArtificial synthetic DNA transfer system and modified viral vectors could efficiently transfect target cells and get highlevel expression. The ciselements of alpha fetal protein or albumin gene have been often adopted in the regulation of therapeutic gene and have shown their effectiveness. Some other gene therapy strategies also promised a good future. Conclusion Searching for more specific and universal liver cancer antigens is the key to improve the target gene therapy efficiency. The individual situation is the basis to select the best transfer system or regulatory elements in the future.
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 explore the clinical value and experience of ultrasound guided combined with laparoscopic microwave ablation in treatment for special site liver cancer．Methods The clinical data of 9 patients with liver cancer treated by ultrasound guided combined with laparoscopic microwave ablation in our hospital from February 2008 to October 2010 were analyzed retrospectively．Results There were 6 cases of primary liver cancer， 3 cases of metastatic hepatic carcinoma. Eight cases of multiple tumors， 1 case of single tumor．There were one or more lesions invading liver capsular，a total of 13 lesions in all the patients． Among them，6 lesions located in diaphragm， 3 closed to bowel， 2 neared stomach，1 located in gallbladder bed and 1 in hilar．No serious complications and no death happened during operation．The following-up time was （9.2±4.7） months （4 to 18 months）， there were 2 lesions of part residual， including 1 case of microwave ablation again，1 case of percutaneous ethanol ablation， and 11 lesions of complete ablation （84.6%，11/13） 1 month after operation by CT examination．Four cases recurred 3 months after operation by CT examination， including 2 cases of microwave ablation again，1 case of percutaneous ethanol ablation，1 patient with pulmonary metastasis and giving up treatment，1 patient with poor liver function and died of liver failure 6 months after operation；1 patient with multiple lesions died of brain metastases 10 months after operation； the rest were still alive．Conclusions Ultrasound guided combined with laparoscopic microwave ablation is a safe and effective method in the treatment for special site liver cancer，the curative effect is good and worth of spread．
In order to rise the efficiency of combined therapy and evaluate the value and status of cryosurgery in advancedstage liver cancer, liquid nitrogen was employed in treating 90 patients with hepatic carcinoma in our department from Nov. 1994 to Dec. 1997. The results revealed that cryotherapy could induce unrecoverable coagulation necrosis of the tumors. The levels of serum AFP decreased after cryosurgery and one patient has been surviving for three years. The authors believe that cryosurgery is an effective method for unresectable lesions of hepatic carcinoma and has a probability in decreasing its postoperative recurrent rate.
Health technology assessment (HTA) is becoming more and more popular recently. For populations in China that share at least half of the global disease burden of liver cancer, it is extremely vital to give rise to an efficient secondary prevention strategy. The China central government launched liver cancer screening program in rural areas in 2005, and then extended to populations in urban in 2012. The studies of health technology assessment of liver cancer screening are based on available evidence, from an HTA perspective, aims to evaluate performance of liver screening, economic burden and cost-effectiveness and some other issues, in order to raise suggestions for possible directions in research and public health program related to liver cancer screening in China.
ObjectiveTo understand the role of metformin on reducing incidence of type 2 diabetes mellitus (T2MD) patients complicated with liver cancer. MethodThe related literatures of metformin treated patients with T2MD complicated with liver cancer at home and abroad in recent years were reviewed. ResultsA large number of epidemiological and clinical data showed that the metformin might prevent the occurrence of the T2MD patients complicated with liver cancer, its mechanism was mainly inhibited the proliferation of hepatoma cells through the ATM-LKB1-AMPK-mTOR pathway, PI3K/Akt/mTOR pathway, or miRNA. The current controversy was the authenticity of the data, the influencing factors included the aging problem and characteristics of metformin user. The prospective study design rigorous remained to be clarified. ConclusionMetformin could reduce the incidence of T2MD patients complicated with liver cancer, and could inhibit the growth of liver cancer cells, which provides a new way of thinking for the comprehensive treatment of liver cancer.
;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.
ObjectiveTo study the feasibility of the establishment of transplantated hepatic cancer models in SD rats. MethodsThe male weaning SD rats were inoculated and transgenerated from the celiar transplantation tumor rats (W2562k) by intraperitoneal injection of abdominal fluid of tumor cells, another weaningSD rats were prepared for the models of solid tumor by subcutaneous inoculation of the abdominal fluid of tumor cells. The solid tumors were cut to pieces of 0.2 cm×0.2 cm×0.3 cm,which were implanted into the liver of the adult male SD rats, and the transplantation hepative tumor models were established. After 7 days, the volume and weight of tumor mass was measured. ResultsThe successful rate of model was 100% (82/82), the natural extinctive rate was 0 (0/82), the successful rate of inoculation was 100% (15/15). ConclusionSD rats are economical, the successful rate of model was high, the natural extinctive low, so the SD rats are ideal selection in establishing transplantation liver cancer model.